'The bottom of our world fell apart' - daughter of man who died while on visit to Dublin
Timothy Fleming's family are working to ensure that hospital procedures are updated after their dad died in 2015
The daughter of a man who died when he became ill on a visit to Dublin said the “bottom of their world fell apart” but now they hope to change things for other families.
Timothy Fleming (69), an Irishman living in England, died after a tear in the lining of his aorta led to a rupture of the artery on February 6, 2015.
The father-of-four, a native of Fossa, Killarney, was living in Middlesex and had travelled to Dublin for a meeting in Tallaght. He became unwell with a severe pain in his abdomen and was taken by ambulance to Tallaght hospital. An inquest earlier this year ruled his death from the condition was as a result of ‘medical misadventure’.
Mr Fleming was initially discharged at around 2am after being diagnosed with gastroenteritis following a phone diagnosis and consultations with various doctors.
However, he was immediately returned to hospital when his pain became much worse.
An ultra-sound showed signs of a tear within the aorta and he was then scheduled for a CT scan. While undergoing the scan his aorta ruptured and he was transferred to St James' Hospital for emergency surgery.
Due to their dad’s initial visit to the hospital his family in the UK were not aware of what was happening.
However on his second admission the family were contacted. They were told come to Ireland immediately that their dad was going for surgery but his chances were good.
“We were like ‘chances for what?’, we had never heard of this condition, are you saying my dad could die?,” Catherine said.
“For all of that time, dad knew that he was seriously unwell, he had no one there from the family to hold his hand, to tell him he would be okay…which was awful,” she said.
Catherine’s niece did manage to speak to her dad on the phone before surgery.
“I was at the airport in Gatwick with my mum, talking about all of the phone calls we’d received that morning and she was having the same reaction as me [thinking] ‘is he going to die?’
“And I was like ‘oh my gosh, no. This is like what you read in the newspapers, this isn’t going to be what happens to our family. We’ll get out there, we might be in Dublin for a few months, if we need to rent a house, we’ll look after dad until he’s better and he’s coming home.
“No sooner had I said those words when the phone rang and it was St James’ hospital saying 'your dad didn’t survive the surgery and you need to come over and formally identify the body'.
“Oh my goodness, it was just like the bottom of our world just fell apart. It was just the most incredible shock and because of how it happened part of that shock stays with you. It was just so sad.”
In a strange twist of fate Timothy’s sister was struck with the same condition, the day after his funeral, but survived.
“She’s doing very well and it’s a story within one family which shows if you act in the polar opposite ways how different the outcomes can be,” Catherine said.
She first attended what would have been Timothy’s local hospital in the UK.
“Very similar to Tallaght they wouldn’t be in a position to treat that condition themselves but they spotted it and transferred her straight away to the Royal Brompton Hospital in London.
“It was all of the ‘what ifs?’. You would think that anyways as a family but the fact that it happened to another family member and she was 10 years older than dad and had other health complications," Catherine said.
The rare condition was among those initially suspected as being behind Mr Fleming's pain when he was brought to hospital.
"Very early on in his first admission to the Emergency Department one of the doctors suspected aortic dissection, among three other fatal conditions, but sadly for dad they didn’t document that and it wasn’t handed over effectively.
“That information and that suspicion seemed to be lost along the way and if they had documented it or effectively handed something over I think we would be in a very different position,” she said.
Ahead of surgery Mr Fleming experienced a heart attack, from which he never recovered.
“So they were operating on dad and resuscitating him at the same time and it’s just so tragic because the surgery itself was actually successful. They were actually able to repair the aorta but they weren’t able to bring dad back so he died.
The family are now working to raise awareness of the condition and have been working alongside experts in the UK and Ireland to improve outcomes for patients.
They are also working with Tallaght Hospital to update procedures around different elements of care.
"As an individual my dad had something very special about him. He would always stand up for the underdog," she said.
"I think that's why this is so important to me because I think had this happened to anyone else he would be absolutely making sure that preventative action was taken.
"He has left an amazing kind of legacy within his family and friends, and we hope to do something bigger in the sense that there will be some change," Catherine added.
Their work with Tallaght Hospital has been very positive to date, Catherine said and the family are awaiting the outcome of an internal investigation.
Following an initial meeting of a working group of which they are part a total 12 suggestions for improving procedures were tabled.
Some of these included updates to how diagnosis is carried out over the phone, updated communications between staff and changes to how patients are discharged from hospital.
“I really look forward to continue to work with them in a very healthy and challenging way and I think more of that needs to happen,” she said.
“Nothing is going to bring dad back for us but at least it will bring some kind of meaning to his passing because otherwise what’s the point?
“It would just be incredibly tragic to walk away and just let that continue to happen.”
Catherine was speaking ahead of a medico legal conference on Friday in Sligo, called Pathways to Progress, organised by Callan Tansey solicitors.
The family have also started a website called www.thinkaorta.org to promote further awareness.
In a statement the hospital said:
"Tallaght Hospital has expressed its sincere regret and condolences to the family of Mr Timothy Fleming, some of whom met with senior hospital clinicians in July to review the case and discuss actions to improve processes, procedures and policies with the focus on improving patient care and outcomes.
"To date Tallaght Hospital has implemented two key recommendations: rare occurrences such as aortic dissection are now included as a regular agenda item for education sessions attended by medical professionals of all levels within our Emergency Department; medical staff are regularly reminded that differential diagnoses should be recorded in patient charts to ensure continuity of care."