Discharged patient suffered fatal injuries in fall at crowded A&E while waiting for taxi home

Seán McCárthaigh

A patient who had been discharged from hospital suffered fatal injuries in a fall in a crowded emergency department while waiting for a taxi to bring him home, an inquest has heard.

Con Lambe (75), a married father of six from Rooskey, Drumconrath, Co Meath, died in Beaumont Hospital in Dublin on March 21st, 2024, a day after he fell and hit his head while attending Our Lady of Lourdes Hospital in Drogheda, Co Louth.

An inquest into his death heard members of Lambe’s family express concern that he was a “fall risk” and should not have been allowed to walk around the hospital unaccompanied.

A postmortem showed he suffered severe traumatic brain injuries and a fracture to the skull from the fall.

A consultant physician and gastroenterologist in Our Lady’s, Ammar Shanin, told a sitting of Dublin District Coroner’s Court that he suspected that Lambe might have tripped over an IV fluid stand of another patient.

Shanin pointed out that the emergency department was very crowded at the time, with patients on trolleys and chairs “the whole way.”

“It was one of the worst days I’ve seen like this,” the consultant observed.

However, counsel for Our Lady of Lourdes Hospital, Caoimhe Daly, intervened to note that the witness’s observation was speculation as he had not seen Lambe fall.

Shanin said he did see another patient slap herself on the face when Lambe had fallen on the ground.

He explained that he had interpreted her reaction as she “blamed herself” for what had happened.

The inquest heard that Lambe had been brought to the hospital in Drogheda on March 19th, 2024, with complaints of chest pain and vomiting.

Shanin said the decision was taken to discharge Lambe the following morning as all his test results, including a chest X-ray, were normal.

He recalled that the patient had also said he was feeling well and had asked if he could go home.

Shanin said he understood that Lambe had been with a nurse to arrange to get a taxi to bring him home when the incident occurred.

In reply to questions from coroner Clare Keane, Shanin said Lambe had been diagnosed with a non-specific chest pain after his overnight stay in the hospital.

Another doctor, Keletso Ramotshabi, told the hearing that he saw the patient “appear to wobble” before falling to the ground on his back. Ramotshabi said Lambe was walking towards his cubicle when he went to grab a curtain to try and steady himself.

He said he did not know what caused the patient to lose his balance.

A staff nurse at the hospital, Esmeralda Diche, gave evidence that Lambe was very upset around 10am when he was told he would have to wait to be collected from the hospital after being discharged.

The inquest heard Lambe suffered the fatal fall around 10.30 am after which he was sent for an urgent CT scan, which confirmed he had sustained serious injuries and would require a transfer to Beaumont Hospital.

Diche said Lambe was able to talk after the incident, but did not explain what had happened.

The nurse said a risk assessment had found that the patient was capable of independent mobility.

However, several of his children told Dr Keane that she should not have been allowed to walk unaccompanied, as he used a walking stick and had issues with his sight.

They also pointed out that he had previously required hospitalisation after a fall and should have been assessed as “a fall risk.”

Diche said she could not recall if any of those issues had been recorded in Lambe’s medical notes.

Relatives of Lambe also complained that they had not been notified immediately about the fall, and it was not until 1pm, about two and a half hours after the incident, that they were informed about it.

“We could have been with him before he was transferred to Beaumont,” said one of his daughters.

She pointed out that her family were only told their father’s condition was critical while they were on their way to Dublin in a taxi.

An assistant director of nursing at Our Lady of Lourdes Hospital, Blessy Varghese, told the inquest that the hospital’s policy on communications with relatives of patients had been updated last November.

Varghese said staff were now told to contact family members “without delay” when a patient was deteriorating or had developed complications.

She said the policy, which had not been changed since 2016, would in future be reviewed every three years.

Returning a verdict of accidental death, the coroner said Lambe had died from severe cranial cerebral trauma due to a fall, while noting he also had a background of significant heart disease.

“It was a very unfortunate accident with such a tragic outcome,” said Dr Keane.

The coroner said she would not make any recommendations as Our Lady of Lourdes Hospital had already updated its relevant policy on communications.

Dr Keane said she endorsed the changes that had been made including reviews to be carried out every three years.