The family of a man who died as a result of medical complications following a fall while walking his dog have called for normal weekday care services to be maintained in hospitals over bank holiday weekends.
An inquest at Dublin Coroner's Court heard Kevin Neligan (74) from Killiney, Co Dublin suffered two broken vertebrae in his neck after tripping over a dog leash while walking the family's bull terrier on Killiney beach on February 19th, 2018.
Mr Neligan, a retired Enterprise Ireland executive, died just over six weeks later at St Vincent's University Hospital after suffering irreversible brain damage following a sudden heart attack during his hospital stay.
His wife, Bettina, told the coroner, Dr Crona Gallagher that the family were puzzled why her husband, who had no pre-existing heart condition, had suffered a cardiac arrest shortly after a tracheostomy procedure.
She claimed his family wanted to arrange private physiotherapy for him in his ward when his condition appeared to deteriorate over a bank holiday weekend.
Ms Neligan said it was “quite extraordinary” that patients would not receive such treatment over holiday periods.
“Patients are on the receiving end of these shortages. You don’t get the care that you think you should get in hospital after paying private health insurance all your life,” she remarked.
However, the hospital's solicitor, Kevin Power, said medical staff were always notified that St Vincent's physiotherapists were available and should be contacted if needed over the course of a bank holiday weekend.
Ms Neligan also wondered if her husband’s death could have been avoided if he had received swifter treatment when he arrived at St Vincent’s on the evening of his fall when he was unable to lie on a trolley because he was in so much pain.
The following day he was transferred to the hospital’s intensive care unit after experiencing breathing difficulties while being sent for an MRI scan.
He subsequently had a tracheostomy on February 22nd, 2018 to assist him with breathing before being transferred to an orthopaedic ward when his condition improved.
Ms Neligan said at that stage he was “on the mend.”
However, she said she did not like his appearance as he had “grown into the bed” when she visited the hospital on a bank holiday Monday on March 19th, 2018.
The inquest heard Mr Neligan suffered a cardiorespiratory arrest two days later shortly after the tube fitted in his windpipe was being suctioned.
Ms Neligan said his family decided to withdraw life support machines on March 30th, 2018 after being informed he had suffered irreversible brain damage.
Consultant orthopaedic surgeon Paul Curtin said Mr Neligan had suffered a serious neck injury which required him to be immobilised.
Mr Curtin said he had never experienced the kind of swelling which the patient had in front of his broken vertebrae which had required intubation and subsequently a tracheostomy.
The consultant said there had been no warning signs of Mr Neligan developing a blood clot or pneumonia and he had been able to walk with the aid of a frame at one stage.
He said having an earlier MRI scan after the deceased had arrived in the emergency department would have had no impact on the outcome.
A postmortem revealed the cause of death was brain damage caused by a cardiorespiratory attack due to a combination of a large blood clot and pneumonia.
Pathologist Dr Kate Dineen said there was no evidence of any infection associated with the tracheostomy.
Returning a verdict of accidental death, Dr Gallagher said Mr Neligan’s fall was “at the root” of all the medical complications that he suffered.
Dr Gallagher said the evidence of several medical witnesses indicated the tracheostomy was not responsible for his death.
The coroner said she would notify St Vincent’s about the issue of staffing levels over bank holiday weekends, noting it was an ongoing “tension” within the health services.
The inquest heard that although St Vincent’s did not carry out any inquiry into Mr Neligan’s death, there was a group at the hospital reviewing the operation of tracheostomy procedures.