UHL ED ‘like a death trap’ when teen presented

UHL ED ‘like a death trap’ when teen presented
UHL ED ‘like a death trap’ when teen presented

A consultant at University Hospital Limerick has told the Emergency Department there was “like a death trap” on the weekend that Aoife Johnston presented at the facility.

Dr James Gray is giving evidence on the fourth day of the inquest into the 16-year-old’s death.

She died in December 2022, after a lengthy wait for treatment for suspected sepsis.

The inquest has already heard testimony that Dr Gray was asked to attend at the ED on the night of 17 December 2022, given the immense pressure on staff, as a result of overcrowding there.

He told counsel for the Johnston family that he was not asked about a specific case by colleagues in the department.

Under cross-examination by Damien Tansey, he said he had been telephoned by Nurse Katherine Skelly at 10.28pm on the night in question.

She articulated that the department was extremely busy and asked if he could come in.

Dr Gray said he had an extremely busy workload and had to be back in the ED at 8am the following morning.

He had to work in the clinical decision unit on the Sunday morning and was the only person who could carry out that task.

“Had I known there was a 16-year-old child in septic shock, a Category 2 patient, who couldn’t get into the resus room, the system failed her, the ED failed her, but if I had known there was a patient like that in the department, I would have come in. The problem is I wasn’t asked about a specific case,” Dr Gray said.

He agreed with Mr Tansey that he was a “pivotal cog in the wheel of the hospital” and the need for his level of experience was extremely important.

Dr Gray outlined how he was working a 48 hour on-call shift on the weekend of 17/18 December 2022. He attended the ED on Saturday and Sunday, during the day.

In addition to his role at UHL, he was also charged with dealing with matters in relation to local injury units at other facilities in the hospital group, in Ennis and Nenagh.

Dr Gray said he had fielded calls almost every hour from staff at these locations, given the number of presentations they were experiencing.

Mr Tansey put it to him that the Johnston family were of the view that had a consultant attended the ED, they would have had the authority to redeploy staff to ensure better patient flows.

But Dr Gray told the inquest that it is impossible for a consultant who is on call for 48 hours to come in if it is busy “because, guess what, it’s always busy.”

He said there was a very chaotic situation at the ED and told Mr Tansey “I’m not Superman”.

Dr Gray compared the ED as being like an airplane with passengers on every seat, with others lying in the aisles. As a result, it could not function properly.

“You have good staff in a dysfunctional environment,” he said.

“There was leadership, unfortunately the leadership was not able to manage the situation.”

Dr Gray said the only way to have eased the pressure in the ED that weakened would have been to implement a major emergency plan. He said this was a function for the executive on call. This didn’t happen.

He went on to describe the care given to Aoife Johnston as being without dignity or privacy.

“It’s an abuse of human rights,” he said.

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