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A man who suffered catastrophic brain injuries following a road crash has removed feeding tubes that provide him with nourishment more than 60 times, the High Court has heard.
The man, who cannot be identified for legal reasons, sustained such severe injuries in a road crash some years ago that he requires 24-hour care at a medical facility.
While the man is non-verbal he is able to communicate by making signs and using pictures. In order to receive proper nourishment, he was fed via a PEG tube inserted into his stomach.
However, the High Court heard that the man had to be moved to an acute hospital because he keeps removing the PEG tube, which is dangerous to his health.
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The man’s case came before Ms Justice Carmel Stewart on Thursday, who described it as being a “very tragic and difficult situation”.
The judge also noted that one of the man’s doctors, an experienced and highly regarded clinician, had described what was occurring as being one of the “saddest and most complicated cases he ever had to deal with”.
Risk of infection
Arising out of the man’s actions the hospital, represented by David Leahy Bl, asked the High Court for various orders allowing it to apply various treatments to the man, which it says are in his best interests.
It has also asked the court to make the man, which the hospital says is “a challenging patient”, a ward of court.
Counsel said that the man has removed the tube approximately 60 times, causing him injury and has scarred his stomach.
It was removed so often that he has had to have the tube re-inserted by using X-ray guidance. He had also removed IV lines which were inserted so that he can receive the nourishment he needs.
The man was given some food orally but that represents a problem as due to his injuries. The man’s ability to swallow is very limited.
His treating doctors fear that, going forward, feeding orally could result in him contracting a serious infection that would put his life at risk.
Counsel said the man has told those treating him that he “does not want to die”.
Pain complaint
While it has been explained to him that he needs to be fed by the tube, or face the risk of starvation, the man had a multiple occasions removed the PEG tube after it has been inserted.
He had complained that the PEG tube is causing him to suffer pain.
Counsel said the hospital had been trying everything it can in order to help the man.
The application to have the man made a ward of court is being made on the basis that he is of unsound mind and incapable of managing his own affairs.
Counsel said that the man has been assessed by both his physicians and by a consultant psychiatrist, and making him a ward of court is the best thing to do given the circumstances.
At Thursday’s vacation sitting of the High Court, Ms Justice Stewart formally opened an inquiry as to whether the man should be made a ward of court.
The judge also made the man’s sister his court-appointed guardian and directed that she be provided with her brother’s medical files.
Through her legal representatives, she has expressed her concerns about his situation.
The judge also ordered that the man be assessed by an independent medical examiner.
The examiner will provide the court and the parties, including the man’s sister with a report about the man.
The judge, who expressed her sympathy to the man’s sister, granted the hospital various orders in regards to the man’s treatment.
The case was adjourned to a date in October.