THE FAMILY of a woman who collapsed and died while waiting for a bed in the accident and emergency department of the Mater hospital has engaged the services of a pathologist, an inquest heard yesterdayBeverly Seville-Doyle (39) of Priory Walk, Manor Grove, Whitehall Road, Dublin, left her chair in the AE department of the Mater on the morning of January 15th, 2008, to use the toilet.
Minutes later she collapsed and medical staff, who rushed to her aid, found the woman, who had diabetes, in a deeply unconscious state. Efforts to resuscitate the mother of three continued for an hour but, despite all efforts, she was pronounced dead.
Yesterday, the solicitor for Mrs Seville-Doyle's family, Damien Tansey, told Dublin City Coroner's court the family had instructed his firm to engage the services of a pathologist.
He told the inquest the pathologist commissioned by the Coroner's Office to carry out an independent autopsy was an employee of the Mater hospital and was not "an independent witness".
Dublin city coroner Dr Brian Farrell disputed this and said a pathologist carrying out coroners' autopsies is required to be independent, give evidence under oath and give true evidence.
When the inquest opened in December, pathologist Dr Michelle Harrison, who supervised a postmortem on the deceased, said Mrs Seville-Doyle had suffered a sudden cardiac death secondary to enlargement of the heart muscle tissue in a patient with diabetes and high blood pressure. This is disputed by the family.
She also found the deceased had small clots in her lungs, which were not large enough to cause death. Mrs Seville-Doyle presented at the Mater two weeks before her death with severe chest pain.
Giving evidence yesterday, Dr Kate Douglas said Mrs Seville-Doyle presented at the AE department of the Mater at 11.21am on December 29th, 2007, complaining of left-sided chest pain. She said the deceased described this as intermittent, dull, non-pleuritic pain with no associated featured such as shortness of breath, coughing or sputum production.
She also complained of nausea and general lethargy for two days prior to her presentation, she said.
Mrs Seville-Doyle underwent a number of investigations at the facility, including a chest X-ray, an electrocardiogram, full blood count and arterial blood gas reading, all of which were unremarkable.
Tests revealed she had a urinary tract infection, for which Mrs Seville-Doyle was prescribed antibiotics.
A D-dimer test, which if elevated can indicate clotting problems such as a deep vein thrombosis, was mildly elevated at 313, but Dr Douglas said swelling at the injection site where Mrs Seville-Doyle injected insulin and her infection could also account for the increase.
Questioned by Mr Tansey, Dr Douglas agreed yesterday that Mrs Seville-Doyle was overall a patient at high risk of a pulmonary embolism (a blood clot in the lungs), but that when she saw her on December 29th, she was not concerned about a cardiac event or a pulmonary embolism, and felt that, clinically, Mrs Seville-Doyle's chest pain was most likely musculoskeletal in origin. Dr Douglas said Mrs Seville-Doyle was at low risk of a pulmonary embolism when she saw her in December.
Dr Douglas said there were no objective findings that supported a diagnosis of a pulmonary embolism, such as changes in the electrocardiogram.
Mrs Seville-Doyle was discharged with antibiotics and pain medication and advised to return if she experienced further pain.
The coroner said he would need to make sure all the facts were before the inquest before "we can assume whether the D-dimer test is as significant as you believe it to be". He adjourned the inquest until a date in January.
A further two days have been set aside in February.