The deceased was a man in his early 60s who was admitted to the Emergency Department of his local regional hospital suffering from a severe epistaxis (nose bleed). He had undergone an elective procedure to the soft lining of his nose (sub mucous diathermy to the inferior turbinates) some 2 weeks previously. In the late evening of the day in question he developed a severe nose bleed while at home and was taken by car to the local regional hospital. On his admission he had his nose packed and observations carried out. Due to a lack of ENT expertise on site a decision was made that the deceased should be transferred by ambulance to a different regional hospital.
The deceased continued to bleed heavily through his nose and his condition was getting noticeable worse. He also complained about a large volume of blood dripping down the back of his throat and at one point vomited a large volume of blood. He was noted to be sweaty and hypotensive and was given a fluid bolus intravenously. The packing to the front of his nose was required to be reapplied due to the severity of the bleeding. He also underwent a transfusion of 2 units of blood. The deceased continued to bleed for a number of hours and complained of feeling nauseous, cold and clammy. An ambulance was arranged once the clinicians caring for the deceased felt that he had been stabilised. Unfortunately whilst waiting for the ambulance transfer the deceased’s condition worsened considerably and the transfer was cancelled while the staff attempted to stabilise the deceased once more. The deceased’s condition did not improve and attempts to stabilise him were unsuccessful, he went in respiratory and ultimately cardiac arrest. He was pronounced dead some 6 hours after the onset of his nose bleed and admission to hospital.
The family of the deceased contacted Augustus Cullen Law as they had strong concerns in relation to the manner in which the deceased was managed at the regional hospital and an Inquest into his death was scheduled to be held. Expert reports from Consultants in Emergency Medicine, Anaesthesia and Otolaryngology were obtained which were severely critical of the care provided by the regional hospital both in terms of the failure to manage the substantial blood loss and resulting hypotension, but also, in failing to adequately protect the deceased’s airway. While measures were taken to pack the front of the nose, nothing whatsoever was done to ensure that the back of the nose was also packed to prevent the aspiration of blood which occurred. The Coroner recorded a narrative verdict in relation to the cause of death confirming death as a result of aspiration of blood.
Proceedings were issued on behalf of the deceased’s family for his wrongful death and in addition 4 related Nervous Shock Claims were also issued on behalf of 4 family members who had suffered grief over and above what would normally be expected as a result of what they had witnessed at the hospital on the night in question. Liability was admitted by the Defendant in due course and a Mediation meeting arranged shortly before the trial was due to commence. The Mediation meeting was attended by a representative of the hospital who sat down with the family and discussed the events of the night in question with them. The family found this approach to be very helpful as they were anxious that the hospital had learnt from what had occurred. The proceedings were successfully resolved and a substantial six figure sum in damages agreed to be paid to the family in addition to the Plaintiffs’ legal costs.
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- Jamie Hart, Senior Associate Solicitor
12 November 2013