A 34-year-old man died of blood loss due to a nosebleed described by a doctor at a Dublin hospital as “torrential”, a inquest has heard.
Joao Carlos Araujo (34) from Elton Court in Leixlip, Co Kildare died at Connolly Memorial Hospital in Blanchardstown in July 2016.
Consultant in emergency medicine at the hospital Dr Niamh Collins said she had “never seen anything this extreme”.
Mr Araujo, originally from Portugal, went to the emergency department twice on July 6th,2016, the day before his death.
Dublin Coroner’s Court heard he told staff he had heard a hissing sound in his right ear before the bleeding began.
He first arrived in the emergency department at the ospital at 9.10am.
He was discharged at midday after the bleeding stopped without intervention.
He returned to hospital at 12.50pm. This time he was spitting blood and doctors inserted a nasal pack to stop the bleeding.
Doctors contacted an ear, nose and throat specialist who advised the nasal pack be left in place for between one and two hours with observation of the patient following removal of the pack.
The bleeding stopped and Mr Araujo was discharged with the advice that he should contact his GP or go to Beaumont Hospital if required.
He stayed at home overnight and the bleeding continued, according to his partner Marcia Pereira.
Full of pain
“He was really tired, full of pain, unable to eat. He had a headache,” she said.
Ms Pereira said the bleeding continued through the next day. “There was drops of blood all over the house,” she said.
At 6pm that evening she saw her partner collapse, with blood coming from his nose and mouth.
She phoned an ambulance and Mr Araujo was taken to Connolly Hospital in cardiac arrest. The emergency medical team battled to save him for three hours.
“The bleeding was torrential, it was like turning on a tap, despite him being in cardiac arrest,” Dr Collins said.
She said the team did everything possible to save him.
“Other than blocking his artery, I had exhausted everything I knew how to do. Everything we did as a team, did not work,” she said.
The man was pronounced dead at 10pm.
“All of us involved found his case devastating... I have never witnessed anything this extreme,” Dr Collins said.
An artery at the back of the nose was identified as the source of the bleeding.
State Pathologist Prof Marie Cassidy gave the cause of death as hemorrhage and shock due to a nosebleed with obstruction to the airway due to blood as a contributory factor.
The pathologist said the only other fatal nosebleed she had dealt with during her career was 40 years ago.
“These are usually spontaneous, they just occur. There seems to be no real reason behind them,” she said.
Coroner Dr Myra Cullinane returned a narrative verdict setting out the facts of the case.