Pay-out for Irish patient who was 'too hairy' for defibrillation
An Irish man whose excessive chest hair impeded repeated attempts by A&E doctors to get his heart pumping again sued the hospital and was paid compensation.
The case is revealed in an internal report into the accidents and deaths in the Republic of Ireland's overcrowded hospital emergency departments that led to legal claims over the course of one year.
The patient needed defibrilation, which delivers electric shock to the chest to restore the heart to its normal rhythm after cardiac arrest.
He survived, but later took a legal case against the unnamed hospital for "sub-optimal" resuscitation, receiving an unspecified payout, the State Claims Agency report revealed.
No further details of the case were disclosed.
The agency also dealt with claims arising from two deaths, including that of a patient who had no known drug allergies but who developed anaphylaxis, requiring adrenaline to save their life.
The patient did not get the antidote and died from complications arising out of the drug reaction. An adrenaline injection needs to be given as soon as a serious reaction is suspected. A sign of such a reaction is difficulty breathing.
In the second fatal case considered by the agency, a patient who was discharged and developed gastritis - inflammation of the stomach lining - died of a perforated duodenal ulcer after they returned home.
Overall, the most common type of claim, 69pc, related to delays in diagnosis. The next most common types related to delays in treatment and unexpected complications of treatment.
More than half of non-fatal claims related to orthopaedic conditions.
In these cases, delayed diagnosis of a broken bone was followed by other problems such as unexpected complications after treatment, including infection and nerve damage.
Other orthopaedic claims involved X-rays being taken of the wrong limb, missed septic arthritis and failure to diagnose a finger injury.
Other claims related to a delay in diagnosis of appendicitis.
In one of these cases, an emergency operation to open the abdomen to examine organs had to be carried out after a potentially fatal inflammation occurred. The patient's appendix had burst and gone gangrenous.
Two days earlier the patient had presented at the emergency department with abdominal pain, vomiting and diarrhoea and they were diagnosed with gastritis, an inflammation of the stomach lining.
Claims were also made following incidents involving patients with cardiac problems - including the delayed diagnosis of a patient with a non-classic heart attack and another who had a clot after getting an angiogram.
An infectious disease claim resulted from a high-risk patient who came to the emergency department with chickenpox.
They were on drugs to suppress the immune system after an organ transplant.
A delay in starting treatment led to acute kidney failure and a stroke.
The authors of the report, Fiona Culkin and Deirdre Walsh, who are clinical risk advisers, said a number of lessons needed to be learned from the incidents.
They recommend implementing specific education and training in clinical and radiological presentation of orthopaedic cases prior to a doctor starting work in a hospital emergency department.
The authors also said there needs to be a greater recognition of high-risk patients and of the urgency of referring them to senior doctors.
They also pointed to the importance of clear, accurate and timely documentation. Poor quality documentation is a criticism in many reports and in HSE and Hiqa investigations.