Inquests into the deaths of four patients who died after they contracted hospital-acquired infections heard yesterday that three of the four infections were acquired at the same hospital.
The Dublin county coroner yesterday criticised infection control policies at St Columcille's Hospital, Loughlinstown, Co Dublin, when it emerged that in three of the inquests patients picked up "superbugs" while being treated at the hospital.
Mary McDonald (87), Berryfield Lane, Fassaroe, Bray, Co Wicklow, died on June 1st this year after contracting the hospital superbug clostridium difficile, which was the direct cause of her death.
Bridie O'Brien (86), Beech Road, Bray, died of a sudden cardiac event due to heart disease with C Diff infection as a contributory cause, while James Bolger (86) died of bronchial pneumonia on February 27th, having tested positive for the superbug MRSA the day before, inquests at Dublin County Coroner's Court heard.
All three died at St Colmcille's hospital.
Coroner Dr Kieran Geraghty said: "I have had inquests where clostridium difficile has come up at hospital and the hospital was hoping to get a microbiologist. I've written to the hospital manager and I've got no reply." Dr Geraghty expressed concern at the number of outbreaks of C Diff at Loughlinstown.
The court heard that Loughlinstown has no designated infection control team or consultant microbiologist and that just one nurse, Kumar Nair - who has been at the hospital for a year and a half - is in charge of infection control policy at the hospital.
"Mrs McDonald was ill, but she might have gone home but for the clostridium difficile infection," Dr Geraghty said.
A consultant who treated Mrs McDonald, Dr Morgan Crowe, told the court that a comprehensive hospital policy was crucial to address the issue of hospital-acquired infection, with regular auditing of the policy.
But the court heard that elements of the existing policy, such as the presence of an infection control team and strict monitoring of the prescription of antibiotics, could not be implemented due to the absence of a microbiologist.
Mr Nair told the court that while current policy at the hospital was to swab all high-risk patients for MRSA colonisation and other infections, there was no way of knowing if the swabbing policy is being implemented.
Mrs McDonald was admitted to Loughlinstown hospital on May 11th with a chest infection. Her chest X-ray showed signs of congestive cardiac failure complicated by pneumonia.
She was started on a course of antibiotics and her condition improved, but she developed renal problems. On May 23rd she had a relapse chest infection and with treatment with antibiotics, she improved again. However, on May 29th she was diagnosed with C Diff. Over the next two days her condition dramatically deteriorated and she died on June 1st.
Postmortem results revealed that Mrs McDonald died from respiratory failure and shock due to acute bronchitis with pseudomonas colitis (caused by C Diff) as a contributory factor. Dr Geraghty returned a verdict of death by hospital-acquired infection.
Verdicts of death by natural causes were returned in the cases of Mrs O'Brien and Mr Bolger.
Meanwhile, Bridget Frasier (82), Lisle Road, Walkinstown, Dublin, died at Tallaght hospital on February 13th this year after contracting clostridium difficile, most likely when she was a patient at St James's Hospital in January.
She had been admitted to Tallaght hospital two days before her death and was treated with antibiotics for a suspected C Diff infection. Tests confirmed the presence of the infection.
Mrs Frasier died from intra-abdominal sepsis due to a likely bowel perforation due to C Diff infection, the court heard. Dr Geraghty recorded a verdict of death by hospital-acquired infection.