Tragic death ruled ‘medical misadventure’

Tragic death ruled medical misadventure

Family and hospital working together to prevent further tragedy after tragic death

The family of a London Irishman who died during a business trip to Dublin hope that lives can be saved in the wake of his death.

Tim Fleming, 69, (pictured above with wife Kathleen) suffered an aortic dissection – a tear in the lining of the aorta which can lead to the rupture of the artery – on 6 February 2015.

During his visit, he became unwell and was rushed to Tallaght hospital after experiencing severe abdominal pain.

An inquest at the Coroner’s Court in Dublin heard that doctors suggested a number of conditions – including aortic dissection – but no definitive diagnosis was given. This information was not communicated to others at the hospital and, following a series of telephone conversations between the patient and the on-call surgical registrar Dr Donal O’Connor, it was suggested that Mr Fleming was suffering from gastritis, that he should be discharged and return to the UK for treatment.

He returned shortly after suffering severe pain and an x-ray showed a tear in his aorta. During a CT scan, Mr Fleming’s condition dramatically worsened and he was transferred with a gardaí escort to St James’ Hospital for specialist surgery.

At St James’ he suffered a sudden rupture of the aorta and a systolic cardiac arrest and, while his aorta was quickly repaired, efforts to resuscitate him were unsuccessful.

Mr Fleming’s daughter, Catherine, described the situation as “the most tragic series of events”.

But she added that, while nothing will compensate for the death of her father, the result of the inquest – that it was “medical misadventure” – provides some comfort.

“You hear the term ‘bittersweet’ but I’ve never really felt it until now,” she told The Irish World.

“Nothing’s going to bring dad back. But it was a very good process at the coroner’s inquest. It was quite a complicated case but their intelligence and the way they were focused and attentive throughout was brilliant.

“We think they came out with a very appropriate verdict and some strong recommendations to take forward.”

She was particularly pleased with the fact that Tallaght have agreed to work with her and her siblings in raising awareness of the condition.

Sincere Regret

The hospital confirmed in a statement that it would be contacting the Fleming family “in due course” to discuss how best to go about this.

“Tallaght Hospital reiterates its sincere regret to the family of Mr Timothy Fleming, with regard to aspects of the care provided on the night of 5/6 February 2015,” a spokesperson said. “The hospital is organising a meeting with members of the Fleming family for the purposes of conducting a review of the case, and to explore what lessons can be learned from this tragic case.”

Catherine said she believes this relationship has the potential to have a big impact and that it would go some way in contributing to her father’s legacy.

“Our dad has paid the ultimate price so for something positive to come out of that is really important,” she said. “We would really like to have some involvement and hopefully make some changes that are visible and measurable.”

Mr Fleming, originally from Fossa, Co. Kerry, had been living in Middlesex for a number of years. He was described as a “young 69-year-old, always out on his bike and a very active grandparent”.

His four adult children – Aishling, Caroline, Catherine and Jeremiah – all live in England but would regularly take trips back to Ireland.

Since their father’s death, they have been raising awareness of aortic dissection and have taken part in a number of fundraising campaigns. Catherine has undertaken work at the Royal Brompton Hospital in London and in March this year, addressed a conference of cardio-thoracic surgeons from Britain and Ireland in Belfast about her father’s treatment and the experience of her family.

Working alongside Heart Research UK, she and her family have raised enough funds to pay for a masterclass in aortic dissection for 12 cardiac surgeons across the UK to be trained in how to perform an aortic arch replacement. On 19 September they will be taking part in an awareness day at Liverpool Heart and Chest Hospital, running workshops for frontline services.

“We can make lots of improvements to this very treatable condition,” Catherine explained. “If you can get your diagnostics right early on, you can really drive up survival rates. It’s about identifying it early and getting patients into the hands of the right surgeons.”

She added that her aunt – Mr Fleming’s sister – also suffered an aortic dissection but that her experience was “the polar opposite” of her father’s.

“My aunty had a perfect diagnosis and surgery and she has recovered very well. Everyone should expect to have that standard of care. Her case wasn’t exceptional, it should be available to everyone,” she said.

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