MS sufferer's asphxiation death 'a mystery'

21/07/2006 - 16:06:56
A woman who was severely incapacitated with multiple sclerosis asphyxiated during a brief stay in a respite care centre, an inquest heard today.

Linda Ryan, 46, from Dublin’s Swords was discovered on the floor with her head caught between the bed rail and the mattress in MS Ireland’s respite centre at Bushy Park in Rathgar on February 27, 2005.

Her husband, Tony Ryan, who also has the debilitating MS, said this was the first time during nine years of visiting the centre that he had not stayed overnight with her.

“She had reached the stage of secondary progressive stage of multiple sclerosis. She was high dependency,” Mr Ryan, who is wheel-chair bound, said.

A solicitor for MS Ireland said the staff were mystified as to how Mrs Ryan, who was highly dependent and only able to move her arms, had managed to get into such a position.

Rose Tucker, a care assistant at the centre, broke down on the stand a she told the inquest of discovering Mrs Ryan around 9.20am sitting in a semi-upright position on the floor with her head caught between the bed rail and the mattress.

Another nurse, Maria O’Brien, said she had sat down with Mrs Ryan’s husband to determine Mrs Ryan’s needs during her week-long stay at the home when she checked in on the previous day.

She told the inquest Mr Ryan had requested she be turned on a two-hourly basis to ease her pressure sores.

Ms O’Brien said she gave all the details to the night nurse as she went off duty around 10.30pm.

Anne Murphy, the registered general nurse on duty that night, said Mrs Ryan was hoisted into bed around 11pm.

“Before leaving the room I placed the call bell in her hand,” she said. The inquest heard around 12.20am Mrs Ryan rang for assistance, and the nuses took care of her and turned her in the bed.

Around 4.30am Ms Ryan’s position was again changed. Ms Murphy said Ms Ryan’s head was centred in the middle of the pillow when they left the room around 4.45am leaving the door slightly ajar.

On previous occasions, Mrs Ryan was turned around 3am and 7am.

But Ms Murphy told the inquest at 7am on this occasion she decided not to turn her.

“When it came to seven o’clock I made a professional decision, as she had had such a comfortable time and I let her sleep,” Ms Murphy, who went off duty at 8am, said.

Under cross-examination by a solicitor for Mr Ryan, Ms Murphy said she had received the assessment sheet detailing the need for turning on a two-hour basis.

On the possibilities of Mrs Ryan changing position in the bed by herself, Ms Murphy said: “In all the years I looked after her she would have been in exactly the same position.”

Following the nurses leaving the room at 4.45am, the inquest heard Mrs Ryan was next checked when Ms Tucker went into the room at 9.20am and found her caught at the side of the bed.

Mr Ryan’s solicitor queried how she had managed to make her way to the floor.

“We have asked ourselves so many times we really don’t know,” Ms Tucker said.

John Gleeson, MS Ireland’s solicitor, said: “It is a complete mystery to MS Ireland as to how this happened.”

Another nurse Louise Brady told the inquest Mrs Ryan’s neck was pressed against the cot rail when she was found and there were no signs of life.

Ms Brady told the iquest that the bed rail goes less than a third of the way down the bed.

Professor Sean O’Briain, the pathologist, said Mrs Ryan had died from positional asphyxia. He said the description of Mrs Ryan’s position when she was foundat 9.15am would accord with his findings.

He said: “I can’t work out how she got there but the finding when she did get there would be completely consistent

Dublin City Coroner Dr Brian Farrell adjourned the inquest until September 7 to hear evidence from gardaí on whether an investigation into the death was carried out.