A woman suffering from anorexia weighed just 30kg (4.7 stone) when she was refused medical admission to a Co Meath hospital.
Sorcha O’Malley (31) from Rathmolyon, Co Meath had a Body Max Index (BMI) of less than 12.9 at the time. A BMI of between 20 and 25 is considered normal.
Ms O’Malley, who had begun restricting her food intake at age 12 was diagnosed with anorexia nervosa at age 22. She died following a cardiac arrest at the Mater Hospital on October 17, 2016.
“Sorcha was a loving mother to her two children. She had a complicated past medical history which included a diagnosis of anorexia nervosa,” the woman’s mother, Mairead O’Malley said.
An inquest into her death at Dublin Coroner’s Court heard Miss O'Malley used laxatives and slimming pills in her late teens and early 20s.
The inquest heard that a diagnosis of anorexia requires criteria including persistent low body weight, low body mass index, a body image issue or dread of weight gain, excessive exercising, purging and the taking of medication to suppress appetite. Ms O’Malley met all of this criteria, the court heard.
She attended an Eating Disorder Therapist within the Louth Meath Mental Health Services in August 2013 and completed this treatment in November 2015.
In June 2016, she was treated at Connolly Hospital for complications arising from her anorexia and transferred to the care of the Department of Psychiatry at Our Lady’s Hospital, Navan. She discharged herself on July 18. A letter from the hospital to her GP stated "she was very rigid, resisting appropriate treatment".
Sorcha’s family contacted a specialist eating disorders clinic for residential treatment and funding of €150,000 was secured for this through her consultant psychiatrist at Navan, Dr Fionn Kelly. However, the clinic noted she was severely malnourished and declined to accept Ms O’Malley until she was able to walk unassisted and when her fasting blood sugars and ECG returned to normal.
A 'very complex patient'
On September 20 2016 Ms O’Malley was advised she needed admission to hospital in order to meet this criteria and she accepted this advice. However, requests to admit her to Navan General Hospital met resistance.
Consultant gastroenterologist Dr Malik Anwar said he felt the patient’s needs would be better served in a multidisciplinary hospital.
“She was a very complex patient; she needed a multidisciplinary approach to make her better,” he said. Dr Anwar noted that the patient required long term tube feeding and said there was only one dietitian in the hospital.
“I didn’t think it was appropriate to admit Miss O’Malley,” Dr Anwar said.
Dr Kelly had referred to Ms O’Malley’s admission as a "highest possible priority". A second psychiatrist in Navan described the case as urgent. Barrister for the family Roger Murray asked Dr Anwar if he was aware the case was urgent.
Dr Anwar said the fax he received about the case noted it was urgent but he was mindful of the objectives that needed to be achieved by admission.
The inquest continues tomorrow.