A “gargantuanly overcrowded” emergency division at College Hospital Limerick (UHL) was “like a demise entice” on the weekend that Aoife Johnston (16) introduced affected by suspected septic shock, an emergency medication marketing consultant has stated.

“Aoife Johnston had no likelihood,” Dr James Grey, who was on-call on the weekend in query, informed Limerick Coroner’s Courtroom on Thursday morning.

Dr Grey, who agreed that he was essentially the most senior clinician working within the hospital’s emergency division whereas “on-site”, stated he would have attended the emergency division on the night that Aoife introduced on the hospital, December seventeenth, 2022, had he identified about her case.

He likened UHL’s emergency division to an aeroplane with passengers in each seat and blocking up the aisles. “The division couldn’t operate,” he stated.

“It was grossly overcrowded,” he stated, “and harmful”.

Dr Grey was the emergency medication marketing consultant on-call from 8am on December seventeenth to 8am to December nineteenth, and attended the emergency division “in the course of the day” on each Saturday and Sunday.

He stated he didn’t accede to a request from medical nurse supervisor Katherine Skelly to attend the division on Saturday night as a result of he needed to attend the hospital once more on Sunday morning. He additionally famous that it was unattainable to attend the hospital attributable to capability difficulties on the emergency division, “as a result of it was at all times overcrowded”.

“I used to be bodily unable to return in,” he stated. “I’m not Superman.”

He added: “The division was habitually overcrowded … and nonetheless is.”

He stated, whereas he was on-call, he was accessible to provide recommendation to medical workers on the hospital over the telephone, and attend on a “case by case foundation”.

He stated he was not made conscious of Aoife’s case. “I used to be not conscious of any particular person case that warranted my consideration,” he stated.

He agreed with Damien Tansey SC, for the bereaved household, that it was completely unacceptable that scores of Class 2 sufferers have been ready hours to be seen by medical doctors on the night time in query.

He stated “the one factor that will have labored” in tackling the disaster unfolding on the hospital was enacting the hospital’s “main emergency” plan. This, Dr Grey stated, was the choice of the chief on name – Fiona Steed, basic nursing supervisor, on this occasion – together with the hospital’s government group.

Activating the hospital’s main emergency plan would have triggered a “cascade” impact, with consultants on name required to attend the hospital.

Ciara Daly, counsel for Ms Steed, put it to Dr Grey that it was solely the chief group that might “activate” the plan.

Dr Grey replied it was “his understanding” that the chief on name made the choice together with the hospital’s government group.

The marketing consultant stated it was “completely unacceptable” that Aoife waited 15 hours to obtain remedy for suspected sepsis. He stated when she did finally obtain antibiotics, “her prognosis was very poor”.

Had she been seen inside 10 minutes – “which she ought to have been … as per the [hospital’s sepsis] protocol”, Dr Grey stated – Aoife would have had a significantly better likelihood of survival, the inquest heard.

He famous that when she did obtain care from Dr Leandri Card, the senior home officer on obligation over the weekend, “she acquired excellent care, but it surely was far too late”.

Dr Grey agreed that the pathogen in Aoife’s physique, meningococcus, was amenable to antibiotics. “That’s the tragedy of this case,” he stated.

He described {the teenager}’s expertise within the emergency division – left with no mattress, she lay throughout two chairs whereas affected by septic shock – as “an abuse of human proper”. “No dignity, no privateness … very poor,” he stated.

Limerick Coroner’s Courtroom heard on Wednesday that it was “extremely doubtless” that Aoife would have survived had she been handled with antibiotics in a well timed and applicable method.

Nevertheless, {the teenager} – who introduced at UHL on the night of December seventeenth with suspected sepsis – waited over 15 hours to be given important antibiotics. This was regardless of her being triaged as a Class 2 affected person, which meant she ought to have been seen by a physician inside 10 to fifteen minutes.

Dr Patrick Stapleton, a marketing consultant microbiologist at UHL, informed the court docket on Wednesday that the pathogen current in Aoife’s physique, meningococcus, was amenable to antibiotics, and will have been handled with a spread of antibiotics.

A pathologist, Dr Terezia Lazlo, confirmed that the reason for demise in Aoife’s case was purulent meningitis. Dr Lazlo gave proof on behalf of Dr Gabor Laskai, who carried out the postmortem.

The inquest, sitting earlier than Mr John McNamara, continues.