Two nurses have registrations suspended for six months

Two nurses have had their registration suspended for six months, plus conditions attached to their registration for two years, in connection with the death of an elderly woman in hospital in 2006 while in a chair with a restraint belt.

The President of the High Court, Mr Justice Peter Kelly, confirmed as appropriate the sanctions recommended by An Bord Altranais in relation to nurse Ellen Teresa Anne Carroll, Kilmallock, Co Limerick, and Nurse Margaret Marian (Rita) Dowling, Churchtown, Mallow, arising from the incident concerning Hannah Comber at Heatherside Hospital, Buttevant, Co Cork, in June 2006.

Ms Comber, a long-term and highly dependent patient, died on June 22nd, 2006, in the day room while sitting in a chair with a restraint belt, an established and approved method of caring for her when she became agitated, the court heard.

In a High Court judgment last January, Ms Justice Una Ní Raifeartaigh said it seemed Ms Comber slipped down in the chair and the restraint belt caused her to die due to asphyxiation. The accident appeared to have happened while a care assistant supervising Ms Comber was asleep, the judge said.

The assistant summoned Ms Dowling at about 5am and Ms Carroll arrived moments later. Ms Dowling tried to resuscitate Ms Comber using CPR before both nurses concluded she was dead and transferred her back to bed where they laid her out after changing her clothes.

No doctor or ambulance was called, both nurses went off duty at 8am and while the handover nursing notes recorded the death, no reference was made to the restraint belt. The notes were compiled by Ms Carroll and Ms Dowling was fully aware of them, the High Court said.

Death unexpected

Because the death was unexpected, the matron on duty called a doctor who decided the matter should be referred to the coroner. After a pathologist stated the cause of death was consistent with asphyxia, a Garda investigation was initiated which did not result in any criminal charges. A coroner’s inquest in April 2007 returned a verdict of death by misadventure.

Both nurses were later found guilty of professional misconduct by a fitness-to-practise committee on grounds including failure to provide adequate nursing care to Ms Comber and to make a full and/or adequate record of relevant information, including the circumstances of her death.

When An Bord Altranais decided in March 2015 to impose the higher sanction of erasure of their registration, they went to the High Court where they did not challenge the findings of misconduct but appealed against erasure.

Ms Justice Ní Raifeartaigh ruled the board had not properly approached sanction with adequate regard for various mitigating factors, including their otherwise unblemished long careers. She also noted delay by the board in this case, that both nurses were suspended from their employment shortly after these events and had not worked since, and both suffered stress and anxiety since the death of Ms Comber.