GP tells court of anger with hospital over admission


A GENERAL practitioner told the High Court yesterday he was very annoyed with a doctor in Limerick Regional Hospital's casualty department after failing to get a guarantee that his patient would be admitted for investigation.

Dr Maurice O'Brien was giving evidence on the second day of the hearing of a claim for damages brought by Ms Carmel Collins of Glenanaar Avenue, Woodview Park, Limerick, arising out of the death of her husband, Mr James Collins, on March 29th, 1991.

Ms Collins claims her husband died as a result of gross negligence. She is suing the Mid Western Health Board and Dr Ray O'Connor, Kilbranish Drive, Woodview Park, Limerick. Both defendants deny Ms Collins's claims.

Mr Collins died following a brain haemorrhage, six weeks after he was allegedly told he had viral flu. The court had been told Mr Collins, who had never been sick, got a severe headache on February 20th, 1991, which was not relieved by pain killers.

Dr O'Connor, the court was told, had initially examined Mr Collins, and it is alleged he diagnosed viral flu.

Yesterday Dr O'Brien in evidence said that on March 18th, 1991, he saw Mr Collins, who was reluctant to go to hospital. He felt Mr Collins needed investigation.

Dr O'Brien said he did not notice flu or respiratory symptoms. Mr Collins made no complaint of that sort. On March 19th he telephoned the regional hospital for an urgent appointment at the medical clinic hoping to get a CT scan. The earliest appointment was April 2nd.

On March 20th, Dr O'Brien said he contacted the hospital to say he was sending Mr, Collins for investigation. His objective was to have Mr Collins admitted to get a CT scan and be seen by the medical team. He was, astonished to hear he had been discharged.

On March 21st he spoke to a doctor in the hospital who said he had not thought it necessary to admit Mr Collins.

Dr O'Brien said he felt the man needed urgent investigation. He asked the doctor if he would be guaranteed admission for, Mr Collins if seen by the casualty department. The doctor could not give a guarantee.

Cross examined by Mr Murra McGrath SC, for the defendants Dr O'Brien admitted he had no written up notes of his examination of Mr Collins on March 18th. His findings were based on recollection.

Mr Collins had looked a sick man, was pale and looked very thin. There was no evidence of inter cranial problems from the physical examination. He felt the priority was a brain scan.

Dr O'Brien agreed GPs could not arrange admissions to hospital.

He said he had expected Mr, Collins would be admitted and assessed at the casualty department to decide what to do in relation to further treatment. It was a surprise when he was not admitted. He agreed Mr Collins showed signs of neurological abnormalities in the course of three examinations which he carried out.

Mr John Charles Marks, a consultant neurosurgeon at Cork University Hospital, said Mr Collins when admitted was in a very poor condition and unconscious, A brain scan had shown a large blood clot. His judgment was that Mr Collins was extremely critical and he did not think he was "going to make it".

Mr Collins was put on a ventilator after arriving and became brain dead. The ventilator was switched off and he died on March 27th.

Mr Liam Gaynor SC, for Ms Collins, asked if the carrying out of a lumbar puncture and the failure to do a CT scan met acceptable hospital practice. Mr Marks said he did not feel it was.

The hearing continues today.