Courts

Death of woman (21) could have been prevented with anticoagulant medication, court told

Eve Cleary from Limerick died hours after being discharged from hospital two days after she fell and hurt her leg

Barry Cleary and his wife Melanie Sheehan Cleary of Corbally, Co Limerick, outside the Four Courts where they have brought an action against the HSE over the death of their daughter Eve Cleary in 2019. Photograph: Collins Courts

Thu Jan 18 2024 - 21:13

If a 21-year-old woman who died hours after discharge from hospital had been given an anticoagulant, the development of a blood clot in her lung that led to her cardiac arrest would have been prevented, a medical witness has told the High Court.

On the second day of the civil action over the death of Eve Cleary, intensive care specialist Dr Christopher Danbury said the anticoagulant Heparin, if given at the time of her discharge from University Hospital Limerick or within an hour of it, would have prevented Ms Cleary’s pulmonary embolism, cardiac arrest and death.

Ms Cleary, from Corbally, Limerick, died in the early hours of July 21st, 2019, two days after she fell and hurt her leg and went to the emergency department of the Limerick hospital. Her death came some three hours after she was discharged and told to rest at home.

Her parents, Barry Cleary and Melanie Sheehan Cleary, and siblings, Kate, Elizabeth, Sarah, Emma and Sean, all of Corbally, Co Limerick, have sued the Health Service Executive (HSE) over her death and for mental distress.

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It is claimed that Ms Cleary was allowed to develop a deep vein thrombosis (DVT) and that an opportunity was missed at the hospital to give her Heparin on admission.

The HSE accepts a formal risk assessment for blood clots was not conducted, but it has denied all other claims. The HSE does not accept the failure to carry out the risk assessment was a breach of duty. It says the treatment and management of Ms Cleary was reasonable and appropriate.

In a report prepared after reviewing Ms Cleary’s case, Dr Danbury concluded that if Ms Cleary had been given Heparin it would, on the balance of probabilities, have prevented her from developing a pulmonary embolism.

He further concluded that but for the failure to prescribe and administer Heparin, she would not have developed the clot in the lung, would not have gone into cardiac arrest and would not have died.

In his report, which was presented to court on behalf of the Cleary side, he said that if a blood clot VTE risk assessment had been made at the hospital, the anticoagulant treatment would have been prescribed and administered.

“I agree that on the balance of probabilities Ms Cleary had a deep vein thrombosis secondary to the lower leg trauma she had suffered,” he said.

He reported that when Eve was discharged home at 8.30pm on July 20th, part of the DVT broke off the clot in the leg, passed through the systemic circulation, and became lodged in a pulmonary artery. This caused a pulmonary embolism that caused a cardiac arrest.

Senior counsel for the HSE, Simon Mills, told the court it was the HSE’s case that Ms Cleary was triaged and it was a number of hours before she was seen by a doctor.

Counsel said Ms Cleary’s mother previously told the court that the hospital emergency department was a very unpleasant place for her daughter to be unwell. He said Ms Cleary did not want to be there.

Ms Justice Emily Egan interjected to say Ms Cleary’s evidence had been that Ms Cleary spoke to her mother and said she wanted to go home but her mother advised her to stay.

Counsel said the evidence will be that Ms Cleary was so determined to leave that a discharge against medical advice form was prepared. The blank form was not signed but had a sticky note on it.

Mr Mills said the emergency doctor and staff “were so alive to the difficulty of her plight” that Ms Cleary’s leg scan was expedited.

The case before Ms Justice Egan continues.

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