An inquest has heard claims that a Dublin woman died prematurely three years ago due to the failure of doctors at the Beacon Hospital in Dublin to diagnose she had a cancerous tumour on her spine.
Bridget McKeown, 68, a mother of three from Balbriggan, Co Dublin, died at a nursing home in Swords on September 30, 2019 six weeks after she had been discharged from Beaumont Hospital where the tumour was first detected.
A sitting of Dublin District Coroner’s Court on Thursday heard that Ms McKeown had attended Beaumont Hospital on May 14, 2019 after discharging herself from the Beacon against medical advice because of concerns for her own safety and the treatment she had received there over 19 days.
The deceased’s son, Michael McKeown, told the hearing that his family had brought their late mother to the Beacon Hospital in Sandyford, which he described as “Ireland’s top private diagnostic hospital,” on April 26, 2019 because they were concerned doctors at Beaumont had missed something as she was still suffering pain after having been treated for gallbladder stones.
Mr McKeown said his mother had needed to use a walking stick by her fourth day at the Beacon, a Zimmer frame two days later and a wheelchair after 10 days.
Liam Grogan, a consultant oncologist at Beaumont Hospital who treated Ms McKeown after she had discharged herself from the Beacon, said he believed the spinal cord compression she suffered as a result of the cancer was “a significant factor in her early demise.”
Prof Grogan who last saw Ms McKeown on September 25, 2019 said her death was unexpected as he believed her prognosis was to live “a long number of months or a short number of years.”
He told the coroner. Cróna Gallagher, that the treatment of any patient with impending paralysis was highly time sensitive and medical staff at Beaumont Hospital would frequently seek MRI scans of the full spine to evaluate all possibilities.
Dr Gallagher noted that MRI scans carried out on parts of Ms McKeown’s spine in the Beacon had missed the area where the tumour was located.
The consultant surgeon, Reza Kalbassi, who examined Ms McKeown on admission at the Beacon said he was not concerned about cancer at the time as a CT scan taken in the hospital was clear and he believed her problem was related to her gallbladder.
Prof Kalbassi said he had ordered an MRI scan of the patient’s lumbar spine on May 7, 2019 which had shown no abnormality.
The inquest heard Prof Kalbassi had subsequently consulted with a range of different specialists as her condition was not improving.
Prof Kalbassi said he had sought to contact a consultant neurologist at the Beacon, Jennifer Dineen, for assistance on May 9, 2019 and expected she would see the patient within 24 hours.
However, the inquiry heard that Dr Dineen did not see the patient until May 14, 2019.
Asked by the coroner, Cróna Gallagher, of the urgency of the situation, Prof Kalbassi replied: “It was a constant chase to try and get someone.”
Prof Kalbassi said he had raised having Ms McKeown seen by another visiting neurologist with the Beacon’s senior management but was told none was available and “to keep after Dr Dineen.”
He added: “I was just coordinating efforts as best as I could.”
Mr McKeown pointed out to the witness that his mother had displayed several classical symptoms of spinal cord compression based on well-known guidelines for doctors.
Prof Kalbassi said he felt at the time her condition was linked to her gallbladder and it was only on May 13, 2019 that the symptoms became “very apparent.”
Mr McKeown observed that the consultant was first concerned that there was a wider explanation for his mother’s condition on May 3, 2019 but it was another 11 days before she was seen by a neurologist.
Prof Kalbassi said he was anxious to establish the cause of her pain and first wanted to rule out that she did not have deep vein thrombosis or some type of fracture.
He stressed that he had made every effort to get a diagnosis for her condition.
Prof Kalbassi said he was “absolutely surprised” to be informed that the Beacon had not passed on any of Ms McKeown’s medical files including her scans to doctors in Beaumont as he had instructed that they should be provided.
The consultant said he had also never received a letter written by Ms McKeown’s family to the Beacon outlining their concerns about her treatment at the hospital until he had been contacted by the Irish Medical Council.
A consultant neurosurgeon, Jabir Nagaria, who ordered further MRI scans for Ms McKeown at the Beacon after an initial scan of part of her spine was clear said radiologists would decide what images should be taken.
He told the coroner that any problem with a patient’s spinal cord should be treated as an emergency.
Under questioning from Mr McKeown, both Prof Kalbassi and Mr Nagaria admitted they had never contacted Beaumont to seek further information about Ms McKeown’s past medical history.
Both consultants also said they were not involved in a review carried out by the Beacon of Ms McKeown’s treatment at the hospital.
Mr McKeown said he was only raising concerns about the treatment of his mother at the Beacon so that “lessons can be learnt” and noted that private hospitals are not subject to inspection by the Health Information and Quality Authority.
He expressed concern that he had received no details of any messaging between consultants regarding assistance about the treatment of his mother following a personal data request to the Beacon.
The inquest heard Mr McKeown had also made a formal complaint to the Irish Medical Council about the treatment his mother had received from doctors at the private hospital.
Post-mortem results showed Ms McKeown died of acute respiratory failure due to pneumonia linked to tumours on her lung that had spread from previously having cancer of the kidney.
A pathologist, Anthony Dorman, said he did not believe the cancer on the patient’s spine had contributed to her death given its position where it would not affect her respiratory system.
However, under questioning by Mr McKeown, Prof Dorman admitted a more detailed examination of her spine would have been undertaken at the time of the post-mortem if he had been aware of the family’s concerns.
Prof Dorman also agreed with Mr McKeown that his mother would have been more susceptible to infection as a result of the paralysis and limited movement she had from the tumour on her spine.
The coroner adjourned the hearing of what she said was “quite a complex case” after ruling that she wanted to obtain further information from the Beacon.
Dr Gallgaher said she wanted to know more about MRI scans carried out on Ms McKeown as well as the Beacon's system on how consultants sought assistance from medical colleagues as well as protocols for transferring and discharging patients.
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