Sunday, June 16, 2024

“Error” at Hospital not noticed for days

AN admission that an error was made in the care of a patient who died in May 2015 at the Midlands Regional Hospital, Mullingar, led to a verdict of medical misadventure being recorded at an inquest held last week at Westmeath Coroner’s Court.

Coroner for Westmeath, Dr. Wilfred Hoover presided over the hearing into the tragic death of a 68-year-old man, during which evidence was given stating that “an error” relating to the administering, over several days, of prescribed medication had taken place at the hospital.
As the formal proceedings opened, Dr. Hoover instructed the court that an inquest is a legal proceeding that does not apportion blame or absolve any party relating to a case.
ERROR
The inquest heard medical testimony that 68-year- old James Murphy, from Enfield, Co. Meath, was admitted to the Midlands Regional Hospital, Mullin-gar on April 7th, 2015.
“An error” led to two anti-coagulants being ad-ministered for a number of days before the oversight was identified.
Mr. Murphy died on May 1st last year in the intensive care unit at the hospital in Mullingar, from inflammation of the bowel, and multi-organ failure, secondary to a blood clot.
Dr. Mark Sheehy, a consultant at the Midlands Regional Hospital, Mullin-gar since 2010, gave evidence that James Murphy was admitted to the hospital on April 7th, 2015, complaining of respiratory distress. As part of his treatment, he was prescribed a subcutaneous blood thinner and also administered an oral anti-coagulant, neither of which was discontinued for several days.
“Two forms of blood thinner were being administered at the same time, which was an error,” Dr. Sheehy stated in his evidence to the inquest.
PATIENT CHARTS
The physician told the court that a clinical assessment management review is ongoing at the hospital, but stated that at one time, pharmacists at the hospital were a “ubiquitous” presence but in the the past 5 to 10 years, budgetary constraints led to this being a less common practice on wards. Pharmacists being present on wards is now becoming more common again, he said.
Miriam Reilly, instructed by the solicitor for the Murphy family, Rita Hamilton, asked Dr. Sheehy if someone on the treatment team would have noted the prescriptions recommended on the patient’s chart and he confirmed that this would be the case.
“These drug charts should be consulted,” he stated.
In the case of the deceased, there were two charts, as there were large numbers of medications being administered as part of his care. Having two charts would have contributed to the problems that arose with this tragic incident, Dr. Sheehy agreed.

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