A woman flagged for “sepsis” at two separate Limerick hospitals but who did not receive timely treatment with the correct medication died of cardiac respiratory failure a day after experiencing a miscarriage, her inquest was told on Thursday, reports Breaking News.
Leona Cusack, aged 33 and from Ballycasey, Co Clare, may have survived if she had been given a “broad spectrum” antibiotic regimen. Her death occurred on February 18th, 2024, reports Breaking News.
It was acknowledged during the hearing that there had been a “breach” in HSE sepsis guidelines, and while Ms Cusack was a patient at University Hospital Limerick, she was initially administered only a “narrow spectrum” antibiotic treatment.
After two days of testimony, the Limerick Coroner’s Court determined that Ms Cusack died from cardiac respiratory failure brought on by neutrophilic myocarditis — a rare condition that can either stem from or cause sepsis, the inquest heard, reports Breaking News.
Eventually, Ms Cusack was “loaded” with antibiotics after her sepsis blood markers rose to extremely high levels on February 17th and increased even more on February 18th.
However, Damien Tansey, the solicitor representing Ms Cusack’s family, stated that the administration of the broad-spectrum antibiotics came too late and ultimately had “no impact” on her declining condition, reports Breaking News.
The inquest heard that Ms Cusack, who was five weeks pregnant following IVF, first arrived at University Maternity Hospital Limerick (UMHL) on February 15th, accompanied by her husband, Conor Cusack.
She was experiencing abdominal cramps and bleeding, underwent blood testing at UMHL, and returned home under the belief that no beds were available at the hospital, reports Breaking News.
The following day, February 16th, the couple went back to UMHL as her condition had worsened — she had begun vomiting and showed a heightened white blood cell count.
Consultant gynecologist Dr Suhaib Akhtar Birmani had identified sepsis as a likely diagnosis and said he initiated the HSE’s official sepsis treatment protocol at the maternity hospital, reports Breaking News.
Despite the protocol stating that a broad spectrum antibiotic should be administered within an hour, this was not done at UMHL.
On February 17th, Ms Cusack returned again to the maternity hospital, after which she was transferred by ambulance to University Hospital Limerick due to a fast heart rate and risk of cardiac arrest, reports Breaking News.
She was admitted into the coronary care unit at UHL under the supervision of cardiologist Dr Cormac O’Connor.
While giving his testimony, Dr O’Connor became visibly emotional and apologised to Ms Cusack’s family for remarks he had made to her sister, Rachael Kirwan, an advanced nurse practitioner.
Ms Kirwan expressed upset over Dr O’Connor telling her that Ms Cusack had “the heart of a lion”, reports Breaking News.
Dr O’Connor explained: “I made the comment to try to comfort (Ms Kirwan), I apologise for any distress caused,” reports Breaking News.
He said he did not recall saying Ms Cusack might be “shadow boxing” in the corner of the room, reports Breaking News.
The cardiologist acknowledged, under questioning by solicitor Damien Tansey, that there had been a “breach” of the HSE’s sepsis protocols when only a narrow-spectrum antibiotic was initially used.
He clarified that efforts were made to determine the source of the infection and denied any suggestion that sepsis had been overlooked, stating Ms Cusack was eventually given a full course of antibiotics, reports Breaking News.
As her condition worsened, Ms Cusack was moved from coronary care to the hospital’s intensive care unit.
According to Mr Tansey, however, the more aggressive antibiotic intervention came “too late” to help, and Ms Cusack passed away at 7.39pm on February 18th, four days after first presenting to UMHL, reports Breaking News.
All hospital personnel involved in her care at both UMHL and UHL expressed their heartfelt condolences to her grieving family.
Limerick Coroner John McNamara called the case “complex” and acknowledged there had been a “breach of sepsis protocol”, reports Breaking News.
He explained that he could not deliver a verdict of natural causes or medical misadventure.
Instead, he described the inquest as a “fact-finding” process and returned a “narrative” verdict based on the sequence of evidence presented, reports Breaking News.
Ms Cusack’s family members cried openly in court as the verdict was read out.
Speaking outside afterwards, her husband Conor Cusack gave a touching tribute to Leona: “Leona was the nicest, bubbliest person you’d ever meet in your life, she was the love of my life.”
Looking toward her parents and sisters, he added: “Sure Eamonn and Clare would tell you she was the best daughter, and Sarah and Rachael would say the same about being their sister. She was loved by everyone,” Mr Cusack said, reports Breaking News.
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