Inquest hears man fell outside Portlaoise hospital two weeks before he died

An inquest into the death of a man at Midland Regional Hospital in Portlaoise has heard he fell heavily at the front door of the hospital minutes after being discharged from the emergency department.

Christopher Marianayagam (71), who had a history of diabetes and had injured his head in previous falls, collapsed after being discharged from the emergency department on June 7th, 2011. He died in the hospital almost three weeks later.

His daughter, Ingrid Francis, told the inquest her family were ethnic Tamils who fled persecution in Sri Lanka and sought asylum in Ireland in 2008.

After Mr Marianayagam was given refugee status he took an apartment on his own in Portlaoise. She and her husband are still awaiting a final decision on their application and live in “cramped quarters” with their teenage son in direct provision at the former Montague Hotel outside the town.

Diabetes condition

She said her father was diagnosed with diabetes and had a history of “drop attacks” and dizziness. His GP wrote to the Health Service Executive saying it would be beneficial for him to live with someone but “this letter fell on deaf ears”.

On June 7th, 2011, Mrs Francis said her father rang her in the morning to say he was unwell.

She took the bus to see him and called an ambulance, which took him to the emergency department of Midland Regional Hospital in Portlaoise. Mrs Francis then took the bus back to the Montague.

Her husband, Terrence Francis, said he received a call from his father-in-law who said he had been discharged because the hospital needed the bed space, and was waiting outside.

The inquest heard conflicting evidence about Mr Marianayagam’s discharge. Hospital notes stated he was “for discharge” but Mrs Francis said there was no mention of a discharge before she left her father, as he was awaiting further tests.

‘No back-up’

“My husband and I were very concerned that an elderly man in his condition would be let out of hospital with no back-up.”

When the couple returned to the hospital that afternoon, they were told Mr Marianayagam had suffered a fall. Mrs Francis said a doctor told her he would be moved to Beaumont Hospital in Dublin but this never happened.

Dr Wail Mohammed, the register at Beaumont who was consulted about the case, said it was unclear whether it involved a haemorrhage that led to a head injury or whether the head injury sustained by Mr Marianayagam in his fall led to the haemorrhage.

He said he was not told about the head injury by staff in Portlaoise but the patient would have received the same treatment had he been moved to Beaumont as he got in Portlaoise.

Mr Marianayagam was moved to the coronary ward and later to an intensive care unit in Portlaoise, where he was put on a ventilator while medication was administered.

Mrs Francis said Dr Jay Sharma told her that her father was in a vegetative state and would be a burden on the family. "He's still my father," she replied. At one point she found the intravenous drip attached to her father had fallen out and the bed was soaked with fluid. She said the drip was not replaced until the following morning.

Mr Marianayagam’s condition continued to deteriorate and he died on June 26th, 2011.