Lawyers for Aoife Johnston's family have said it is a matter of great concern that the terms of reference for the new review were decided upon, without any input from the family.
Damien Tansey, Senior Counsel and Senior Partner, Damien Tansey Solicitors, Sligo told RTÉ News there was no family or person more profoundly interested in this investigation than the Johnstons who lost their beautiful 16-year-old daughter.
He also said some media had recent access to an internal review of the case by University Hospital Limerick from December 2023, but the family did not.
Details of that report were officially published by the HSE yesterday alongside the terms of reference for the new investigation by former chief justice Frank Clarke.
Mr Tansey said the family will want time to fully consider the terms of reference for the new review and will have something to say about that, with a view to altering or enlarging the terms, in order to cover areas that are of primary concern to the Johnston family.
An inquest into the death of Aoife is due to begin on 21 April in Limerick.
The teenager, who was from Shannon, Co Clare, died after a 12-hour wait in the UHL emergency department on 19 December 2022.
She was diagnosed with bacterial meningitis and developed sepsis.
The terms of reference say that the independent probe will be an evidence-based report on the circumstances surrounding her death and the clinical and corporate governance of the hospital.
The new investigation follows a December 2023 systems analysis report received by the HSE into the case, details of which are set out in the terms of reference.
Overcrowding is endemic in UHL, according to details of the earlier systems analysis review of the case, which was commissioned by the clinical director of the hospital.
The report found that the national guideline number 26 on sepsis management in adults and maternity was not followed on 17 December 2022, leading to a delay in sepsis care of 12 hours.
It found there was little apparent understanding of the risks and inefficiencies caused to patient care by a crowded environment.
The report said there were insufficient nursing staff to provide adequate monitoring and care to the patients in the emergency department.
There were also insufficient emergency medicine doctors and just one emergency consultant who is on call for the whole weekend.
It also found there was a high turnover of staff both nursing and emergency medicine non-consultant hospital doctors leading to low experience levels and low situational awareness.
In a statement, the HSE said they did not want to "comment in detail on the systems analysis review ... pending the completion of the independent investigation".
However, it added: "When adverse incidents occur the HSE does not await the outcome of all investigations before commencing improvement plans. This is the case also with UHL/UHLG.
"After a systems analysis report, individual services develop improvement plans directly linked to the recommendations and these are actioned and followed up. Again, this is the case here.
"The HSE wants to assure the public that continuous improvements are under way at UHL/ULHG and people should continue to avail of the many good services there delivered by our staff."
