Child’s death led to major reform, says ambulance chief

The medical director of the National Ambulance Service has given a guarantee that there will be no repeat of a situation where it failed to send an ambulance for a child who was fatally injured after falling from an upstairs window in Co Cork.

Dr Cathal O'Donnell said he was confident there would be no repeat of what happened when the ambulance control centre at Cork University Hospital stood down an ambulance which was due to be dispatched for 23-month-old Vakaris Martinaitis.

Serious head injuries
The child died at the hospital on May 8th last, two days after suffering serious head injuries when he fell from an upstairs window on to a concrete area outside the family's home at The Paddocks, Castleredmond, Midleton, on May 6th.

The child was brought to hospital by neighbour Kevin Hennessy in his car after an ambulance was stood down because the call-taker at the ambulance control centre at Cork University Hospital believed the child had suffered a simple fall in a green area and was not seriously injured.

Mr Hennessy and his daughter saw the child on a green area, not realising he had fallen from a window on to concrete but had been moved on to the grass by his Lithuanian father, Vidas, who had limited English.

Earlier this month, a verdict of accidental death was returned by a jury at Cork City Coroner’s Court, which heard that the loss of a number of minutes through the failure to send an ambulance to the scene was not a factor in the child’s death.

The HSE appointed a panel of independent experts last May to review the case.

The review panel, chaired by Dr David McManus, medical director of the Northern Ireland Ambulance Service, noted the ambulance control staff at Cork University Hospital failed to assess appropriately the child's condition at the scene and failed to provide post-dispatch advice to the caller.

Dr O’Donnell said the ambulance service was already implementing some of the 12 recommendations made by Dr McManus and his team, including giving higher priority to cases where information is limited or the people involved in the incident have poor English, he added.

The ambulance service has contracted a third-party company that will provide translation services in live time via conference calls to assist with any 999 calls where the caller is someone with limited English, he said.

Among the other recommendations by the review team, which are also being implemented, are clear delineation of roles between call takers and call dispatchers and the appointment of a team leader at each call centre with the authority to decide on the appropriate response.

External review
Speaking yesterday at the publication of the panel's report, Dr O'Donnell admitted that a mistake had been made but the ambulance service had moved quickly to address the issue by appointing the external review team to ensure a quality service and provide public confidence in the service.

“What happened should not have happened and we fully accept that, and I have apologised to the family. Our responsibility is that if a member of the public dials 999, we will send an ambulance every time – that did not happen on this occasion and it should have happened.”

Dr O’Donnell said that notwithstanding the mistake made on this occasion, people should be aware that the ambulance service handled 600 emergency calls daily and 230,000 such calls annually and the overwhelming majority of these were handled properly and in line with protocols.

Dr McManus said the review showed the mistake arose from the failure to follow proper protocols and had nothing to do with resources.

He said the ambulance service is moving from 12 ambulance control centres to two such centres and such a model with fewer centres dealing with higher volumes of calls has been found internationally to lead to a better service.