Peamount refuses to take high-risk TB patient

Management at Peamount Hospital has refused to allow the transfer of an acutely ill and highly-infectious tuberculosis patient…

Management at Peamount Hospital has refused to allow the transfer of an acutely ill and highly-infectious tuberculosis patient from the Mater Hospital, The Irish Times has learned. Dr Muiris Houston, Medical Correspondent, reports

A man of east European origin was admitted to the Mater on Wednesday with a diagnosis of open TB. With this form of active tuberculosis the patient is highly infectious to others.

It is understood that when doctors at the Mater decided to transfer the recent immigrant to the TB unit in Peamount, management there blocked the move, even though both the medical director and the senior hospital medical officer had agreed to treat the man.

It is believed the individual entered the State in a container delivered to Dublin Port. However, when he made contact with friends, they were so alarmed at how unwell he appeared they brought him to the A&E department of the Mater.

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It was quickly established that he had open pulmonary tuberculosis after an initial sputum sample was analysed. The man was transferred to a single room in an attempt to isolate him from both patients and staff.

Medical sources have confirmed the patient is being treated as if he has multidrug resistant TB (MDRTB). Because of the high incidence of this type of TB in his native country, he has been commenced on a cocktail of five antibiotics and is being barrier-nursed.

However, the Mater does not have a fully pressurised isolation room in which to place the man. Neither does Peamount, but it is easier to isolate people there.

The refusal by management at Peamount to accept his transfer follows a series of court actions precipitated by a decision to terminate the contract of its medical director, Prof Luke Clancy, with effect from March 22nd. In the High Court on Wednesday Ms Justice Laffoy amended an earlier interim injunction so that any admission to Peamount by Prof Clancy could not take place without the permission of the hospital.

A spokeswoman for Peamount, while refusing to comment on individual cases, said: "In the light of yesterday's legal decision Peamount will not be admitting any new patients."

Peamount Hospital is the national specialist referral centre for tuberculosis. A 60-bed respiratory unit includes 30 beds for the treatment of TB patients. In 2002, doctors there looked after 96 people with TB, representing almost 30 per cent of cases in the Republic.

Sixty-three of these came from the catchment area of the Eastern Regional Health Authority, which currently provides €19 million in annual funding to the hospital. A five-year strategic plan published in 2003 said the hospital wished to refocus its services to provide a range of rehabilitation and continuing care services for older people and the intellectually disabled.