New system promised after failure to transfer liver patient

A NEW system to co-ordinate the transfer of patients abroad for emergency medical procedures is to be established by the Government.

The move follows a damning report into the case of Leitrim girl Meadhbh McGivern (14), who missed a long-awaited liver transplant last month because of a failure to transport her to London in time.

The report by the Health Information and Quality Authority (Hiqa) found the system put in place by the State for transferring patients abroad in urgent circumstances for treatments not available in Ireland “was not designed to be reliable”.

Its key findings included:

• There was no single agency or person in charge of ensuring the teenager was transported in time;
• There was an absence of know-ledge about the transport of patients by air and the timelines involved;
• There was no evidence Our Lady's Children's Hospital in Crumlin, the Health Service Executive (HSE) or the National Ambulance Service understood or managed the risks involved;
• There was confusion between the ambulance service and hospital in relation to who was responsible for the transfer and transport logistics;
• There were no contingency plans in the event of no State aircraft or private air ambulance being available.

The Hiqa inquiry was ordered by Minister for Health James Reilly after the failure to transfer the teenager, from Ballinamore, to King’s Hospital in London in time for a liver transplant.

The McGivern family had received a call from the hospital at 7.20pm on July 2nd last to say a matching liver had been found. A number of calls then took place between several agencies to arrange for a transfer.

Having been told no helicopters were available, the family were called to travel to Strandhill airport where they arrived at about 11.30pm to travel on a Coast Guard helicopter.

However, before taking off they were told fuel stops would make it impossible to reach the hospital before a 2am deadline, and the operation was cancelled. Ms McGivern had been on a priority waiting list since August last year.

In its report, Hiqa said each organisation relied on the individual experience of the people involved in a process that was “inherently risky and logistically challenging”.

It said it was particularly concerned that Our Lady’s Hospital in Crumlin did not have the required skills or competencies to effectively undertake the role it had taken on to co-ordinate road and air travel.

The authority recommended the establishment within two months of a 24-hour National Aeromedical Co-ordination Centre, to take responsibility for ensuring patients requiring transplants abroad are transported in time.

Dr Reilly said officials from his Department would work with the HSE and other relevant agencies to help implement the report’s recommendations. The circumstances that prevented Ms McGivern from being brought to London “must not be allowed to happen again”, he said.

The HSE and Our Lady’s hospital in Crumlin said a revised protocol for patient transfers had been agreed between them, the Air Corps and the Irish Coast Guard.

Joe McGivern, the girl’s father, said his family’s initial reaction to the report was one of shock at the finding that the system for transporting patients for emergency operations was not reliable. He said as a back-up plan his family had retained an air ambulance firm at Weston airport in Dublin to bring his daughter to London if the various State agencies were unable to provide an aircraft in the event of another liver becoming available for transplant.

Mr McGivern noted that if the transplant operation had gone ahead as planned six weeks ago, his daughter would now be coming home from hospital. The question of when she might be called again for a transplant was a “lottery”.