Marian Feeley, 75, of Newmarket-on-Fergus, Co Clare, died of pain and gallbladder problems a few days after joining the UHL in February 2018.
The investigation was adjourned from September 2019 when Limerick coroner John McNamara requested a deposit with a radiologist before a finding was recorded in the woman’s case.
In 2018, the investigation heard that Ms. Feeley passed away at 1:42 a.m. on the afternoon of February 22, 2018.
The pathologist Dr. Olubunmi Ipadeola performed an autopsy and concluded that she had died of septic shock while he also found a number of other underlying conditions.
Ms. Feeley’s family raised the issue of a procedure performed on her in the hospital that resulted in a blood vessel bursting and bleeding from the liver and asked if this could have contributed to her death.
Dr. Ipadeola had acknowledged the bleeding in his report but found it was confined to the liver and still believed that sepsis was the leading cause of death.
When the investigation resumed at the Kilmallock courthouse last week, it was found that Ms. Feeley had been admitted to Limerick University Hospital in January 2018 with acute cholecystitis. She was then taken to Ennis General Hospital and released home.
She was then re-admitted to Limerick University Hospital on February 19, 2018 with suspected acute cholecystitis and sepsis.
A deposit was read out by radiologist Siobhan McGrane, who operated on Ms. Feeley in the resuscitation room of the emergency room at Limerick University Hospital.
Dr. McGrane said a CT scan confirmed acute cholecystitis and localized perforation of the gallbladder.
She said she had been informed that Ms. Feeley was seriously ill and was at risk of death from sepsis. Dr. McGrane said it had been decided that percutaneous cholecystostomy tube placement as a last resort emergency procedure was the only viable clinical option available alongside medical management to save Ms. Feeley’s life and could not be safely delayed.
The investigation found that Ms. Feeley’s husband had obtained consent to the procedure.
However, family members who were present at the investigation raised concerns that the trial may have contributed to their mother’s death.
They also raised concerns about “all of their care” at UHL and Ennis Hospital, particularly about Ms. Feeley being discharged from both hospitals early before she felt well enough to go home.
“I begged and pleaded with her not to send her home because she was wrong. She didn’t eat, she threw up, her stomach was still swollen, ”said Ms. Feeley’s daughter Laura Feeley about the examination.
“We asked her not to send her home. In Limerick, we were told that Mom was no longer an acute patient, so she had to go to Ennis and spent about a week there, ”she added.
When asked by coroner John McNamara how Ms. Feeley was doing at Ennis Hospital, Ms. Feeley’s daughter Laura replied, “She was very bad, very bad. She shouldn’t have been released. ”
Ms. Feeley said her mother was “taken back to the hospital and then this procedure was performed” and that she later died.
Mr. McNamara stood up for a period of time to review all statements in the case.
When the investigation reopened, Mr. McNamara noted the family’s concerns about Ms. Feeley’s discharge from Limerick University Hospital and Ennis Hospital “in the recent past prior to her death.”
Mr. McNamara said he also understands that the family has concerns about the bleeding following the procedure Ms. Feeley had undergone, which radiologist Siobhán McGrane detailed.
Mr. McNamara noted that Dr. McGrane pointed out that there was a complication with the procedure on the liver that could cause bleeding.
“Dr. McGrane said she would rather wait three to five days, but it appears that your mother was extremely sick at the time, ”he said.
Mr McNamara said he was taking into account what the family had said to him, but he also had to be guided by what is on the record and what the doctors said in their testimony during the exam and what the pathologist who did the autopsy performed said.
“When a pathologist reports on a coroner’s case, he is independent of the hospital. He is assigned by the coroner to do this. I need to be guided by the medical findings from the autopsy and the evidence, ”McNamara said.
He suggested recording a narrative judgment. Mr. McNamara stated that a narrative judgment is a factual statement “or a summary of what happened”.
Mr McNamara said the narrative verdict would be that Marian Feeley, 75, with a history of previous visits to Ennis General Hospital, was admitted to Limerick University Hospital in January 2018 with acute cholecystitis. She was then taken to Ennis General Hospital and released home. She was then re-admitted to Limerick University Hospital on February 19, 2018 with suspected acute cholecystitis and sepsis.
“She then suffered bleeding from the right lobe of the liver as a complication of the procedure, which was then embolized to stop the bleeding. Unfortunately, she got worse and died on February 22, 2018. She died of complications from acute cardiorespiratory failure and septic shock from cholecystitis. One factor contributing to her death was ischemic liver damage after embolization after insertion of the cholecystostomy tube. ”
Mr. McNamara expressed his condolences to the family.
“I know nothing will bring your mother back. You obviously had a very traumatic experience, ”he said.
A HSE representative present at the investigation expressed their condolences to the family on behalf of the HSE.
“Not to question how our mother died would gloss over this story.”
A statement released by the Feeley family after the investigation reads: “A narrative judgment has explained in a small way the events that led to our mother’s death, but for us it does not explain the what, why, how, who? or when? Our mother’s story was the beginning of the end when she visited a dentist in 2015 after four of her teeth were removed in one session. Hours later she was scattered on the kitchen floor, apparently suffering from a stroke.
This stroke stopped mom, but her sense of humor and will to live remained strong. In 2018, she developed a fever and upper body pain. The hospital informed us that she had acute cholecystitis. They gave her antibiotics and sent her home. Unfortunately, the hospital staff informed us that she had a stroke and had nothing to do with her condition when she returned. She needed a cholecystostomy.
The irony was the treatment she needed, so when her health deteriorated sharply and injured her liver a month later, she went on, but ultimately we are told she died of heart failure and sepsis. Not to question how our mother died would gloss over this tale. Everyone should be aware that the HSE book of condolence fills every sacred hall in this land. We would like to take this opportunity to thank all of our mother’s carers. ”
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