Death of epileptic patient could have been avoided: Doctor

The death of an epileptic patient could have been avoided, but the monitoring needed to decide if the person was suitable for surgery was unavailable at the time, a doctor said yesterday.

Consultant neurologist Daniel Costello said that, in the last three years, two of his patients have died of sudden unexpected death in epilepsy and that “one, possibly, could have benefited from surgery”.

Dr Costello referred to the deaths to highlight the fact that an epilepsy monitoring unit (EMU) at Cork University Hospital, where he works, remains closed, despite the very real risk of death to people with epilepsy, and the critical role the unit could play in deciding how best to treat them.

The unit did not exist at the time the two patients died. However, it has since been developed to state-of-the-art standards, but remains closed because the HSE has been unable to fund staff to run it.

The same situation applies to the country’s only other EMU at Beaumont Hospital in Dublin, which temporarily closed in June to facilitate an upgrade, but has not reopened.

Dr Costello said he now has about 90 people with epilepsy on a waiting list to access the EMU at CUH, while another 180 people are waiting to access the unit at Beaumont.

The EMUs are part of the HSE’s National Epilepsy Clinical Care Programme and were refurbished for almost €1m.

Dr Costello said that CUH was fully supportive of the new unit and that it was ready for clinical use, but five nurses and two technologists are needed to run it.

Without the units, he would have to start referring patients abroad for treatment, he said.

“Referral of people with epilepsy to an international epilepsy centre for tests that can be done in Ireland will cost approximately €20,000 per person,” Dr Costello said. His patients did not want to go abroad to access tests that were available locally, he added.

Dr Costello said the “culture of containment” within the HSE was having “direct, observable consequences for patients trying to access clinical services” and was “directly leading to patient distress”.

There are 40,000 people with epilepsy in Ireland, of whom 30% have difficulty controlling epilepsy and would stand to benefit from the EMUs.

The units provide a safe environment in which to observe patients’ seizures round the clock, with a view to helping make a definitive diagnosis, helping identify which part of the brain seizures are occurring in, and which patients might best benefit from surgery.

The closure of the units was raised in the Seanad yesterday by Senator Marie Moloney, who called for them to be reopened. She said she would “urge the HSE to act swiftly on the matter”.

She called on Health Minister James Reilly “to have an open debate with members of the Seanad on the progress being made on the matter”.