Investigation launched after death of second teenage girl at University Hospital Limerick

File image of University Hospital Limerick

THE UL HOSPITALS Group has launched an internal investigation into the death of a 16-year old girl who died in the consistently and chronically overcrowded University Hospital Limerick three weeks ago.

There were 113 patients on trolleys in corridors and wards at the hospital on 29 January 29, the day the girl died.

It is understood that the girl is from Co Limerick.

It is the second internal inquiry into the death of a female teenager at UHL in as many years.

Sixteen year old Aoife Johnston, from Shannon, Co Clare, who developed meningitis, died after languishing on a trolley for 12 hours in the overcrowded Emergency Department in UHL, in December 2022.

The 16-year-old girl who died suddenly on 29 January, was rushed to UHL suffering from breathing difficulties, according to this morning’s Irish Independent.

The newspaper said it understood that in this case, the girl had been initially admitted to the hospital’s resuscitation area but was deemed well enough to be transferred to a trolley in a corridor.

However, her condition reportedly deteriorated further and following repeated pleas from her mother, a doctor ordered she be moved back to the packed resuscitation area.

She was reportedly then placed on a trolley in the middle of the resuscitation room as there was no room in any individual berth.

An informed source said that on arrival in the resuscitation area, the girl’s condition deteriorated rapidly and her mother made increasingly anguished cries for help.

As medics rushed to revive the girl, another patient was transferred out of a resuscitation berth and the girl was moved in to the space, however, desperate efforts by staff to revive the girl failed and she was pronounced dead.

An inquiry has been launched into the circumstances surrounding the tragedy and the care the girl received at the hospital on the day of her death.

The girl was admitted with a severe chest infection in early January.

She was treated for over two weeks and was discharged home, the newspaper reported.

Within days the girl’s condition deteriorated and she was rushed back to hospital.

On the day of her death, 29 January, University Hospital Limerick was by far the busiest in the country with 113 patients on trolleys, including 54 patients on trolleys in the ED and 59 on trolleys on wards, according to figures published by the Irish Nurses and Midwives Organisation.

In a statement to the Irish Independent, the UL Hospitals Group offered its “sincere condolences” to the girl’s family on “their devastating loss”.

“We can confirm that a preliminary assessment has been carried out in line with the HSE Incident Management Framework and the findings from this assessment will be shared with the family pending the results of a post-mortem examination,” the statement continued.

Under the HSE Incident Management Framework, all major incidents are initially put through a preliminary assessment which will then assist in classifying the seriousness of each incident.

When a patient suffers harm it is regarded as a Category 1 incident and will be subject to a review.

In the case of Aoife Johnston, a review into her death at UHL has led to an independent judge-led investigation.

Aoife died from sepsis complications of bacterial meningitis after waiting 12 hours in a severely overcrowded emergency department on 19 December, 2022.

An HSE internal review found overcrowding in the hospital was “endemic”.

The “boarding” of patients who are deemed ill enough to be admitted to a ward in the emergency department “is a planned part of patient flow” in UHL, the review said.

It added: “There is little apparent understanding of the risks and inefficiencies caused to patient care by a crowded environment by the hospital system in terms of the impact on the emergency medicine doctors assessing and managing patients and the nursing staff’s ability to provide safe care.”

“The use/misuse of the resuscitation area for all monitored interventions leads to crowding and an overemphasis on activity in this area. There are insufficient emergency department nursing staff to provide adequate monitoring and care to the patients in the department.”

“There are insufficient doctors to care for the numbers and acuity of patients presenting in the timescale expected by the triage system, the hospital and the community.”

“There is a high turnover of staff, both nursing and emergency medicine junior doctors, which leads to low experience levels and low situational awareness.”

On 7 February, a record 150 patients were on trolleys or chairs without a hospital bed at UHL.

On 1 February, the teenager’s devastated family and friends gathered for her funeral.

The same day, during a debate in the Seanad, Health Minister Stephen Donnelly defended the Government’s handling of the overcrowding crisis in Limerick.

“In 2019, the hospital budget was €265m. It is now €315m. There has been a large increase in money, workforce and beds,” said Donnelly.

“In the emergency department, extra emergency medicine consultants have been sanctioned.”

Responding to a motion by senators calling for the Government to do more to alleviate the pressures in UHL, Donnelly said: “The core message is that we will continue to invest in UHL and in the hospital group. We will continue to invest in the workforce and in beds.”

“We have seen the team in UHL respond in recent weeks and drive down the number of patients on trolleys.”

Minister Donnelly told the Dáil that ”there were eight patients on trolleys in UHL” on 1 February.

According to figures released by the INMO, which counts the number of patients on trolleys every weekday, there were 100 patients on trolleys on 1 February.