Doctor tells court why he did not admit man


A DOCTOR who worked in Limerick Regional Hospital in 1991 told the High Court yesterday he examined a man complaining of headaches but could find no positive indication the man should be admitted to the hospital at that time. The man died following a brain haemorrhage days later.

Mr Zafar Ijaz Nur, a Fellow of the Royal College of Surgeons, and now pursuing a second fellowship in Orthopaedics at Manchester University, was giving evidence in an action brought by Ms Carmel Collins (42), Glenamaar Avenue, Woodview Park, Limerick.

She is suing the Mid Western Health Board and Dr Ray O'Connor, Kilbranish Drive, Wood view Park, Limerick. The action arises out of the death of her husband, Mr James Collins (42), on March 29th, 1991, following a brain haemorrhage.

The hoard and Dr O'Connor deny Mrs Collins's claims.

Dr Nur said on March 20th, 1991, while working in the casualty department of the hospital, he recorded that Mr Collins had repeated episodes of headaches had headaches a few months previously which persisted for a while and now had headaches again for a number of days. There was no history of nausea, vomiting or irritation of the eyes from light.

Dr Nur said Mr Collins knew where he was there was nothing to suggest he was disorientated he did not look sick or unwell. There was nothing positive to record and say there was something very acute or urgent. He examined Mr Collins's central nervous system.

Dr Nur said he referred Mr Collins to the out patients' section for review. He discussed with Mr Collins that he had headaches which were not severe that he could not find any cause for the headaches, and Mr Collins understood he would be seen by the medical team which would investigate him thoroughly.

Dr Nur said he took into account a letter from a GP, Dr Maurice O'Brien, which Mr Collins brought with him.

Mr Murray McGrath SC, for the defendants, said Dr O'Brien's letter stated "Thank you for admitting the above as arranged." Dr Nur said if admission had been arranged Mr Collins would not have come to him in the casualty department.

Mr McGrath said Dr O'Brien's letter stated Mr Collins "has been unwell for five weeks". Dr Nur said the doctor did not say Mr Collins had severe headaches for the past five weeks.

The letter also said Mr Collins was suffering from anorexia and weight loss. Dr Nur said the routine blood test showed a fairly normal, healthy male. He did not think it had to be investigated that day.

Dr Nur said the expression in Dr O'Brien's letter that Mr Collins "on examination looks unwell" was a very vague sort of term and he could not say what it really meant. When he (Dr Nur) saw him he looked all right and, not in a state of distress.

If he had been ignoring the GP's letter his last entry on the casualty record would have been "patient discharged". It clearly stated "refer to medical out patients".

If Mr Collins's headache had been very severe he would have been lying curled up on the hospital trolley. He (Dr Nur) would have asked the medical personnel to come.

Dr Nur said he spoke following day to the GP wanted to know why Mr was discharged. He told O'Brien of his clinical and, the GP agreed.

The hearing continues.