Former GP told inquest he kept no records of injections before woman’s fatal brain bleed

An inquest heard former GP Paschal Carmody had no treatment records for an 83-year-old woman who later died from a fatal brain bleed

Marlyn Hilliard, 83, died from a catastrophic brain bleed on February 11, 2025, at Cork University Hospital. File picture

A former GP told an inquest that he had no records of injections allegedly given to a patient who later died from a fatal brain bleed, despite receipts produced in court suggesting he did.

Marlyn Hilliard, 83, died from a catastrophic brain bleed on February 11, 2025, at Cork University Hospital.

Her son, Nicholas Hilliard, asked Cork Coroner’s Court whether injections he said his mother received from former GP Paschal Carmody at his practice in Killaloe, Co Clare, could have contributed to her death.

Mr Carmody said he carries out a regenerative therapy to relieve joint and ligament pain called Prolotherapy.

This treatment involves injecting a substance into weak or painful joints and ligaments to irritate the area and trigger an inflammatory response. This stimulates blood flow and fibroblast cells to grow new tissue around the injected area.

The aim of the treatment is that the new tissue will strengthen the joint or ligament and reduce pain.

The injections consist of hypertonic dextrose (sugar), lidocaine, and saline.

Pathologist Dr Margaret Bolster said dextrose injections would not cause a brain bleed.

However, she said there was no scientific evaluation of what was in the injections Mr Carmody administered.

Dr Bolster performed Mrs Hilliard’s post-mortem at Cork City Morgue on February 12, 2025.

Her cause of death was intracerebral haemorrhage – a major brain bleed.

She had no signs of trauma. The brain haemorrhage pushed her brain down onto the brain stem, which controls breathing and the heart, leading to death.

Thickening of blood vessels was found in the brain, which would have decreased blood supply and is often associated with high blood pressure, Dr Bolster said.

Liam Kelly, who had known Mrs Hilliard for eight years and lived with her and her husband for four years at their home in Laetare Lodge, Rossbrin, Schull, Co Cork, said she had been preparing dinner on the evening of her death but was “a little quiet.”

He heard a crash from the utility room and found her collapsed on the ground.

“I asked if she was alright and her words were garbled,” he said.

Bubbles were coming from her mouth, and he cleared mucus and called an ambulance at 6.32pm. He also called a priest.

An ambulance arrived about 20 minutes later and took her to CUH, where she was later pronounced dead.

Mrs Hilliard had enjoyed good health for her age, although she suffered from arthritis, he said.

Although she had been advised by Mr Carmody to see a rheumatologist, she never did, Mr Kelly told the coroner.

She had fallen while preparing dinner three months earlier and had reportedly “collapsed” in Schull while shopping six weeks before her death, Mr Kelly said.

But she was “a very stoic person” who “never gave in to morbidities and always dismissed them,” Mr Kelly said.

A receipt from December 2024 appeared to be the last time Mrs Hilliard visited the Killaloe clinic, the court heard.

Giving evidence, Mr Carmody said he had no recollection of this visit.

He also said he had no records of any treatments given to Mrs Hilliard.

Coroner Philip Comyn said Mr Carmody initially denied treating Mrs Hilliard.

However, Mr Carmody later said he may have administered one treatment to her on her second visit to the clinic.

She first attended in spring 2024, and on her second visit some weeks later, he may have injected her, Mr Carmody said.

In total, he recalled the deceased visiting him three times in spring 2024, the court heard.

However, Mr Comyn produced several receipts from later that year — including €300 from September, €600 from August, and €700 from December 2024.

Mr Carmody said he did not recall these later visits and had no records of any treatments given on those dates.

He said that while he sometimes keeps records of treatments, he does not always.

He agreed with the coroner that it would be advisable to keep meticulous records.

However, because his practice was in natural or complementary medicine, it had its own rules to follow, he said.

Some pain was inevitable following injections, as they cause an inflammatory reaction, but this pain usually subsides within days, Mr Carmody said.

Nicholas Hilliard said the family knew his mother was attending Mr Carmody’s practice in early 2024.

The injections he believed she received caused “extreme pain” following visits from April to June.

After one later appointment, she returned home “talking at a very fast rate.” Instead of going to bed, she spent hours on her computer.

The following day, she was “speaking very fast, erratically,” and said her arthritis pain was “80% cured.”

However, her pain returned in the following days and weeks, he said.

Similar patterns were observed after subsequent appointments, he said.

A deposition from Dr Helen Finlay noted that the family had been concerned about their mother’s mental health due to an interest in conspiracy theories and extreme religious views — especially after the covid-19 pandemic.

Mr Carmody expressed his sympathies to the Hilliard family on their mother’s death through solicitor Justin Condon.

Coroner Philip Comyn said that while Mrs Hilliard’s cause of death was clear, what gave rise to it was “less clear,” and the court was “suffering a lack of information.” He said he “found it unusual” that Mr Carmody had no records of what he administered.

There was therefore “a lacuna” regarding what was given and whether it affected her or not.

Mr Comyn said he was left with “considerable doubt” and returned an open verdict.