The family of a Mayo man who died from Covid-19 in Mayo University Hospital believe procedures relating to the control of Covid-19 in place in the hospital contributed to his death.
John (Jackie) Carolan, a retired ESB worker, of Ballymunnelly, Bellacorick, Co Mayo, died in Mayo University Hospital on 1 April 2020 after contracting Covid-19.
The 79-year-old father of four was admitted to the hospital on 18 March 2020 after suffering a stroke at home.
The inquest into his death, which took place today in Swinford Courthouse, heard that he was admitted to the acute stroke unit in the Elderly Care Medical Ward under the care of Professor Tom O'Malley.
During his stay in the hospital, Mr Carolan failed to respond to treatment and his condition deteriorated. He was tested for Covid-19 on 31 March, the day before he died.
The test subsequently came back positive for Covid-19 on 3 April and it was revealed that a patient with Covid-19 was placed in his ward before his death.
Mr Carolan was not tested for Covid-19 on his admission to hospital and it is his family's belief he contracted the virus following his admission.
Teresa Shaw, daughter of Mr Carolan, who works as a nurse in the Royal Maternity Hospital in Belfast told the inquest that after reviewing her father's medical files it was clear that his condition deteriorated after the first week and he was presenting shortness of breath and symptoms for Covid-19.
She said that her family had a number of unanswered questions following their father's death which included why he was not tested for Covid-19 earlier and why a patient with Covid-19 was placed in a ward with vulnerable people.
"Why were there no Covid-19 wards available across the hospital and why were Covid-19 patients placed in wards where there were vulnerable patients.
"Our father never got the chance to recover or be rehabilitated from his stroke due to contracting Covid-19 at Mayo University Hospital. However if he had been screened earlier and provided with respiratory support, would the outcome have been different? We will never know," she told the inquest.
Ms Shaw also criticised what she described as the lack of communication between hospital staff and her family during their father's care. She stated that she only discovered that a patient with Covid-19 was placed in the ward shortly before his death.
"I suppose I was naive and that there would be a designated Covid ward like everywhere else but there wasn't at that time. I don't why there wasn't planning arranged for it.
"Four side rooms on a ward is not a designated ward. There is too much risk for cross contamination. It was too risky," she said.
Mayo University Hospital rejected the suggestion that there was no designated ward for Covid and suspected Covid patients and said they were following national guidelines at the time which were evolving at the start of the pandemic.
Grainne Quiry Lynskey, Quality and Patient Safety Facilitator at Mayo University Hospital, explained that the guidelines at the time was to place suspected Covid patients in single rooms. However as the number of suspected cases increased they were placed in bays within wards and then onto full wards.
She said the Wards C and D were designated Covid wards at the time of Mr Carolan's death but David O'Malley, solicitor for the Carolan family, criticised the description of them as 'designated' as there were Covid and non-Covid patients present.
He said the family believe that room was available in Mayo University Hospital for a designated ward at the start of the pandemic to care for suspected Covid patients to reduce the risk of cross-contamination.
Collette Murray, who was the Clinical Nurse Manager in the Elderly Care Medical Ward in March 2020, said that in 40 years of nursing she never experienced anything like what happened at the start of the pandemic.
"I was 20 years a manager at that stage and I did find it very challenging. I had 22 patients there and there was this pandemic out there that was trying to get into the hospital and we were trying to prevent it from coming in," she said.
She said the procedures were evolving every day and accepted she was concerned with Covid coming into her ward. She said her staff were designated to look after a select number of patients and not to move them into other areas of the ward.
She accepted that staff treated both suspected Covid patients and non-Covid patients but the last Covid patient admitted onto her ward was on 13 April 2020 and there were no cases for another ten and a half months.
Professor O'Malley said that Mr Carolan did not respond to treatment as he had hoped and described his neurological decline as rapid. He said that Mr Carolan experienced a cough but this was also a common symptom for stroke victims who had difficulty swallowing and respiratory infection was not uncommon in stroke victims.
He accepted that Covid-19 accelerated the neurological decline in him. He had requested a post mortem but at the time, the number of post mortems were restricted due to the pandemic and one was not performed.
In his submissions, Mr O'Malley suggested that the two verdicts available to the Coroner Pat O'Connor to record were one of misadventure or a narrative verdict. He said that there was misadventure as Mr Carolan was placed in danger as a result of a Covid patient being placed in his ward.
However, Mr Conor Bourke, senior counsel for Mayo University Hospital and the HSE, said there was no case for misadventure or narrative verdicts and in his opinion the appropriate verdict was death due to natural causes.
Mr O'Connor, Coroner for Mayo, said he would take time to consider the evidence in the inquest and adjourned his decision until 21 March.
He said there were a number of factors which the inquest has to deal with but he added that at the centre of it was a grieving family and expressed his sympathies to Mr Carolan's widow Madge and her four children.
He also commended the staff in Mayo University Hospital and noted that Ms Shaw had accepted the physical care afforded to her father was good.