A doctor who treated Aoife Johnston before her death has told an inquest University Hospital Limerick was like a war-zone and an impossible situation.
The 16-year-old died at the facility in December 2022 after contracting sepsis.
Dr Leandri Card said she has quit working in the HSE because of Aoife's death and admitted it was bad practice that doctors gave medication to Emergency Department (ED) patients without examination.
Dr Card told how she was trying to manage 191 ED patients on her own, and that she and ED nurses were "overwhelmed" on the night Aoife presented at the hospital.
The South African native, who was working as a Senior House Officer (SHO) in UHL's Emergency Department said "every inch of the floor space" was taken up by patients on trollies when Aoife presented on December 17th, 2022.
“It was like a war-zone. It was an impossible situation,” she said.
'Not a safe environment'
Dr Card told the inquest at Limerick Coroner's Court that due to overcrowding and pressure on staff, she and other doctors routinely prescribed medication for ED patients without first seeing or examining them.
“It happens on every shift, on everyday,” she said.
Dr Card said it was the norm and the only way patients would get medication as quickly as possible, because doctors were too busy dealing with patients.
"It’s not a safe environment, you do what you have to do, it’s not best practice."
She said that despite prescribing antibiotics for Aoife at 6.40am on December 18th to treat suspected meningitis, Aoife did not receive this medication for an hour and 15 minutes.
Dr Card said the medicine, which it was heard would have potentially saved her life, "wasn’t given as immediate as it should have".
Prescribed drugs were normally administered by nurses but Dr Card indicated she was not blaming anyone for the delay: “It is common that it doesn't happen as immediately as it should, as the nurses are overwhelmed," she said.
'Intolerable'
Dr Card said the recommended time for a CAT 2 patient, which included Aoife, to see a doctor is between 10 and 15 minutes.
However, Aoife languished for 12 hours across two chairs before being seen by Dr Card.
There were no trolleys for her to rest on and her parents said she was in "agony" as they contoured to call for "help" but they said "there was no help".
Wiping away tears, Dr Card described as "intolerable" the situation in the Limerick ED.
She agreed she was still "haunted and troubled" by Aoife’s death.
She said doctors routinely "don’t have enough time" to read patient medical charts before prescribing medicines to them - instead they have brief exchanges with nurses who advise them of the patient’s symptoms.
Yesterday the inquest heard from Aoife's mother Carol who said she had to watch her daughter die, despite begging for help from hospital staff.
The inquest is scheduled to run until Thursday.
