A FORMER senior house officer in Limerick Regional Hospital told the High Court yesterday he did not think a lumbar puncture killed a man who later died of a brain haemorrhage.
Dr Patrick Seigne (32), who attempted to carry out a lumbar puncture on the man, said he had clinical signs of meningitis.
Dr Seigne was giving evidence in the action brought by Ms Carmel Collins (42), of Wood view Park, Limerick, against the Mid Western Health Board and Dr Ray O'Connell, Woodview Park. The action arises out of the death of her husband, Mr James Collins (42), a blocklayer, on March 29th, 1991. The board and Dr O'Connell deny Ms Collins's claims.
Dr Seigne examined Mr Collins on March 22nd, 1991. Mr Collins had been complaining of headaches for five weeks and had been diagnosed as having viral flu.
Dr Seigne said Mr Collins was confused when he saw him and he took a history of the complaints from Ms Collins. Mr Collins had never attended a GP and was a healthy man. He had been a heavy smoker and drank five pints a night.
He examined Mr Collins and found he had a headache, a slightly raised temperature, raised whitecell count and marked neckrigidity which would be in keeping with someone who had meningitis. He had also considered another diagnosis, but was unsure and spoke to his registrar. They decided to do a lumbar puncture and probably a CT scan in the morning.
Dr Seigne said he attempted a lumbar puncture to try to get cerebral spinal fluid. He had performed 15 or 20 such punctures before that and felt competent to carry out the procedure.
He attempted a lumbar puncture on three occasions but was not successful. He should have got back clear fluid but got a "bloody tap", which indicated he had not penetrated the spine.
Dr Seigne said he had been having a lot of trouble and the man was agitated. He thought he gave the man 10mg of Valium on two occasions to attempt to sedate him. To achieve a lumbar puncture one required a certain amount of sedation.
He sent blood specimens to the laboratory which came back clotted. It was clear the lumbar puncture was unsuccessful.
The registrar said to give Mr Collins an antibiotic as they thought he had meningitis. The registrar did a lumbar puncture, and it was successful. It was clear but blood tinged in all three samples.
Cross examined by Mr Liam Gaynor SC (instructed by Twomey, Scott and Co), for Ms Collins, Dr Seigne said there was no deterioration in the patient's condition from the time he started to look after him until he left his care at 9 a.m.
Dr Seigne said he first attempted a lumbar puncture at 4 a.m. It could have taken two to three hours at that time of the morning to arrange a CT scan.
Mr Justice Johnson asked if Dr Seigne had come to the conclusion on the balance of probabilities that Mr Collins had meningitis and could not have a CT scan for perhaps two to three hours, and that there were possible consequences of failing to deal with meningitis for that length of time.
Dr Seigne said a person could die very quickly - in a couple of hours - from a malignant form of meningitis. If he had not treated Mr Collins he could have deteriorated quickly. If the CT scan had been done two or three hours later it might have been top late.
The hearing continues.