An elderly man whose primary cause of death was listed as covid had only a mild form of the disease, an inquest heard.
John Carolan from Bellacorrick, Ballina, Co Mayo suffered a stroke at home on March 18 2020 and was admitted to Mayo University Hospital (MUH.)
The retired ESB worker’s condition gradually deteriorated and he died on April 1 2020. The medical cause of death was listed as covid 19 infection with acute cerebral infarction (stroke) and a background of dementia.
Mr Carolan was one of the first people to die with hospital-acquired covid 19 at the hospital, solicitor for the family, David O’Malley told an inquest into his death.
Consultant Geriatrician and Stroke Physician at Mayo University Hospital Professor Tom O’Malley said while the cause of death listed for Mr Carolan was covid infection, he suffered only a mild to moderate form of the disease.
“In Mr Carolan’s case I would have said the cause of death was stroke with covid,” Prof O’Malley said.
Mr Carolan was not swabbed for covid 19 on admission to MUH. He was placed in a four bed bay, on the elderly care stroke unit.
Hospital policy followed national guidelines and used single rooms for covid positive patients and staff were caring for a covid positive patient on that ward, the court heard.
A series of x-rays of Mr Carolan’s lungs conducted during the course of his stay came back clear.
“He didn’t have serious covid 19 pneumonia,” Prof O’Malley said.
The inquest heard Mr Carolan had eaten his breakfast at home with his wife on the morning of March 18.
“He was slurring his words when he spoke. I rang the doctor … He washed and dressed himself. His speech had returned to normal by the time he left in the ambulance,” Madge Carolan said.
The Carolan family reported communication difficulties with staff once Mr Carolan was admitted to hospital.
“The care was very good it was just the lack of communication. It was difficult to get an exact picture of what was going on,” Mr Carolan’s eldest child Teresa Shaw said.
“Because there was no visiting and we couldn’t see the patient, it was difficult,” Ms Shaw said.
“He was treated on a ward with covid positive patients and we didn’t realise this, otherwise we would have raised concerns,” Ms Shaw said.
On April 1 the family were informed by staff that Mr Carolan had deteriorated and he was given morphine and midazolam. He passed away at 11.10pm that night.
On April 3 the family were informed that a swab taken the day before his death had returned positive.
On April 28 the family received a note to say the cause of Mr Carolan’s death was due to covid 19.
The inquest heard that MUH operated under national guidelines issued by the HSE, utilising isolation rooms and single rooms before placing Covid positive patients on bays and wards. On April 13 the hospital changed policy and all covid positive patients were to be treated on a designated ward. From that point for more than ten months, the elderly care unit where Mr Carolan was treated remained covid free.
Under questioning from solicitor for the family David O’Malley, Professor Tom O’Malley agreed that he was part of the national committee that advised early in 2020 to place patients with covid together with non covid patients.
“I would have been concerned about that. There was a large committee involved in that and I was only part of it,” Prof O’Malley said.
“I would have agreed with using single rooms and everyone was expected to help, we were accustomed to infection controls for years.
“We were there to help in what was a war- like situation. It was like a war, that was what we were feeling,” Prof O’Malley said.
It was not hospital policy at the time to swab patients for covid on arrival.
From April 13, different wards were designated specifically to covid as numbers grew and there were not enough single rooms, the inquest heard.
Asked by the coroner if Mr Carolan might have survived if covid was not a factor, Prof O’Malley replied “I don’t think so.”
“I feel it (covid) accelerated the stroke, it was a neurologically related covid death,” Prof O’Malley said.
The coroner said some 6,500 deaths have been recorded with or from covid to date in Ireland and asked how the medical profession deals with that.
Prof O’Malley said with hindsight an estimated 50% of covid deaths had been misinterpreted but said ‘in the early stages we were very conditioned to believe’ the disease was extremely severe.
“In Mr Carolan’s case it (covid) was mild to moderate and I would have listed stroke, with covid, as the cause of death,” Prof O’Malley said.
The Coroner thanked the family and MUH staff for their evidence and adjourned the inquest until March 21 to return his verdict.