THE STATE Pathologist Dr Marie Cassidy told a Wexford court yesterday that a bedridden woman died of pneumonia which developed from infections she got at her home where she was confined with multiple sclerosis.
Wexford Circuit Court heard Evelyn Joel (59) died from pneumonia at Wexford General Hospital on January 7th, 2006, after most likely contracting blood poisoning from faecal matter infecting her open wounds.
Ms Joel’s daughter Eleanor (37) and her partner Jonathan Costen (39) have both pleaded not guilty to the unlawful killing by neglect and reckless endangerment of Ms Joel, who was living with them at the time at their home in Cluain Dara in Enniscorthy.
Dr Cassidy told the court that she conducted a postmortem on January 9th, 2006.
She said Ms Joel was slim but not skeletal but that her ribs and pelvic bones were protruding.
The State Pathologist said Ms Joel’s limbs were floppy and there were pressure ulcer wounds all over her back, thighs, groin and side, adding that there was no evidence that the dead woman had been physically assaulted or otherwise abused.
She said Ms Joel had advanced brain damage from MS and suffered from emphysema in the lungs, which developed into pneumonia. Ms Joel was also described as being dehydrated.
Dr Cassidy concluded that Ms Joel had died of pneumonia, complicating sepsis syndrome due to infected pressure sores, due to immobilisation, due to multiple sclerosis.
Under cross-examination from Rosario Boyle SC, for Eleanor Joel, she told the court that even in expert hands, pressure sores could occur quite rapidly in patients who were stationary over a lengthy period.
She said Ms Joel may not have been aware of any pain.
“She developed blood poisoning because the sores became infected with bacteria . . . It had gotten into the open wounds because they hadn’t been treated until a late stage.
“It allowed the infection to progress and develop in the bloodstream.”
She agreed with Ms Boyle’s assertion that heavy smokers could develop emphysema.
Ms Boyle asked Dr Cassidy to describe unintentional negligence and the State Pathologist said this scenario arose when someone with physical or psychological difficulties was incapable of caring for a person.
She said passive negligence was due to either general ignorance or a lack of skill or experience on the part of the carer.
The case continues.