Widow's tearful call for urgent review of cardiac services
Husband died while being transported between hospitals
The widow of a young farmer who died from complications while being transferred between Waterford and Cork hospitals has pleaded with Health Minister Simon Harris to urgently review cardiac services.
Bernadette Power issued the plea as an inquest heard that the death of her husband, Thomas (40), was due to a heart attack side effect "most feared" by doctors.
It was so severe that even had a Waterford cath lab been open, it would likely not have saved him, a Cork Coroners Court jury was told.
Mr Power died from a large 3cm rupture in his cardiac wall brought on by "a silent heart attack" suffered between three and seven days earlier.
The inquest jury returned a verdict of death by natural causes - but issued a recommendation that Mr Harris review resuscitation drug packs provided in ambulances for patient transfers between hospitals.
The ambulance transferring Mr Power to Cork ran out of special adrenalin doses.
Speaking after the inquest, Bernadette Power revealed she had only been married to Thomas for nine months - and had been pregnant with their first child when he died on June 18, 2017.
Ms Power gave birth to her baby boy, Thomas Junior, on November 22 - five months after her husband's death.
"Today is a very sad day because on September 17, 2016, when I married Tom I never thought that on April 19, 2018, I would be attending the inquest into his death.
"I would now urge the Government to improve cardiac services in the south east region and to reconsider the provision of a second permanent cath lab at University Hospital Waterford (UHW) to serve the people of the south east on a 24/7 basis.
"This is a service sadly lacking at the moment," she said.
Despite the south east region having a catchment of 500,000 people, the UHW cath lab only operates from 9am to 5pm Monday to Friday.
Major cardiac surgeries also cannot be undertaken in Waterford - with patients having to be transferred to Dublin, Cork or Galway.
"Silent heart attacks are worse than heart attacks with severe pain," explained cardiac consultant Dr Ross Murphy, who pointed out that people often don't have symptoms sufficient to seek urgent medical assessment.
Ms Power had told her husband as he left UHW for transfer to Cork that she loved him and she would see him shortly.
He went into cardiac arrest as the ambulance undertaking his transfer passed Dungarvan en route to Cork University Hospital.
The young farmer had to be transferred to Cork because the Waterford cardiac cath lab was closed that Sunday.
Coroner Philip Comyn also heard that the ambulance ferrying Mr Power ran out of adrenalin en route and had to be resupplied by a Cork ambulance.
Because of emergency treatment stops along the road in Dungarvan and Midleton, the trip to CUH took one hour and 41 minutes.
Despite desperate attempts in the ambulance to resuscitate him, Mr Power was pronounced dead shortly after arriving at CUH at 1.50pm. Assistant State Pathologist Dr Margaret Bolster found that Mr Power had a 3cm rupture in the free wall of his heart.
The young man also had 400ml of blood in the pericardial sac around his heart instead of the normal 10ml.
This had the effect of compressing his heart and stopping it beating.
Dr Murphy said the outcome from such major ruptures in the heart wall are normally "dismal".
"It is a very, very big tear - you can die from a 0.25cm tear. It is a most feared complication (from a heart attack)."
Dr Murphy said he did not believe having a cath lab operational in UHW would have made any difference in this particular case.
"I have no evidence that it (a cath lab) would have made a difference. A cardiac theatre, perhaps."
Mr Power would have required immediate draining of the fluid around his heart - and immediate emergency open-heart surgery to repair the 3cm tear.
UHW does not handle major cardiac surgery which is only available in Dublin, Cork and Galway.
Mr Power's death sparked a major campaign for better cardiac services at UHW.
The campaign has been led by his family, including his parents, Michael and Eileen, and his siblings, Joan and Catherine.
Mrs Power wept as she recalled the day of her husband's death.
"The last words I spoke to Tom were: 'Love you and see you in Cork'. We were going out for six years. We were married nine months," she wept.