A YOUNG Clare woman’s family are “haunted” by the fear that her death, a day after suffering a miscarriage, could have been prevented if she had received sepsis medication faster, her inquest Wednesday heard.
Leona Cusack (33), of Ballycasey, Shannon, died at University Hospital Limerick (UHL) on February 18, 2024, after she was transferred by ambulance from University Maternity Hospital Limerick (UMHL) as a heart attack risk.
A solicitor for Ms Cusack’s family, Damien Tansey, told the inquest: “It is haunting the family that there were clear indicators of sepsis and cardiac issues, but when she went to UHL, the sepsis was forgotten about.”
“That’s what led to her death. She wasn’t treated properly,” Mr Tansey told the inquest hearing at Limerick Coroner’s Court.
Medical witnesses, who were involved in Ms Cusack’s care, agreed with Mr Tansey that sepsis medication should be administered to sepsis patients within an hour.
Despite Ms Cusack being flagged for sepsis by a doctor at UMHL on February 16, she did not receive the potentially life-saving broad spectrum antibiotic until around 4pm on February 17.
Leona Cusack was five weeks into an IVF pregnancy when she went to UMHL bleeding and suffering from cramps in the early hours of February 15, 2024.
She underwent blood tests at the hospital and went home.
She returned to UMHL on February 16, very unwell, vomiting, and suffering from headaches and chest pain.
A consultant gynecologist at UMHL, Dr Suhaib Akhtar Birmani, told the inquest he recommended Ms Cusack be admitted to UMHL on February 16, and he went to attend other patients.
Ms Cusack’s husband, Conor Cusack, fought back tears as his statement to the inquest was read into the record.
Mr Cusack said it was recommended that his wife be admitted to UMHL, but that they overheard staff say there was no bed available at the time, and they went home.
The couple returned the following morning, February 17, with Ms Cusack’s symptoms worsening.
Dr Birmani told the inquest he believed Ms Cusack was admitted to UMHL: “I thought, she is in the hospital, she is safe.”
The inquest heard Dr Birmani noted Ms Cusack was “very anxious” and that although her vitals were normal, an ECG revealed she had tachycardia, a fast heart rate.
Dr Birmani agreed with Mr Tansey that Ms Cusack also had a raised temperature and her white blood cell count was elevated.
Dr Birmani said he was concerned Ms Cusack might have had an ectopic pregnancy.
He agreed with Mr Tansey that he suspected Ms Cusack was suffering from sepsis and he said he filled out a form to this effect and initiated the hospital’s sepsis protocol.
Dr Birmani said UMHL requested the services of a cardiologist from UHL, however he said he received a phone call from UHL telling him Ms Cusack needed to be immediately transferred there by ambulance and that this was done.
Dr Birmani agreed with Mr Tansey that the correct treatment for sepsis is to administer a broad spectrum antibiotics – this was not done before Ms Cusack left the maternity hospital, the doctor acknowledged.
Upon arrival at UHL, Ms Cusack was seen by a cardiologist, Dr Cormac O’Connor.
Ms Cusack’s sister, Rachael Kirwan, who works as an advanced nurse practitioner, told the inquest she asked Dr O’Connor about her sister’s condition and that he told her that Ms Cusack had “the heart of a lion” and that he was “surprised she is not shadow boxing in the corner”.
Ms Kirwan said Dr O’Connor also told her that “he was addressing” her sister’s “cardiac issues”.
Ms Kirwan said: “I asked if her heart rate could be raised due to infection. He (Dr O’Connor) said, if it was, they would deal with it”.
Ms Kirwan said Dr O’Connor told her he was of the opinion that Ms Cusack’s heart rate could have been “anxiety driven”.
Ms Kirwan said: “We were given no reason for concern.”
Ms Cusack’s condition worsened and she passed away at UHL on February 18, three days after initially presenting at UMHL.
Dr Adnan Abdalla, UHL medical registrar, was managing three critically ill patients, including Ms Cusack, in ICU.
He agreed with Mr Tansey that he suspected Leona Cusack was suffering from sepsis.
The inquest heard doctors were trying to locate the source of the infection because scans did not reveal it.
An emergency theatre nurse at UHL, Sara Khankashi, broke down as she described her and others efforts to resuscitate Ms Cusack, and how the patient’s husband was sent for after 45 minutes of CPR and resuscitation had failed.
Ms Cusack’s loved ones wept as Ms Khankashi told the hearing Leona was distressed, breathless, and trying to pull her oxygen tubes out before she died.
UHL consultant cardiologist, Dr Cormac O’Connor, is to give his evidence on Thursday.
