A TD has called for an investigation after a man collapsed on a busy street after being turned away from hospital because he did not have a referral letter from his GP.
The man, who is in his 50s, presented himself at St Columcille's Hospital in south Dublin, telling staff he was suffering from chest pains.
After pleading for attention, he is understood to have been told he needed a referral letter from his GP in order to be seen by a doctor.
He left the hospital just after lunchtime and got the bus to nearby Bray in order to visit his doctor.
However, he suffered a suspected heart attack on Bray Main Street and was cared for at the scene by passers-by until the emergency services arrived.
He was rushed to St James's Hospital, where he has since undergone surgery.
Details of the case have been provided by the man's family to Sinn Fein TD for Wicklow, John Brady.
Mr Brady said he and the family are now demanding an urgent investigation following the incident.
"We are talking about a matter of life and death here," said Mr Brady.
"I have sought a meeting with hospital management to establish what exactly the protocols and procedures are here.
"I am also calling on Health Minister Simon Harris to demand a full investigation by the HSE."
St Columcille's was downgraded in November 2013, with a decision being made to shut down the emergency department.
As a result, those cases are diverted to St Vincent's University Hospital.
However, the hospital does have a medical assessment unit (MAU) and an injuries unit (IU).
While the hospital would not comment on individual cases, a spokeswoman said the medical assessment unit did not accept "walk-in patients".
"The medical assessment unit assesses patients referred by GP with acute medical conditions such as chest infec- tion, urinary tract infection, collapse, deep vein thrombosis, anaemia without active bleeding, fever and headaches," she said.
"The MAU is open seven days per week, from 8am to 6pm.
"It accepts GP referrals and patient transfers from St Vincent's University Hospital. It does not accept walk-in patients.
"The IU is open seven days per week, from 8am to 6pm.
"It manages minor injuries, and governance of the unit is with the emergency department in St Vincent's University Hospital."