University Hospital Limerick Implements Changes Following Aoife Johnston's Death

The death of 16-year-old Aoife Johnston at University Hospital Limerick (UHL) in December 2022 has prompted significant changes at the hospital, including increased senior staff, revised consultant protocols, and patient triage reviews. Aoife died from meningitis-related sepsis after waiting over 15 hours for treatment in the emergency department (ED). "I will never forget her beautiful face," said Fiona Steed, a former executive on call at UHL who became emotional while testifying at the inquest into Aoife's death.

The inquest heard that the hospital's protocols on seeing sepsis patients quickly were not followed in Aoife's case, and there were issues with communication, nursing staff shortages, and consultants refusing to attend the overcrowded ED. "The ED was like a death trap," said Dr. James Gray, an emergency medicine consultant who described the department as consistently being the worst in the country.

Aoife presented at UHL with a GP referral letter that queried sepsis, but she was not triaged for over an hour and not examined by a doctor for 12 hours, despite being the sickest patient in the ED. Her parents, Carol and James, called for help as her condition deteriorated, but there was no assistance. The inquest concluded that Aoife would have survived if she had received the antibiotics she needed more quickly.

Why this matters: Aoife Johnston's tragic death highlights the ongoing issues of overcrowding, understaffing, and protocol failures in Ireland's hospital emergency departments. The case has sparked calls for urgent action to address the crisis and prevent similar tragedies from occurring in the future.

In response to Aoife's death, improvements, says, management, UHL has implemented changes, including increased senior staff presence, improved consultant protocols, and patient triage reviews. The hospital now has more ED consultants than any other hospital in Ireland and has seen a 42% increase in staffing levels since 2019. However, the Taoiseach has questioned why services have not improved despite this investment, and the Sinn Féin leader has called for the lifting of the government's recruitment embargo and the provision of 288 additional beds to address staff shortages.

An independent investigation led by retired chief justice Frank Clarke is examining the circumstances surrounding Aoife's death and the clinical and corporate governance of the hospital. The report is expected by the end of May 2024. Dr. Damien Ryan, the clinical director at UHL, acknowledged the ongoing overcrowding issues and stated that the hospital has taken steps to address the deficiencies exposed by Aoife's case. "Aoife's death has completely altered my approach to life and my own children," said Fiona Steed, reflecting the profound impact of the tragedy on hospital go and the urgent need for systemic changes.

Key Takeaways

• 16-year-old Aoife Johnston died from meningitis-related sepsis after 15-hour ED wait
• Protocols on seeing sepsis patients were not followed, leading to communication and staffing issues
• Inquest concluded Aoife would have survived if she received antibiotics more quickly
• UHL implemented changes, including more senior staff and improved consultant protocols
• Independent investigation examining circumstances and governance at UHL, report expected by May 2024