No CT scan for woman who died from haemorrhage

A FEMALE security guard at Shannon Airport died from a brain haemorrhage just weeks after she was sent home from the Mid-Western Regional Hospital where she was wrongly diagnosed as suffering from migraine, an inquest in Limerick heard.

Louise Butler, aged 21, of Cappa Lodge, Sixmilebridge, Co Clare, died at the hospital on November 16, 2006.

She had been discharged on October 12, with severe headaches despite pleas, by her and her mother to have a CT scan carried out but to no avail.

A verdict of “medical accident” was returned by the jury.

The inquest was told that Ms Butler had previously been admitted to the hospital in 2004 suffering from severe headache, but an MRI scan carried out then showed up normal.

Her mother, Christine Butler told coroner Isobel O’Dea that Louise collapsed at work and was brought to hospital by ambulance.

Louise told her mother that the headache she was suffering from was like a “hammer blow” to the back of her head.

Mrs Butler said Louise told every doctor who asked that the pain was like a hammer blow.

The doctors at the hospital were adamant it was migraine.

“She (Louise) began to insist on a scan. The treating doctor at this time was [consultant physician] Dr Maeve Skelly. I began to insist on a scan as well.

“Louise was discharged from hospital on October 12, 2006. I begged Dr Skelly not to send Louise home because she was still very sick,” she said.

The headaches had not improved. Louise was still very seriously ill with a headache at home, vomiting and not sleeping.

“I rang the hospital repeatedly to try and bring the date of the scan forward. Eventually the hospital agreed to perform the scan on November 13, 2006.

“However, Louise tragically collapsed on November 14 and never recovered.”

She died at the hospital on November 16.

In reply to Marjorie Farrelly, for the HSE, Mrs Butler denied Louise was anxious to get home.

Dr Skelly testified the admitting doctor noted that Louise’s symptoms were consistent with migraine. On reviewing the diagnosis, Dr Skelly agreed the symptoms were consistent with migraine and she considered subarachnoid haemorrhage unlikely.

She said Louise complained of more severe pain than when she was admitted in 2004, but this did not necessarily change the nature of the pain.

She said the first mention of a CT scan was by Mrs Butler and she decided to order a scan to reassure the family they were not missing something like a tumour.

Dr Skelly said the words “hammer blow” were never mentioned to her to describe the patient’s headache.

Dr Skelly said the case had weighed heavily on her and she was profoundly sorry over the death of Louise.

She added that every time someone presents with a headache she thinks of Louise.

Asked if she could do things differently, she replied: “In an instant.”

Dr Skelly said she has changed her procedures in dealing with patients. She now personally takes their medical history and no longer delegates this to other doctors.

Pathologist James O’Driscoll said Louise Butler died from a ruptured aneurysm at the base of the brain.

The jury returned a verdict of medical accident, with death due to brain haemorrhage and recommended that, in cases where patients present with persistent and severe headache, they should get a CT scan or lumber puncture within the minimum time frame.


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