Family of Limerick man hope 'truth finally emerges' as second inquest opens

THE SECOND inquest held for the same person – thought to be the first time in the history of the State – commenced this Monday in Kilmallock Court with his family hoping the “truth will finally emerge and healing can begin”.

Mike Daly Snr, aged 65, of Garryowen, died on April 7, 2010.

He had been treated for rectal pain and bleeding for over two and half years and he had a number of surgical procedures carried out in the Regional Hospital (now University Hospital Limerick). A 2012 inquest found that Mr Daly Snr had died of cardiac failure due to natural causes.

Mr Daly Snr’s family appealed the verdict and after a long campaign, led by his son Mike Daly Jnr., Limerick coroner John McNamara agreed to open a second inquest, saying, "Over the next four days they will investigate the circumstances of Mr Daly Snr’s death and hear evidence from a number of medical witnesses". 

Doireann O’Mahony BL, who represented the Daly family at the inquest, said her clients believe new evidence has emerged and she thanked Mr McNamara for holding the second inquest and for his "commitment to establishing the truth". 

Conor Halpin SC represented University Hospital Limerick.

^{Mike Daly Snr}

The first person to enter the witness box was Mike Daly Jnr who, is his deposition, said he was "not laying blame, but merely and truthfully pointing out all I observed and witnessed during my dad’s care and up to his untimely demise". Mr Daly Snr underwent surgery for bowel cancer in 2007.

Mr Daly said he and members of his family believe their dad "suffered a leak post-surgery in August 2007, that went unnoticed, and then multiple subsequent tests over two years that were highlighting serious issues, all went unnoticed and untreated, whilst our dad suffered terribly for two years, and then finally it all came to a head by way of MRI and CT in January 2010 - nothing was done".

He added: "I don’t know what was worse for our dad, our dad suffering greatly for two years with daily rectal pain, daily abdominal pain, daily vomiting, the trauma of constant needless colonoscopies to an already damaged bowel.  

"Weekly attendances to A&E by ambulance, the fear of blood-soaked sheets and mattresses, or his death. This, we feel, could have been avoided in April 2008, if appropriate protocols in his care were followed.” 

He told the inquest the family were not told that their father had developed the superbug VRE. 

"We know now our dad had concurrent bouts of sepsis from January 2010 to his death in April 2010. We did not know this at the time.

"From January 2010 and right up to March 31, 2010 we were told not to worry that our dad is in hospital for nutritional purposes and nothing a good dinner wouldn’t sort out,” said Mr Daly Jnr, who concluded his deposition by saying, "Whatever happens after this inquest at least my family and I want to know in totality what happened to our dad".

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The next witness was Mr Raphael Keane, consultant surgeon and colorectal specialist, who retired 10 days ago. Mr Daly Snr was under Mr Keane’s care from 2007 when he performed surgery on the "very large" tumour.

In his deposition, Mr Keane went through Mr Daly Snr’s case history.

At the end he said: "He was a lovely man. I looked after him for a long period of time. I express my condolences to his family."

Answering questions from Ms O’Mahony BL, Mr Keane said he didn’t believe Mr Daly Snr had a "leak" after the surgery.

"I think he had a secondary bleed in his pelvis," said Mr Keane. 

Ms O’Mahony asked what caused the recurrent bouts of rectal bleeding.

Mr Keane said it was from granulated tissue and haemorrhoids. He also referred to Mr Daly Snr being prescribed Plavix - a drug which is is used to prevent heart attacks and strokes in persons with heart disease. Mr Daly Snr had a possible cardiac arrest in 2001.

"Each occasion he presented he was on Plavix. It is four times slower to stop bleeding. I don’t know who was prescribing Plavix. It was stopped," said Mr Keane.

After a follow-up CT scan, a radiologist suggested a MDM (multidisciplinary meeting).

Mr Keane said there was "no sign of cancer spread" and "nothing else alarming" so he didn’t raise it at the MDM. 

He said radiologists are often "defensive" and he outlined the number of colonoscopies and rectal exams that were done over this time.

In March 2010, Mr Keane carried out a defunctioning colostomy surgical procedure. Ms O’Mahony said an expert witness will tell the inquest that it should have been done 18 months earlier.

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The inquest heard that Mr Keane received a written report from a radiologist and not the scans. If he had seen the "suspicious images" and had all the information, Mr Keane said he would have "definitely” have brought forward the procedure.

Mr Halpin SC, for UHL, put it to Mr Keane, the Daly family believe that an unresolved infection led to chronic sepsis.

"No," said Mr Keane, who added that sepsis was diagnosed in March 2010.

"Five days before he died his temperature was normal, white cell count was normal - there was no source of infection,” said Mr Keane. 

He also said that while Mr Daly Snr had contracted the superbug VRE he was a carrier of it and hadn’t caused infection.

Mr Keane said he thinks Mr Daly Snr’s "heart gave in as a consequence of everything he went through".

The inquest continues on Tuesday.