A student who collapsed and died from a bleed on the brain did not receive an emergency scan to diagnose her condition, an inquest heard.
Lisa Niland (19) from Drimbane, Curry, Co Sligo died three days after she collapsed at a fast food restaurant.
An inquest into her death heard that a doctor did not sanction an emergency out of hours brain scan because he was not aware the patient had displayed neurological symptoms.
Miss Niland collapsed at 8.30pm on January 17 2017. She was with her boyfriend about to order a milkshake when she slumped to the floor and vomited, her father Gerry Niland told Dublin Coroner’s Court.
She was rushed to Sligo General Hospital where her father described her as groggy and imbalanced.
“She got a sudden, massive pain in the back of her head. She slumped to the ground, then she vomited,” Mr Niland said.
She was fully conscious when she was assessed by a doctor in the Emergency Department (ED) at 11.15pm.
“She was in excruciating pain, she had no balance,” Gerry Niland said.
She was no better at 2.15am when the ED registrar phoned the ED Consultant on call Dr Fergal Hickey seeking his opinion on whether an emergency CT scan was required. An out of hours CT scan requires the authorisation of a consultant, the court heard.
Dr Hickey advised she be admitted to hospital and a scan carried out in the morning.
However, Miss Niland went into cardiac arrest the following morning as her family received the results of a CT scan that was performed 10.15am.
Solicitor for the Niland family Damien Tansey asked why Dr Hickey did not sanction the scan.
“I made a call in good faith taking the various factors into consideration,” Dr Hickey said.
“She did not show hard neurological signs at that point, that’s what was conveyed to me and that’s what informed my decision,” Dr Hickey said.
Dr Hickey said he was operating in ‘a very imperfect system’ and said in his experience Beaumont Hospital was unlikely to accept a fully conscious patient in the middle of the night.
The ED registrar Dr Kate Langtree said she had conducted a full neurological assessment before contacting Dr Hickey but had not asked the patient to leave her bed.
Dr Langtree said she was surprised at ‘resistance’ from the medical registrar to admit Miss Niland due to the lack of a clear diagnosis, following Dr Hickey’s advice. The medical registrar Dr Nagmeldin Hassan Abdoun Hafiz, denied this. The patient was subsequently admitted to the medical department.
Miss Niland suffered three cardiac arrests before was transferred to Beaumont Hospital at 1pm on January 18 2017. She died two days later.
“Our lives were shattered and ruined forever,” Mr Niland said.
A postmortem found Miss Niland suffered a catastrophic cerebral bleed due to an arterial abnormality.
Coroner Dr Myra Cullinane adjourned the inquest to hear evidence from a consultant at Beaumont Hospital before returning a verdict.