A YOUNG Dublin boxer who was referred to hospitals with breathing problems by his GP twice in 24 hours and who was discharged from hospitals on both occasions, died just over two days after his first hospital admission, an inquest heard yesterday.
Stephen Keeler (28), Rossmore Drive, Ballyfermot, was referred to the A&E department of Tallaght hospital by Dr Eugene O'Connell on the evening of July 8th, 2002 with a suspected collapsed lung, Dublin City Coroner's Court heard.
An X-ray revealed the father of one, who worked as a painter and decorator, had a chest infection and he was discharged home with appropriate antibiotics. There was no evidence of a collapsed lung detected, the inquest heard.
The following morning Dr O'Connell called an ambulance to take Mr Keeler to hospital when he returned to the surgery at 11.30am looking visibly unwell with a "bluish tinge" and reduced oxygen intake in his left lung. Dr O'Connell requested another chest X-ray to rule out a collapsed lung.
Mr Keeler was brought to St James's Hospital because he was not in the catchment area for Tallaght. He was discharged from St James's at 2.30pm with a diagnosis of reduced air entry to the left base of his lung and pneumonia. Once again there was no evidence of a collapsed lung.
Dr O'Connell told the inquest he was surprised at the discharge and felt the patient was ill enough to have been retained in hospital. His family were also extremely concerned that he was discharged.
Early on July 10th, Mr Keeler was brought to the Mater hospital. He was later removed to St James's as there was no intensive care bed in the Mater. He died at St James's at 9pm. A surgeon who attended Mr Keeler, at St James's on July 9th, told the inquest Mr Keeler was complaining of a minor pain in the left side of the chest, but was overall "well" with normal vital signs including respiration and blood pressure.
Linus Offiah said he believed Mr Keeler did not need to be admitted. "He was the sort of patient you could treat on an outpatient basis . . . he had early pneumonia changes on X-ray and he already was on antibiotics for that." However, he had an elevated heart rate and his oxygen saturation levels were marginally low, the court heard. The inquest was told Mr Keeler died of septic shock from a streptococcal infection which had developed over the four to five hours before his death.
Mr Keeler was stabbed six months prior to developing his fatal chest infection. Consultant surgeon at Tallaght, Dr Geoff Keyes, who treated Mr Keeler following his stabbing, said he didn't believe there was any connection between the two.
The inquest continues today.