Aoife Johnston inquest hears University Hospital Limerick was 'akin to a war zone'
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A clinical nurse manager has described conditions in University Hospital Limerick (UHL) on the night teenager Aoife Johnston died as "akin to a war zone".
The 16-year-old from Shannon, Co Clare, died on December 19, 2022, after a 12-hour wait at the hospital's emergency department.
The inquest, before Limerick Coroner John McNamara, is scheduled to run for four days. It will examine the care provided to Aoife Johnston at UHL on the 17 and 18 of December 2022, with some 25 witnesses scheduled to give evidence.
Aoife Johnston's mother Carol told the inquest that she watched her daughter die and she "wouldn't wish that on anyone".
Her father also told the inquest that his daughter "got sicker and sicker and sicker".
Katherine Skelly, the clinical nurse manager who was on duty on December 17 when Aoife Johnston was admitted, described how on the previous night, the hospital had 130 patients waiting to be seen in the emergency department. She said that while that was "unsafe by any standards", the situation got even worse on December 17 when there were 160 patients waiting.
She said there should have been 20 nurses on duty but there were only 15.
"We could have done with 30, such was the volume of patients," she said.
She also described how she rang two consultants to tell them how bad the situation was but that one declined a request to come into the hospital, and another initially declined a similar request but did subsequently attend sometime after 11pm.
She said the “crisis” which unfolded at the hospital was “very clear and alarming”.
“What I observed was akin to a war zone. Every available floor space was taken up, trollies were lined up next to each other, blocking doors.”
Ms Skelly said there were 67 “category two” patients in the ED, including Aoife, who she deemed to be “dangerously ill” patients.
She said Ms Johnston and these 66 other seriously ill patients were waiting more than ten hours to see a doctor when the recommended standard waiting time for category two patients was 15 minutes.
When Ms Johnston presented with sepsis with her parents, they laid her across two chairs together because there were no trolleys available.
Ms Kelly told how patients were sandwiched together cheek by jowl on trolleys, some, including children, were “sitting on the floor” due to a lack of space.
All the while, Ms Johnston was “dying in front of the staff’s eyes”, said Damien Tansey, senior counsel for the Johnston family.
Ms Skelly said in her opinion the paediatric area was “unsafe”.
Staff were working under “unimaginable stress” and patients some patients received “substandard care”, while others simply “left the hospital without getting treatment”.
She added that UHL had become "too accustomed to crisis" and that staff were "constantly firefighting" just to provide basic care to the volume of patients presenting there.
Under cross-examination by counsel for the Johnston family, Ms Skelly said she had been devastated by the death of the 16-year-old.
"I never worked in A&E after that weekend," she said, stating that she left her job at the hospital because of the events on 17 and 18 December 2022.
"It absolutely broke me professionally and personally that that poor girl died."