Inquest paused as Aoife Johnston's sister leaves in tears 

Ms Johnston, aged 16, died on December 19, 2022, from meningitis-related sepsis after waiting 15 hours and 15 minutes for treatment in the emergency department of UHL.

She attended the hospital at 5pm on Friday, December 17, 2022, and her first antibiotic was administered at 7.15am on Saturday, December 18.

The teenager had been referred to the hospital by her doctor after suffering headaches and vomiting.

Several medical staff have told the inquest that the hospital emergency department was like a ‘warzone’ due to overcrowding.

UHL manager: 'I will never forget her beautiful face' 

On Wednesday, a former executive-on-call at the hospital sobbed when she was asked if Aoife’s death impacted her.

Fiona Steed, who no longer works at UHL and is now with the Department of Health, described how Aoife’s death “moved” her and other staff.

“I will never forget her beautiful face. 

I look at my own daughters and realise how lucky I am to have them. I think of Aoife.

As Ms Steed spoke, Meagen Johnston left the room deeply upset saying: “We have to go home without Aoife every day.”

Two framed photos of Aoife have been placed at the top of the courtroom.

Her family, including her parents and sisters as well as her friends, sat together throughout the different witness testimony.

They have said that no other person should suffer like Aoife and that they are “haunted” by her loss.

The court was also told that her family donated some of her organs following her tragic death.

Family 'screaming and roaring for help' 

Senior counsel Damien Tansey for the family described how on the night the teenager was admitted the family was “screaming and roaring” for help.

He said that the family understands Aoife’s death was not intentional, but they want answers.

Medical staff said that, as a category two patient, she should have been seen within 10 to 15 minutes and received antibiotics.

The court was also told that the blood tests taken from Aoife showed she was amenable to all antibiotics and there is nearly a 100% chance of mortality if sepsis is not treated quickly.

As Aoife’s sister left the inquest, Coroner John McNamara said the courtroom could take a few minutes’ break and that Ms Steed could step down if she wished.

Phone call about 'major emergency' in A&E

After composing herself, Ms Steed outlined what steps she took when she received a phone call from nurse Patricia Donovan who described earlier a “major emergency” in the emergency department.

Ms Steed said: “I called the [UHL] clinical director ... I escalated it.”

She said she later sent a text to the clinical director but did not receive a reply that night and that her role in the hospital did not include “the power to compel consultants to come in”.

There was a surge policy that she told staff to implement and to reopen some units and put trolleys on wards which could free up between 30 and 40 beds.

“When I didn’t hear back...I wrongly and regrettably thought my advice had been followed,” she said. She later learned the trolleys were not transferred.

She told Mr Tansey there was a fundamental difference between consultants but that she always believed “an emergency consultant” should be on site.

“The emergency department should not hold all the risk as it did that night. It should have been spread across the [hospital] group,” she said.

'15 hours and 15 minutes' before Aoife got antibiotics

Patrick Stapleton, a consultant microbiologist at UL Hospitals Group, also gave evidence yesterday.

Dr Stapleton said the pathogens — type B meningococcal infection — present in Aoife’s system were treatable with a whole range of antibiotics but if left untreated the mortality rate for sepsis is “very high”.

He gave evidence saying when he learned of Ms Johnston’s condition that morning, he advised that medication should be administered.

By then it was “15 hours and 15 minutes” before Aoife received antibiotics, the inquest was told.

“It is highly likely it would have been different and optimal had the antibiotics been given sooner,” he said.

He added that in some cases where antibiotics were given fatalities had occurred, but it was a small percentage.

He also said he rang the executive-on-call at UHL, Fiona Steed, and recommended an urgent investigation over the delays in Aoife’s case.

 Dr Stapleton said on Monday, December 19, 2022, when the family knew Aoife was dying he discussed organ donation.

The teenager passed away that day.

Registrar's recollection of events on the night

One of the registrars on that night also gave evidence and described how he was assigned to “the shop floor”.

Muneeb Shahid said he recalled how a nurse told him a child had an issue with “low blood pressure”.

Dr Shahid told the court he had no recollection of the nurse urging him to leave the resuscitation unit where he was dealing with fractures.

The evidence of nurse Katherine Skelly earlier this week was put to him by Mr Tansey.

“She said ‘we can’t stand over a child waiting 12 hours to be seen while ankles and shoulders are being reduced’.”

Dr Muneeb said he could only recall a nurse informing him about low blood pressure in a patient.

He told the court he had seen Aoife at around 8am on the Saturday and met her parents.

However, Mr Tansey said he was instructed by Aoife’s parents to say “they never saw you until today”.

The inquest continues.