The emergency unit at University Hospital Limerick (UHL) was severely overpopulated and hazardous, akin to a death snare, when 16-year-old Aoife Johnston arrived in a state of probable septic shock, as stated by an emergency medicine specialist. Dr. James Gray, the on-call consultant at the time, expressed at the Limerick Coroner’s Court that young Aoife stood no chance.
Dr. Gray, the highest-ranking physician working at the ‘on-site’ emergency unit, mentioned that he would have made his presence at the A&E that evening, December 17th, 2022, if he had been apprised of Aoife’s condition. He compared the state of UHL’s emergency unit to a stupendously filled airplane, congested to the point of individuals occluding the walkways, rendering the department utterly dysfunctional.
On-call from 8:00 AM on December 17th up until the same time on December 19th, Dr. Gray visited the A&E during the daytime on both Saturday and Sunday. He declined nurse Katerine Skelly’s request to come in on Saturday evening given that he was scheduled for a Sunday morning hospital visit. He additionally stated that the overpopulation at the emergency department often made it practically impossible to access the hospital.
Due to overwhelming occupancy, Dr. Gray was physically incapable of making his way to the unit. The problem of overcrowding remains a persistent issue in the department. He asserted that he was always approachable during his on-call hours to offer guidance to the hospital’s medical staff and attend to patients individually. However, he remained ignorant about Aoife’s case.
In alignment with Damien Tansey SC’s argument, Dr. Gray denoted it as utterly intolerable that scores of Category 2 patients were queued to see physicians during the course of the dreadful night.
Dr Gray asserted that the crisis ongoing at the hospital could have only been addressed successfully by triggering the hospital’s “major emergency” strategy. General Nursing Manager Fiona Steed, along with the administrative team of the hospital, was given this responsibility. The cascade effect would have been initiated by this plan, mandating the on-call consultants to promptly attend to the hospital’s needs.
Dr Gray found it completely intolerable that Aoife had to wait for 15 hours to get her suspected sepsis treatment. By the time she received her antibiotics, her chances of survival had grimly diminished.
On Wednesday, it was disclosed in the Limerick Coroner’s Court that there was a high probability of Aoife surviving had she been promptly and suitably treated with antibiotics. Despite being classified as a Category 2 patient, necessitating immediate medical attention within 10 to 15 minutes, she had to wait for more than 15 hours to receive crucial antibiotics on her arrival at UHL on the evening of December 17th, suspected with sepsis.
The court heard from Dr Patrick Stapleton, a consulting microbiologist at UHL on Wednesday, that the meningococcus pathogen found in Aoife was susceptible to antibiotics, and could have been handled with a variety of antibiotics. Dr Terezia Lazlo, a pathologist, ratified that the cause of Aoife’s death was purulent meningitis. The inquest presided over by Mr John McNamara is still ongoing.