Legal action being considered

A CLARECASTLE family is considering legal action against the Health Services Executive arising from the death of Thomas Keenan, aged 53, in an ambulance outside Ennis hospital in the early hours of the morning of Wednesday, September 22.

Mr Keenan, according to his son, Thomas Jnr, became unwell at home with chest pains, which he initially thought was indigestion.
“He drove from his home at 57 Church Drive, accompanied by his wife, Anne, son Patrick and his girlfriend Lisa and his youngest daughter, Charlene, aged 13.
“My father drove in some of the way and my brother took over as the chest pains got worse. When they arrived at Ennis hospital, my mother ran up to the main door of the hospital, which was locked. She banged at the door and was screaming that her husband was having a heart attack,” Thomas Jnr told The Clare Champion.
Mr Keenan’s widow, Anne, 52, alleged, “I was banging at the door for four to five minutes before anyone took notice. I was screaming for someone to come out, that my husband was having a heart attack.”
She claims she could see medical staff inside the hospital looking out. “I thought they were ringing for an ambulance but next thing the guards arrived,” she added.
Anne said nurses came out to her and tended to her husband.
“One nurse tried to pump his heart and another was doing other work on him. He was still in the car. I kept asking him to bring them in to the hospital,” she said.
She added that up to six gardaí arrived on the scene as the nurses were tending to her husband.
“We don’t know why the guards were called at all. Maybe hospital staff thought there’d be trouble. I know my mother was screaming and causing a racket but she was very upset and scared,” Thomas Jnr commented.
Anne said that when the gardaí arrived, one of them got the assistance of the ambulance crew. “My husband was put into the ambulance and they shut the doors and wouldn’t let me in.”
Her son said that sometime later they were informed that Thomas was dead. The family are angry that Thomas was not admitted to the hospital.
“We were told that he couldn’t be moved, because people have to be resuscitated before they can be moved but they moved him from the car to the ambulance, so why couldn’t he be moved from the car to the hospital instead.
“We feel his death could have been prevented if he had been brought into the hospital,” Thomas Jnr alleged.
Thomas Jnr added that while the family is grieving for their father, their main feeling is anger.
He added that the family is considering taking legal action against the hospital. “It is still very hard for us and there are a lot of feelings but we are thinking about following up on this legally. We are speaking to legal people this week about it,” he said.
Thomas doesn’t feel his father was treated with dignity.
“We’ll never know what would have happened if he was brought into the hospital but at least we’d know that the best medical efforts were made if he had been.
“He should have been given the respect of being brought into the hospital. We are all devastated and disgusted.
“It was handled ridiculously by the hospital. The HSE should smarten up. A&E has to be 24 hour to deal with situations like this.”
He said there was no threat from his family to the hospital staff.
“Even when more of our family and friends arrived after he died, there was about 12 of us and there was no threatening behaviour,” he said.
The results of the post mortem have not yet been presented to the family.
A spokesman for the HSE expressed sympathy to Mr Keenan’s widow and family on their bereavement but outlined that certain procedures have to be followed when someone presents with cardiac arrest.
“Sudden cardiac arrest is always traumatic and it can be difficult for relatives to understand the various medical interventions in a highly distressing situation.
“For example, the natural instinct is to want your loved one moved immediately into a bed, whereas medical best practice requires resuscitation to be administered on the spot,” he commented.
He further explained that the Keenan family knocked at the window and door of the hospital seeking help for Mr Keenan, who was in a state of cardiac collapse. A nurse opened the door, called for backup and at the same time called an emergency ambulance.
Gardaí in Ennis have confirmed that they received a call from Ennis hospital at 3.30am and a number of gardaí went to the hospital. The call from Ennis Hospital to the gardaí was in relation to a medical emergency arising from a man with chest pains.
The HSE spokesman further commented that as Mr Keenan had collapsed in the car, it was not advisable to move him into the hospital as the priority was to attempt resuscitation.
“This was administered in the car by the nurse and the on-call doctor until the ambulance arrived, when paramedics took over resuscitation. They continued to work on the patient in the ambulance until he was pronounced dead and at that stage, the patient’s body was taken to the hospital mortuary,” he said.
Gardaí have confirmed that Mr Keenan was pronounced dead at 4.07am in an ambulance in the grounds of Ennis hospital.
The HSE has further explained that the hospital policy, a protocol for the management of all persons self presenting to the Mid-Western Regional hospitals in Ennis and Nenagh between 8pm and 8am requesting treatment, states that in the event that a person’s condition gives rise to immediate concern, the assistant director of nursing (nights) or senior nurse manager on duty will be called to arrange for the person to be assessed by the doctor on call with a view to arranging the person’s onward transfer to the emergency department of the Mid-Western Regional Hospital, Limerick.
“The transfer of the patient should be initiated immediately by ringing 999/112 for all acutely ill patients. Where resuscitation is required, this will be administered by qualified staff.
“This is what occurred in the case of Mr Keenan. Other options available to persons urgently seeking treatment include ShannonDoc and the ambulance service,” the HSE spokesman said.
Asked why the gardaí were called to Ennis hospital in relation to this situation, the HSE spokesman confirmed that the gardaí were not called as part of the medical response that arose from Mr Keenan’s condition.
“Resuscitation of Mr Keenan was ongoing in the ambulance for a considerable length of time when the acting director of nursing on night duty noticed that a large number of family members had started congregating at the front of the hospital and were becoming very loud and unruly.
“In the interest of patient and staff safety, she called the gardaí, as would be normal for any large group of people behaving in such a manner.
“The calling of the gardaí was not part of the medical response and they were not called until well after the appropriate medical, nursing and ambulance staff were at the scene attending to Mr Keenan,” he stressed.
He added, “The gardaí were called to the hospital for the management and safety of staff and patients because of the unruly behaviour of a crowd of people outside the hospital door.”
The HSE also stressed that medical help was promptly provided to Mr Keenan and attempted resuscitation was well underway before any gardaí were even called to the scene.
“In fact, medical intervention had continued for approximately 45 minutes and it was nearing the end of the medical intervention that the gardaí were called in response to an unruly group who had gathered at the hospital.
“When the gardaí arrived, there were two nurses, three doctors and four ambulance people dealing with the situation, all being co-ordinated by the acting director of nursing.”