Accidental death verdict on man who died after horse fall

DISAGREEMENTS EMERGED yesterday at an inquest between a senior nurse and a number of doctors about the promptness of treatment given to an injured man in his 40s at Connolly Hospital Blanchardstown, last year.

The inquest at Dublin County Coroner’s Court was into the death of Charles Flattery (46), Carberry, Co Kildare, following an injury to his chest.

Mr Flattery died in the intensive care unit of the hospital on July 28th, 2008, one week after an accident when a horse bolted as he tried to mount it and one of its hooves landed on his chest.

Mr Flattery’s wife Laura said he had been badly winded and could not catch his breath, and she called an ambulance.

Coroner Dr Kieran Geraghty heard he had been admitted to the ICU where he stayed for four days before being transferred to a high-care ward. Mrs Flattery said her husband had been doing well on the Thursday, had visitors and was optimistic about being discharged the following week.

His surgical consultant, Eadhbhard Mulligan, said when he left Mr Flattery on the Friday evening he had been talking about taking a holiday and seemed well.

The court heard Mr Flattery woke with acute pain at 2am on Saturday morning. Mrs Flattery said when she visited on Saturday her husband was in pain and asked several times to see a doctor.

Nurse Maura Cadden said she came on duty at 8am on Sunday and Mr Flattery seemed to be very ill. He had been in a lot of pain, she said, and this was not abating.

“My main desire was to get a full and proper review and any symptoms treated accordingly.”

She contacted the senior surgical registrar Dr Tom Gallagher by bleeper but he was in surgery and could not come.

A senior house officer arrived at 9.30am and despite a request from Ms Cadden that the consultant on call be asked to review the patient this did not happen.

Dr Gallagher said this was because Mr Mulligan was the appropriate consultant to be kept informed on Mr Flattery’s condition. This happened.

Mr Flattery was transferred to ICU at about 12.30pm, following a review by the anaesthetist. Anti-biotics were started for a possible infection at this point. He later suffered two cardiac arrests and died at 1.10am on Monday.

Mr Mulligan, who reviewed the notes, disagreed strongly that there were signs of septicaemia and MRSA infection over Mr Flattery’s final weekend.

He disagreed with the coroner that earlier administration of antibiotics might have saved him. The notes did not indicate this, he said, and the on-duty doctors had reacted appropriately.

Dr Iqdam Tobbin, who carried out the postmortem, gave as his cause of death heart failure secondary to bi-lateral pneumonia and pulmonary thrombosis caused by a chest injury.

The jury returned a verdict of accidental death.