The last words Carolyn O’Neill heard from her 16-year-old daughter were "Mammy, I can’t breathe."
Soon after, on 29 January 2024, Niamh McNally died in the emergency department at University Hospital Limerick (UHL), where she had been admitted for the second time in three weeks.
"Four times I called out for help and I said, ‘Guys, Niamh is really deteriorating now… please can someone help?’ No one came near us," Carolyn told Prime Time.
Niamh was born with a congenital heart defect and underwent multiple surgeries as a young child but her health had remained stable.
An inquest into Niamh’s death returned a verdict on 26 November of medical misadventure. A postmortem found Niamh died from "asphyxiation secondary to pulmonary haemorrhage likely resulting from the erosion of collateral arteries" in the heart.
Speaking to presenter, Miriam O’Callaghan, Carolyn described her daughter and the final hours and weeks leading up to her death.
Niamh, she says, was "a lovely girl, very quiet, full of energy," someone who "loved school" and had "a lovely group of friends."
Niamh underwent three open-heart surgeries as a child, along with two scoliosis operations.
"She was a Trojan, she was just a fighter." After the invasive spinal surgeries, Carolyn said Niamh was up walking "within five hours of the operation."
A typical teen, according to her mother, Niamh "loved her fashion" and her friends and would spend hours in her bedroom making "amazing videos."
In late December 2023, she developed a persistent cough. By New Year’s Eve she was spiking temperatures.
On the second week of January 2024, she began coughing up blood. "Then, I knew it was serious," Carolyn said.
They went straight to UHL, where she said they were "very good on admission." Niamh had suffered a collapsed lung and "within the first hour they had her on a drip… a chest X-ray… a heart monitor."
Niamh remained in hospital for 14 days and was then discharged. She had lost weight and was exhausted, but at home she seemed brighter. They were planning a holiday.
"We were sitting down saying we’re going to go to Lisbon, five-star hotel, nothing but the best."
The following night, everything changed.
While her mother was out doing a food shop, Niamh began vomiting blood again.
"I’ll never forget it," Carolyn said. "She just started vomiting loads of blood… she couldn’t talk to me."
When Carolyn reached home, "the whole bed was covered in blood, saturated, her hair was covered… her whole pyjama was covered."
They waited together for the ambulance. "The two of us sat at the end of the bed and we just cried. We were just lost."
Paramedics and two doctors arrived at the house and Niamh was transferred to UHL shortly after 3.30pm on 29 January. Carolyn followed behind.
In the emergency department, she asked staff to contact the consultants who knew Niamh’s history. "Please contact him… he knows her history," she said. "And they didn’t."
Carolyn says Niamh waited hours before she was assessed. When a doctor eventually took bloods, her infection markers were extremely high. Even getting to an X-ray proved difficult, she said.
"They couldn't get a porter… so I ran down the corridor. I said, 'I'll get a wheelchair. I'll bring her down myself.'"
By the evening, Niamh was taken out of her room and was on a trolley on a corridor. She was slipping in and out of consciousness. "Her whole body was shutting down… her feet were frozen… her hands were ice," Carolyn said.
Niamh deteriorated further while on the corridor and started vomiting blood again. Moments later, Niamh turned to her mother. "Mammy… I can’t breathe. She died in front of me."
She described the room as suddenly chaotic. "All hell broke loose, all the doctors ran into the room, about 20 people at this stage."
After 55 minutes of attempts to resuscitate her, Niamh was pronounced dead.
The HSE later apologised to Carolyn, which it reiterated at the recent inquest, and since in a statement to Prime Time.
HSE Mid West said it "deeply regret[s] the failures in care that led to Niamh’s death. We are constantly working to improve patient outcomes and we regret that in this instance our standards fell short."
"Staff are committed to providing the best possible care in the face of rising demand in what is Ireland’s busiest emergency department," it said, adding that they "are committed to improving access for patients and ensuring that we provide the right environment and support for staff to deliver the high level of care the people of the Mid West expect and deserve."
Speaking at her home in Limerick, Carolyn said "I wouldn't like any other family to go through what Niamh went through was just horrendous. I got no closure from it."
For her, the loss remains overwhelming.
"I’m heartbroken she’s gone, because we were so close."
The full interview with Carolyn O'Neill and Miriam O'Callaghan, produced by Aaron Heffernan, will broadcast on the 4 December edition of Prime Time at 9.35pm on RTÉ One and RTÉ Player.
