A WOMAN who collapsed and died while waiting for a bed in the accident and emergency department of the Mater hospital had presented at the facility two weeks earlier with severe chest pain that continued up to the time of her death.
Beverly Seville-Doyle (39), Priory Walk, Manor Grove, Whitehall Road, Dublin 6W, left her chair in the AE shortly after 6am on January 15th last to use the toilet. Minutes later, the mother of three collapsed in the toilet and medical staff, who were on the scene in a matter of moments, found her in an unconscious state with no pulse.
Attempts were made for an hour to resuscitate Mrs Seville-Doyle, who suffered from diabetes, but all efforts failed and she was pronounced dead.
An inquest into her death at the Dublin city coroner's court yesterday heard that Mrs Seville-Doyle was seen by consultant nephrologist Dr Denise Sadlier for a scheduled visit to the outpatients' department on January 14th. She complained of chest and back pain, which had been continuous for two weeks. Mrs Seville-Doyle had attended the AE at the hospital two weeks earlier with chest pain, and she had a range of tests.
All the tests had satisfactory results and she was discharged with an analgesic for pain relief and an antibiotic for a lower respiratory tract infection.
Dr Sadlier was concerned about the pain and decided Mrs Seville-Doyle should be admitted. She was also experiencing bouts of vomiting, with blood detected on one occasion.
At 5pm, she was taken by wheelchair to the AE, as there was no bed available for her.
She was treated for dehydration and elevated glucose levels.
The pain was suggestive of muscular-skeletal pain and there was nothing to suggest a cardiac cause or any clinical evidence of a pulmonary embolus (a blood clot in her lungs), said Dr Sadlier.
By 2am, her condition had improved remarkably and she was alert and comfortable. Her glucose was under control, the vomiting has stopped and all her vital signs were stable. However, Mrs Seville-Doyle, who was on a chair as there was no trolley available, still had chest pain, the cause of which was never established.
Dr Sadlier said while none of the medical staff are happy when patients have to stay in AE, not one member of the staff believes medical care is compromised by being there. She said there could have been a longer delay on a ward.
Pathologist Dr Michelle Harrison found at postmortem that Mrs Seville-Doyle had suffered a sudden cardiac death secondary to enlargement of the heart muscle tissue in a patient with diabetes and high blood pressure.
She found that the deceased had small clots in her lungs, but they were not large enough to have caused death. She said they perhaps "precipitated" changes that led to the cardiac arrhythmia, but that was speculation.
Earlier in the day, the court heard Mrs Seville-Doyle was taking the oral contraceptive Microlite. At the request of counsel for the family, Damien Tansey, Dr Harrison read from a booklet that comes with the medication which states that one of the contraindications for taking it was severe diabetes.
Coroner Dr Brian Farrell adjourned the inquest until a date in January 2009.