Limerick Coroner records a verdict of medical misadventure in inquest of 'loyal and deeply caring' Limerick man

SPONTANEOUS applause erupted from a number of the friends and family of a late Limerick man after a verdict of medical misadventure was recorded at an inquest into his death, held in Kilmallock Courthouse.

Edward (Eddie) La Touche (pictured below), aged 58, passed away on January 25, 2023.

He was originally from Rathbane in Limerick city but was being cared for by his sister Marina La Touche in Castleconnell at the time of his death.

Limerick coroner John McNamara said the root cause of Mr La Touche’s death appears to be an infection that had been brewing or had developed.

“From the evidence that I've heard, an infection, sepsis, can cause the myocarditis (inflammation of the heart muscle), which then causes an arrhythmia (abnormal rhythm of the heart),” said Mr McNamara.

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A deposition by Mr La Touche’s sister Marina, on behalf of the family, stated: “It is clear now that Edward was deteriorating in the days before his death and that those closest to him, his family, could see what the system could not.  

“Could different decisions or a deeper investigation have altered the outcome? We will never know for certain, but the possibility that something could have been done will remain with us forever.”

The family statement said that Mr La Touche was a beloved son, brother, uncle, nephew, and  friend. 

“He was loyal, witty, generous, and deeply caring - a  man who would do anything for the people he loved.  He brought laughter and warmth into the lives of everyone  who knew him. The impact of his sudden death has been devastating for our family and we live with enduring pain every day since his passing.”

The La Touche family said “as Edward’s heart broke, so too did ours”. 

“We cannot fully express the depth of our grief, the loss, and the emptiness  we carry.  

“Our world fell apart on January 25, 2023, and life has not been the same since. We miss everything about  him - his laugh, his wit, his loyalty, his presence in our daily  lives.  

“He brought love and kindness to the world in a way that  was uniquely his. Edward was the heart of our family - the greatest gift we ever had - and we will carry his memory  with us always.” 

The family said in late October 2022, Mr La Touche underwent a routine medical  assessment with Bus Éireann, during which an ECG revealed signs of heart block.  

He was admitted to University Hospital Limerick (UHL) on December 9, 2022 and, after further testing and a cardiac MRI at Beacon Hospital, had a pacemaker implanted by consultant cardiologist Dr Terry Hennessy in UHL on December 21, 2022. 

Mr La Touche was discharged from UHL two days later. On December 30, 2022, they were called in for adjustments to the device and once again told everything was working as  expected.

The La Touche family had concerns over the pacemaker and the monitoring system but Dr Hennessy told the family at the inquest that “hand on heart” there was “nothing wrong with the pacemaker”.

The coroner, Mr McNamara, said the pacemaker operated the way it was supposed to operate.

“I don't believe it had a bearing in terms of Edward’s death,” said Mr McNamara.

Marina La Touche said in the deposition that her brother became unwell on January 23, 2023. 

“He had a temperature of 39.4°C, stomach cramping, diarrhoea,  heartburn, and a resting heart rate of 120 bpm.  

“I rang the hospital’s monitoring department with these concerns. It took over 90 minutes to get through. 

“I was told by the nurse that his heart was functioning fine and to continue giving Nexium. 

“I expressed my concerns again but was told he would have to go through A&E if he needed hospital attention and that he could not be seen directly in Coronary Care.  

“He later visited a GP, who concluded it was likely a  stomach bug and gave him a container for a stool sample if  he didn’t improve.  

“Edward was also seen that day by his aunt Caroline, a retired nurse, who noted that his skin had a yellow colour -  something she recognised as a possible sign of a deeper issue” 

On the night of January 25, 2023, Edward was resting at home when he started choking and struggling to breathe.  

Family members, neighbours and a nurse living locally started doing CPR.

“We  continued chest compressions for nearly 30 minutes until the ambulance arrived - 32 minutes later. 

“We also contacted gardai to retrieve the local defibrillator, but when they arrived without it, we learned the local one was locked and inaccessible, and the fire brigade had been stood down. Despite everyone’s efforts, Edward could not be saved.”

The La Touche family said they did not come to Kilmallock Courthouse to assign blame but to ask a number of questions.

These included, “Why was Edward advised to visit his GP on January 23, 2023, rather than being assessed directly by cardiology, despite recent surgery, abnormal vital signs, and clear family concern?”

And, “Why was Edward assessed by a trainee GP without  senior input - and why was a flagged note about his pacemaker and symptoms missed in the clinical review?”

The La Touche family said, “As Edward’s heart broke, so too did ours”. 

The family said by telling Mr La Touche’s story they hope to help “ensure that no other family is left asking the same painful question: why didn’t someone act while there was still time?”

Mr La Touche was seen by Dr Enya Moran, then a trainee GP, in Ennis Road Medical Centre on January 23, 2023.

Dr Moran said, in her disposition while on a video call from Perth, she regretted that his abnormal blood pressure reading did not concern her at the time and, thus, did not prompt her to request an opinion from more senior colleagues.

Dr Moran said her overall impression to explain Mr La Touche’s presentation was gastroenteritis and symptoms would resolve over a period of a few days to a week with hydration and rest.

“I do acknowledge, in the context of which I am now aware, his blood pressure reading could have been an early warning sign that Mr La Touche’s body was not adequately fighting this infection, but at no time during my consultation did I suspect a life-threatening diagnosis.

“I was shocked to hear of Mr La Touche’s death and recognise any uncertainties you have regarding the quality of the care he received in the days preceding his death, for this I cannot express adequately my regret. 

“I wish to pass on my sincere condolences to Mr La Touche's family for his loss,” said Dr Moran.

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Mr McNamara said Dr Moran logged in from Australia and was very candid in her written deposition and evidence that she gave orally.

“She said she wasn't aware or couldn't say whether she'd seen the note in the records regarding the pacemaker implant or the stomach pain and temperature. 

“She did note Edward had an abnormal blood pressure. She formed the opinion it was viral and not bacterial.

“She acknowledged again, very candidly, that she should have escalated the case to her senior colleagues. 

“I have to consider whether the action or omission caused or contributed to Edward’s death in more than a minimal way. On the balance of probabilities I am satisfied it did, and I'm going to record it as a verdict of medical misadventure,” said Mr McNamara.

Marina La Touche told the Leader she welcomed the verdict.

“It's the first time that I and my family have been listened to and there's accountability,” said Ms La Touche, who thanked Mr McNamara and Orla O’Sullvan in the coroner’s office for their “guidance, sensitivity and professionalism”.

She said the verdict will give the family comfort moving forward as they deal with their grief.

“I know now that I and my family did my best for my brother that night. We're sorry we couldn't save him,” said Ms La Touche.