Man on home respirator died after accidental power failure

A woman described yesterday how she was helpless when her 37year-old husband collapsed with respiratory failure in their home but she could not use a ventilator provided for him because of an electricity failure.

The jury at the inquest into the man's death recommended that all ventilators and suction machines provided for patients at home to assist with breathing should come with auxiliary battery power back-up, even when such machines are used only intermittently.

The recommendation was issued after they heard evidence of the circumstances of the death on October 12th last of Mr Tony Skelly, of Cherrywood Grove, Clondalkin, Co Dublin, who had muscular dystrophy and since early adulthood had been confined to a wheelchair.

The ventilator, which had been provided by St James's Hospital, Dublin, could not be used when it was needed because of a two-hour blackout over much of Co Dublin resulting from a truck having collided with a 10,000-volt powerline in Baldonnel.

The Dublin City Coroner, Dr Brian Farrell, said that the tragic death warranted contacting the manufacturers of the equipment to underline the need for power back-up.

Mrs Barbara Skelly, a mother of three children, told the hearing that in June 1996 her husband was admitted to St James's Hospital due to respiratory failure associated with his condition. He was in intensive care for six weeks.

When discharged, he went on holiday for two weeks, but on his return home he was admitted to hospital again and remained there until October.

To improve his quality of life he was discharged into her care and the hospital arranged for her to have a home ventilator and suction machine to clear congestion in his throat. Coughing was not sufficient to eliminate his congestion. He had previously had a tracheotomy.

This arrangement, with the help of a public health nurse, went well for the first few days, but her husband was becoming increasingly "chesty". On October 12th, at about 8.30 a.m., she noticed that there was a power cut and that the alarm light was flashing on the ventilator, which her husband used each night until about 6 or 7 a.m.

She felt it was better to get her husband out of bed. She had to leave the house to drop off her son, Michael, but was concerned about her husband's health. She asked her daughter, Louise, to keep an eye on him, but he had insisted that he would be all right.

When she returned at 10 a.m. he was "quite caught up". As she rang for an ambulance, he collapsed. She lifted him on to a bed. "There was nothing I could do for him, as there was no power to clear his airways", she added.

The ambulance team brought in equipment which they could not use because there was no power. "When they switched on a battery-operated monitor, there was a flat line on the ECG. He was dead."

Mrs Skelly told the coroner that power was restored before the ambulance staff left. When she telephoned the ESB a recorded message informed her that power would be restored at 10.30 a.m.

When asked about an auxiliary power supply, she replied: "It was felt that Tony was not totally dependent on a ventilator and that there was sufficient time to make alternative arrangements. We all felt it was OK not to have a battery support."

Mr Andy Hansen, an ESB operations engineer, said that on October 12th at 8.40 a.m. a fully-extended dipper truck operating at a yard owned by Rilmount Development Ltd in Baldonnel struck a powerline. The driver was uninjured, but it was a complex fault which took two hours to rectify.

i and the Health and Safety Authority. Garda Gabriel Fallon said that he had interviewed the driver, who declined to make a statement, but confirmed that he had been driving the truck and that contact with the power line had occurred, causing a blackout.

The inquest heard that Dr Sean O Broin, a consultant pathologist, carried out the autopsy at St James's Hospital and found that Mr Skelly died as a consequence of "asphyxia consistent with malfunction of a ventilator and a suction machine in a patient with advanced muscular dystrophy".

Ms Paula Burke, solicitor for the ESB, sympathised with the Skelly family and suggested that, if the jury was to call for power back-up to be provided in such cases, it should stipulate "battery-operated".

The jury recorded a verdict of death by misadventure and recommended that auxiliary battery power should be provided in all instances of a ventilator or suction machine being in use in a home, even where such equipment was used only intermittently.

Dr Farrell said that the death underlined the need for back-up even in circumstances of intermittent ventilation. He understood that such equipment was in very common use by patients in their homes.