Inquest hears man who left hospital in pyjamas was probably being treated for sepsis and pneumonia
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A hospital patient who died after he walked out into a bitterly cold January night was likely being treated for sepsis as well as pneumonia, the inquest into his death has heard.
Patrick Rowland, aged 69, appeared to meet several criteria for being at risk of leaving the hospital but night nurses were not told, for example, that he had informed day staff he wished to leave.
Within weeks of his death, Mayo University Hospital placed an alarm on the basement door through which he exited, coroner Patrick O’Connor heard.
Mr Rowland was brought to the emergency department just after 6am on January 15, 2023, and was moved to a ward after 42 hours.
When his son, Cormac, left at 12.40am on January 17, Patrick appeared to be sleepy and safe. However, very soon after this, he walked out of the hospital clad in slippers and pyjamas.
Consultant geriatrician Tom Lee gave evidence of examining Mr Rowland on the morning of January 16.
Dr Lee said the results of a portable X-ray of his chest “were in keeping with pneumonia”, and he appeared lucid during a conversation lasting several minutes.
Dr Lee agreed with Roger Murray SC and partner with Callan Tansey Solicitors acting for the family, that medical records filled by other healthcare staff indicated “he fulfilled the criteria” for sepsis. He said to the best of his knowledge: “I think it is likely that he did”.
Dr Lee agreed that the medical records show while the opinion of a respiratory doctor was recommended by a radiologist, there is no evidence this was sought.
Questioned on whether Mr Rowland had expressed suicidal intent, he said he had no recollection of that.
Luán Ó Braonáin SC, acting for Mayo University Hospital (MUH), said “it is not being suggested in any way by the hospital” there was an intent for self-harm in this incident.
MUH services manager Denis Mullins said the external door used by Mr Rowland to exit is a stores door in a “secluded location”.
It is between 100m and 150m from the ward. He said he understands the patient went there down the stairs.
It is a fire door so it cannot be kept locked, he added. They installed an alarm system on January 30, 2023.
Mr Mullins agreed the death of Mr Rowland was absolutely the catalyst for this action.
He agreed with Mr Murray that, should this door now be opened at 3am, for example, security guards would be alerted. This was not the case in mid-January 2023, he said.
The court also heard Mr Rowland’s son Cormac recently met with hospital staff and followed the route his father took.
Evidence about ward doors was given by MUH director of nursing Pádraig Ó Lúanaigh.
He said the hospital “routinely operated at about 120% capacity” saying certainly at times “we had more patients in the building than we had beds for”.
He was not involved in Mr Rowland’s treatment.
The ward doors are ordinarily closed but not locked.
He said it is “likely” they were left open that night due to the number of patients on trolleys being brought up from the emergency department.
This happened around midnight and afterwards, he agreed with Mr Ó Braonáin.
He read from a document on in-patients at risk of fleeing or absconding from the hospital.
Risk factors included being agitated, angry, lacking insight into their condition, and verbalising a wish to leave.
These affected Mr Rowland according to evidence heard on Tuesday, the coroner noted on Wednesday.
Mr Murray said depositions indicate ward nurses were not told he had expressed a wish to leave to at least three emergency department staff.
In response, Mr Ó Lúanaigh agreed this is surprising.
Statements from two doctors at registrar level in the emergency department were read into the record. The coroner expressed disappointment they were unable to attend.
The staff witnesses expressed their sympathies to the family.
Mr Rowland’s wife Louisa, his son Cormac, and many other family members and friends were again in attendance at the inquest yesterday.
His son, Cormac, told the court previously how shocked he was to receive a phone call from his father at 1.12am saying he was outside the TF Royal Hotel.
Following an intensive search involving gardaí, Coast Guard, Civil Defence, and many volunteers, Mr Rowland’s body was recovered from the river two days later.
The inquest continues on Thursday at Swinford Courthouse with 14 more witnesses.