Frantic efforts to save a frail pensioner from a burning ambulance may have been hampered by the seatbelt he was wearing, it emerged yesterday.
Christopher Byrne (79) died in the inferno that engulfed the ambulance shortly after it arrived outside the emergency department of Naas General Hospital on Thursday afternoon.
The heroic rescue efforts of two paramedics are believed to have been hindered by the seatbelt which patients have to wear during transport for their own safety.
Mr Byrne, of Ard Brid in the Kildare village of Suncroft, was previously treated in the hospital for a serious lung condition and had undergone a tracheostomy to help him breathe.
As family and friends mourned his tragic death yesterday, investigations got under way to try to find out the cause of the blaze which turned the ambulance into a fireball.
The HSE serious incident unit is focusing on an oxygen tank in the ambulance which, on initial inspection, appears to have exploded after possible exposure to a spark or other risk.
Naas-based paramedic David Finnegan, who was treated for burns sustained in the incident, was released yesterday evening from St James's Hospital.
His colleague, Stephen Lloyd, who was thrown across the tarmac by the force, was treated for shock and injuries at Naas Hospital on Thursday and discharged.
A probe by the Health and Safety Authority and the gardaí could taken months to complete.
Damien McCallion, HSE director with responsibility for the ambulance service, said its probe would concentrate on the oxygen supply in the ambulance.
"The HSE has also directed its supplier to undertake a programme of checks on the oxygen in all ambulances. Staff are asked to re-familiarise themselves with the emergency ambulance evacuation procedures."
Senior paramedic sources said the investigation would also look at whether the incorrect gas was put into any of the cylinders.
Another line of inquiry will look at whether a 12-watt bulb that comes on automatically when the oxygen storage unit is opened blew. This could have resulted in the cylinder or cylinders combusting due to a possible leak.
Two other areas of investigation will focus on the engines of those particular Mercedes ambulances, which have been fitted with a fire-suppression unit, due to serious concerns over previous engine-related fires.
A heart monitor which is fitted in all ambulances, contains a lithium ion battery, which has in the past caught fire in certain conditions. Michael Dixon of the National Ambulance Service Representative Association (NASRA) said yesterday it was important to do a thorough audit of all the ambulance fleet.
"So far we are dealing in speculation," he said. "But it is important that the investigation is wide and includes any risks posed by entonox , a mixture of oxygen and nitrous oxide which is used for pain relief.
He said the problem of unexpected fires was sorted out in recent years but other elements of the ambulances such as the central locking system should be looked at.
"The tragedy shows the lengths to which paramedics are prepared to go to protect their patients and the public can be resassured of the care they will receive."
The ambulance involved is a 152 registration, making it about one year old.
The Health Service Executive had €7.5m to buy 47 new emergency ambulances last year and it is understood the National Ambulance Service fleet replacement scheme had more than €18m to invest this year on 50 new vehicles.