Two elderly patients spend two days on Tallaght Hospital trolleys

Patients requiring isolation poorly isolated in cubicles with curtains

Two elderly patients have spent almost two days on trolleys at Tallaght Hospital while other patients are quarantined behind curtains, according to a treating doctor.

On Wednesday, 62 patients were being treated in three functioning cubicles in the emergency department, while patients on trolleys were blocking all other cubicles, emergency medicine consultant Dr Jim Gray said.

The problems at Tallaght come as trolley numbers nationwide hit 418 on Thursday. University Hospital Limerick had 52 patients on trolleys, according to figures from the Irish Nurses and Midwives Organisation.

In Tallaght, 11 of those on trolleys were there for over 24 hours, and four of these were aged over 75 years and had been there for over 24 hours.

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By Thursday afternoon, two of the over 75-year-olds were still on trolleys, one for two days and the other for one day and 20 hours, Dr Gray said.

He described the situation as dangerous and “a governance failure on a massive scale,” with Tallaght in “blatant breach” of HSE and other targets and standards of care. “It is only a matter of time before we have our next crowding related mortality at Tallaght emergency department.”

At this time last year, Tallaght was the focus of controversy after it emerged a 91-year-old patient spent 29 hours on a trolley. Dr Gray said promises by the Taoiseach that a similar situation would not arise again rang hollow as breaches of care regulations occurred “with impunity”.

Since August, Tallaght has been trying to deal with an outbreak of an antibiotic-resistant superbug that has forced the closure of at least two wards and resulted in an undisclosed number of patients testing positive for Carbapenem Resistant Enterobacteriaceae (CRE).

Dr Gray said patients requiring isolation because of the outbreak were being poorly isolated in cubicles with curtains. Most were sharing toilets with other patients.

The hospital’s escalation plan was not dealing with the crisis, he said.

“Yesterday represented an ongoing very grave dangerous critical situation which is the latest over a period of several weeks of increasing isolation need due to infection control requirements and of a sad return to the elderly admitted boarders festering on trolleys in the emergency department over 24 hours.”

The death rate for vulnerable at-risk patients from CRE can be as high as 50 per cent, he said.

The hospital, while stressing it could not comment on individual cases, acknowledged on Thursday night that services were under additional pressure due to increased admissions and the CRE situation.

Writing directly to Dr Gray, the hospital said there was no additional risk for patients or staff from being in a waiting room with a CRE patient, as infection was spread primarily through shared toilets.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.