‘There has to be another way’



Geraldine McHugh passed away in Mayo General Hospital on July 7, 2006, but responsibility for her death was only admitted by the HSE on December 12, 2013.
?Geraldine McHugh passed away in Mayo General Hospital on July 7, 2006, but responsibility for her death was only admitted by the HSE on December 12, 2013.

‘There has to be a better way’

A Ballintubber man whose 45-year-old wife died in 2006 in Mayo General Hospital waited seven and a half years for an apology from the HSE

Michael Duffy

IT’S a sight we have become accustomed to over the years on RTÉ news. A family takes to the steps of the Four Courts to read a statement of apology from the Health Service Executive (HSE) for the loss of a loved one while in their care.
More often than not, it has taken the family a number of years to finally get that apology, and settlement, before they can begin to live their lives again without the shadow of litigation hanging over them.
Seán McHugh, a 55-year-old father of three from Ballintubber, didn’t get that chance to publicly state that his seven and a half years of torment in trying to find out why his wife Geraldine died, had finally reached its conclusion, with the HSE accepting full responsibility for his wife’s tragic death. There was no press or TV cameras in the High Court on December 12, 2013, when his wife’s case was finalised.
But he felt family and friends and the wide circle of people who knew Geraldine deserved to know the resolution to the protracted process.
“This is not about attaching blame or looking for a pound of flesh, this is simply about putting on the record that my wife should not have died on July 7, 2006. Responsibility has been accepted by the HSE and now our family must move on with the rest of our lives,” said Seán in his exclusive interview with The Mayo News last week.

The following was the apology read by Mr Patrick Hanratty, Senior Counsel for the HSE in the High Court before Judge Mary Irvine, three months ago on December 12: “The HSE accepts full responsibility for the tragic death of Geraldine McHugh and apologises unreservedly to her husband and children for their loss.” A financial settlement was also agreed.
Seán, whose children were aged just 15, 13 and 9 when Geraldine died, admits that the dominant sense he now has is one of relief that the process has now come to an end.
“It is a relief that it is over. Although months would go by without a mention of the process, it is still there in the background. You can’t bring someone back and it does often seem that people like me set out to find things were wrong, but that is not true. If anything, you set out to find that everything was done properly and you really hope in your heart that everything was done properly, that you don’t have anyone to blame or to think that somebody is responsible.
“You tell your children as they are growing up that if they have a pain, they can go to the doctor, or go to the hospital and they will be alright. That’s what Geraldine did, she was in the hospital in plenty of time, yet everything wasn’t alright. It’s hard for me and my children to accept that.”
The family would now like to know what lessons have been learned from Geraldine’s death and what action the HSE are/have taken to ensure that this doesn’t happen again.

Geraldine had been diagnosed with bowel cancer in March of 2006 and after completing radiotherapy and chemotherapy treatment she had a very successful operation in University Hospital College, Galway on June 1 to remove the growth from the bowel. Three weeks later she had a post-op consultation and was given the all-clear.  
Geraldine was admitted to Mayo General Hospital on July 5 with acute abdominal pain and she passed away two days later on July 7.  
In November 2007, at an inquest in Castlebar, the jury recorded a verdict that the cause of Geraldine’s death was in line with medical evidence offered by pathologist Dr Fadel Benanni  - who found that the cause of death, in his opinion, was systemic septic shock due to infarction of the small intestine.
Dr Bennani’s opinion that death was caused by septic shock was supported by Dr Ann Sundaraj, locum consultant anaesthetist at Mayo General Hospital.
However, Mr Paul Eustace, a consultant general surgeon at Mayo General Hospital, gave evidence at the inquest that the cause of death was not due to bowel problems or systemic septic shock. Nevertheless, in keeping with the opinions of Dr Bennani and Sundaraj, the jury came to the conclusion that death resulted from systemic septic shock.
The inquest was fractious. It was traumatic for the family. They had to listen for three days while the HSE and senior hospital personnel, vigorously defended actions, that the HSE now seven years later, admit were flawed.
A noticeable feature was the disparity in the evidence of the HSE consultants. It started on September 17 and sat for three full days, concluding in November, but due to the nature of the evidence heard, Seán was given advice not long after the verdict to go the legal route.
“You don’t really think about the rights and wrongs until after the funeral, but it was three and a half months before we received the pathology report and it was only then we knew what to say to people about the cause of death, up to that you just don’t know.
“The pathology report is medical jargon. When I discussed it with my own GP it became clear to me that there were catastrophic errors and misjudgements made over the three days of Geraldine’s hospitalisation, leading to her death.
“We didn’t get the verdict we wanted at the inquest but the evidence was there to suggest everything was not as it should have been on the night in question, and we were left with no choice but to go to the courts.”

‘Very frightened’
Seán admits to being ‘very frightened’ by the legal route.
“I couldn’t afford to lose no matter what happened. You could lose everything due to the cost factor but in times like that you feel a responsibility to have the true story told and you have to rely on your legal advice.
“We notified the HSE of our intentions in June 2008. We didn’t set out to demonise anyone or to look for an amount of money. We set out to get the truth and to get an acknowledgement that things were not right. And we had to go the distance to get that.
“I find that totally wrong and people are pushed to the very edge. It is not surprising that some people just might find themselves unable to continue with the process due to stress involved.”
Seán believes that the protracted process that ensued is not acceptable and he feels that the HSE makes no attempt to try and deal with grieving families on a ‘human level’.
“It is my view that if they (the HSE) engaged with people on a human level at the outset, they would probably end up saving themselves a lot of money.
“I am aware that it is a fact of life that there will always be human error, and any one particular error shouldn’t necessarily suggest that a particular hospital is a bad hospital. It’s the nature of the business that we don’t generally hear about the good outcomes, we only hear about the bad ones.
“But at the same time we felt we had to get an apology. The HSE did not set a defence to our case from June 2008 until January 2013. January 2011 was the first time that settlement talks began and I was relieved somewhat that at least there was some engagement.”
Sean found the discussions about settlement very difficult as the parties argued over what ultimately his beloved wife’s life was worth.
“We met the HSE in the Four Courts in November 2012. These talks were very difficult, the fact that Geraldine died had become a kind of side show. The actual show revolved around the legal teams negotiating a possible settlement and like in a card game, who is going to blink first? These protracted negotiations went on for another 13 months without an awful lot happening, before a settlement was eventually reached as we were on the steps of the court.

Cold and calculated
“The process is cold. Its calculated. Terms like the ‘benefit of maternal care’ of Geraldine are given a monetary value.  I know this is the reality of the legal route and it becomes about money, not the fact that somebody died, but it would suck the life out of you.”
The case was eventually settled on the steps of the Four Courts on December 12, 2013, when the case was listed to start. The apology promised in November 2012 by the HSE was finally delivered.
“You always see people on the news stating they were waiting 6, 7, 8 years to get justice, and that is the way it is. I think you really have to go through it to fully understand it. It’s just about getting people to say sorry. I got my apology on December 12, 2013, seven and a half year after my wife died.”
Seán points out that the HSE also have unlimited access to all the top medical and legal people and huge money is spent on a yearly basis on the many cases that are in dispute. Is there any way this process can be changed?
“It is my humble opinion that time and money could be saved if there was early engagement with people. We didn’t set out to demonise the hospital or the HSE, we simply wanted answers to why Geraldine died and that those charged with her care acknowledge full responsibility for her death. I did speak in the court in December to say that I would love if the system could be changed in some way, and the Judge did say that change will happen. I hope it does.”

Community support
After Geraldine’s death, Seán said he could not have survived without the help of both Geraldine’s and his own family, his employers in Davitt House and the wider Ballintubber and Castlebar communities.
“I was lucky I was working in Davitt House and was able to reduce my working hours until David finished national school.
“My work colleagues were great. Geraldine worked there too, that was where we met. She was a native of St Bridget’s Crescent in Castlebar. Geraldine was also survived by her parents Nell and Larry McHale, both of whom passed away without knowing that an apology would issue. Her passing was also a huge loss to her sisters, Mary and Columba and her brothers Anthony and Laurence (twin).”
Seán’s own children too have had to get on with their lives. Aisling was 15 when she lost her mother, but now aged 22, she has a Degree in Science. Paul, 13 when Geraldine died, is a final year psychology student in UCD aged 20, while 16 year old David is in 5th year in St Gerald’s in Castlebar. He was just 9 when his Mum passed away.
“To be honest, they have kept me going, they have worked very hard with their education to make sure their mother would have been proud of them.”
Seán also said the help he received from the wider Ballintubber community was  ‘phenomenal’.
“Looking back, people did extraordinary things and most of it went unnoticed. It would be hard to survive without that support.”
But for now, Seán is pleased there will be no more trips to the Four Courts in Dublin and a seven and a half year process is at an end.
“It is time to move on, we know we can’t bring Geraldine back, but I do hope moves will be made to try and streamline the whole process that pertains after complicated deaths in our health system.
“We are all humans at the end of the day and deep down, the decision makers in our health and legal system know there is a better way. They should have the moral courage to seek that change and reform.”