Judge slams 4am hospital transfer of patient with Alzheimer's
The transfer last week of an "elderly, frail and unwell" woman from a hospital to a nursing home at 4am "in the dead of winter" was "bordering on the inhumane", the President of the High Court has said.
Mr Justice Peter Kelly also described as "completely unacceptable" the failure of the hospital's discharge note for the 82-year-old woman, who has Alzheimer's Disease and impaired capacity to swallow, to state how she was to be fed.
That failure, which the HSE said was due to an "oversight" for which it apologised, led to her GP, after seeing the woman on January 15, hours after her discharge, being concerned she would starve to death.
The judge, on Monday, directed an inquiry into whether the care plan which the hospital had proposed was medically justifiable or if the woman should receive the normal treatment for her condition involving feeding through a tube into her stomach.
Due to her various conditions, and concern of risk of aspiration if she received food orally, the woman was on a glucose drip since being admitted to hospital on January 4.
After the GP unsuccessfully tried last Monday to contact a hospital doctor to clarify the position on feeding, solicitors for the woman's family correctly brought Monday's court proceedings on her behalf.
Later on Monday, the hospital contacted the nursing home to clarify the position on feeding/care plan she was to receive.
The judge said he wondered what would have happened had the woman not had a committed family, a committed GP, committed solicitors and, as a ward of court, easy access to the court.
He expected the hospital to review its discharge procedures to ensure this situation would never happen again as it was "unacceptable" and could have "fatal consequences".
He also questioned the advisability of having a normal transfer from hospital at 4am especially where a patient was "elderly, frail and unwell".
While the HSE said the 4am transfer was due to non-availability of ambulances any earlier, that was "an explanation, not an excuse".
He accepted it was in the woman's best interests to return to the nursing home but queried if doing so at 4am was in her best interests.
However, he was happy the situation was now resolved, a "comfort feeding" plan - involving small amounts of food being given to her orally - was in place since Tuesday and the woman was doing well.