Heartbroken family of Aoife Johnston settle action against HSE following death in Limerick hospital

The death of Aoife Johnston at UHL was “almost certainly avoidable”, a report by former Chief Justice Frank Clarke last month found

The family of teenager Aoife Johnston has settled a High Court action against the HSE over her death at University Hospital Limerick two years ago.

The 16-year old Leaving Cert student from Shannon, Co Clare, died from meningitis on December 19, 2022, two days after presenting at the UHL emergency department with symptoms of suspected sepsis and during which her condition worsened. It later emerged she was left for more than 13 hours without antibiotics.

While Ms Johnston came to UHL at 5.39pm on December 17 with a letter from an out-of-hours GP service raising the possibility of sepsis, she was not prescribed medication until before 6am the next day and only received this between 7.15am and 7.20am.

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In the High Court proceedings, it was claimed there was an alleged failure to have sufficient staff on duty in the UHL emergency department of the hospital which led to gross delays for Aoife Johnston. It was claimed this was not explained merely by high patient numbers and that clearly there were not enough staff on duty on the evening in question.

A central allegation in the claim was that the death of Aoife had been allegedly hastened and there was an alleged failure to treat Aoife as a seriously ill patient until she completely deteriorated at 7.45am. Aoife’s parents, Carol and James Johnston, had sued the HSE on behalf of their family over the death of their daughter. There were also claims for nervous shock as a result of the teenager’s death.

It was claimed that there was a delay in carrying out the triage on Aoife at UHL and an alleged failure to have an acutely ill patient seen by any doctor until about 6am the next morning. While there had been correct advice in relation to fluid steroids, antibiotics and anti-viral medication, these were not given until 7.15am.

There was also, it was further contended, an alleged failure with regard to the blotchiness of Aoife’s skin and a mark on her left eye. There was also an alleged failure to note that calf pain and the stiffness Aoife complained of were a common feature of meningococcal sepsis.

In the High Court this week, counsel for the Johnstons, Jonathan Kilfeather SC, instructed by Damien Tansey solicitors, told the court that the case related to the death of Aoife Johnston and the only aspect that needed to be addressed by the court was the division of the statutory mental distress payment, known as the 'solatium'.

He said the family had agreed an approach and the grandparents had waived their claim in relation to a share of the solatium. The details of the full settlement, which is confidential, also includes a claim for nervous shock.

Mr Justice Paul Coffey ruled on the division of the solatium among Aoife’s parents and two sisters, Meagan and Kate, and noted the settlement of the proceedings, which were then struck out.

The death of Aoife Johnston at UHL was “almost certainly avoidable”, a report by former Chief Justice Frank Clarke last month found. It found the UHL emergency department was in such confusion that “there was no reality” to care plans that night.

Mr Clarke said there were lost opportunities where someone could have realised how sick Aoife was and taken action. A system to alert staff of patients in crisis proved “inadequate” in light of the high patient numbers that night. The medical evidence indicates this tragedy was “almost certainly avoidable,” he said.

He made 17 recommendations, including that the hospital site should be assessed for further expansion and if it is found to be too small to cope with expansion, then another plan must be made. He also said communication systems at the hospital should be reviewed.

The former Chief Justice in the body of the report said overcrowding was so severe that marking Aoife as ‘Category 2’ — the second highest alert level — did not have any effect. “There was no reality to patients who were categorised in Category 2 being seen by a clinician within anything remotely resembling that timeframe,” he said.

The unit was down five nurses and was one doctor below a full roster. As a result, he said the alert “system, if it can be called that, was inadequate to deal with a very difficult situation”.

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