Áras Attracta resident died from natural causes - inquest

A CORONER has returned a verdict of death from natural causes on a 72-year-old resident of an HSE-run centre for persons with disabilities in Mayo despite hearing from a pathologist that extreme dehydration and malnutrition were contributory factors in the man's death.

Mr. Patrick O'Connor, coroner for Mayo, delivered his verdict today after hearing expert evidence  that Francis (Albert) Loughney, who died at Mayo University Hospital on November 18, 2012, would have died anyway even if prescribed antibiotics and been hospitalised earlier.

Professor Cillian Twomey, retired geriatric consultant, carried out an extensive review into the medical circumstances of Mr. Loughney's death at the request of the DPP.

Mr. Loughney, a single man with learning difficulties, who formerly lived at Gortskeddia, Crossmolina, had been a resident of Ãras Attracta, Swinford, since 1999.

He died at Mayo University Hospital a day after being referred there by Foxford based GP Dr. Tomás O'Ceallaigh.

Dr. Tamas Nemeth, consultant pathologist Mayo University Hospital, gave the cause of Mr. Loughney's death as sepsis due to acute bronchitis and broncopneumonia with 'severe contributing factors of extreme dehydration and malnutrition'.

Professor Twomey, during cross-examination by Michael O'Connor, counsel for the next of kin, said earlier hospitalisation and treatment by antiobiotics would not have changed what he described as the 'inevitable outcome.'

He continued: 'I think Mr. Loughney was dying when he was referred to hospital.'

The professor added: 'It seems to me a pity that position wasn't anticipated more accurately so that supported palliative care could have been provided for him where he had been so well looked after for the previous 30 years.'

Professor Twomey said the predominant cause of his death was infection, that Mr. Loughney was more susceptible to the consequences of infection because of his poor physical state.

Ãras staff, in the course of their evidence, described the deceased as 'a loveable man' who had an excellent  relationship with them and enjoyed telling stories of his past as a farm labourer.

Mr. Loughney, they said, also liked music and discussing (GAA) football.

One of the first witnesses to give evidence, Ms. Maura Loftus, Carrowkilleen, Crossmolina, a relative of the deceased, explained that Albert was one of five children taken into care when their mother died.

She said that between 1956 and 1958 he came to live with her family at Ballina Road, Crossmolina. He would do simple farm chores under supervision.

Another relative of Mr. Loughney's, John Moyles said he saw Albert once in 2012. He noticed he had gone downhill in the last two years of his life.

He believed Albert was being looked after well in Aras Attracta and he was always well dressed.

He added: 'It was only when I saw the autopsy report on Albert that I got an awful shock.'

Cross-examined by Mr. Michael O'Connor, barrister for the next of kin, Mr. Moyles said that in his early years in State care Albert had been a victim of abuse.

He would talk to him (witness) about being physically beaten while in the care of the Christian Brothers in Salthill, Galway.

Ms. Ann Burns, programme director for Aras Attracta, told the inquest that reports of Albert's period with Mayo Mental Health Services relating to 1997 indicated difficulty in swallowing food and vomiting and nausea.

Ms. Burns said Mr. Loughney had a gradual decline in health with increasing dependency levels. In 2010  he was recommended a support plan of supplementary drinks for when diet intake was poor.

Ms. Mary P. Gallagher, clinical nurse manager, described him in her evidence as 'a very pleasant anxious looking man,of small stature and very slight build.'

She added: 'He rarely ate a complete meal and would only eat about two thirds of any food offered to him.

'All staff in Unit 2 always went to great lengths to provide him with foods that he liked - Complan, honey, ice-cream, hot chocolate.

'His weight was monitored and recorded on a monthly basis.'

Returning a verdict of death from natural causes, the coroner, Mr. Pat O'Connor, said it was regrettable it had taken so long for inquiry to be completed. 

He described the deceased as a very likeable person, 'one of life's special people', who had been well looked after in Ãras Attracta.

The coroner concluded by saying he hoped lessons would be learned and some good would come from Mr. Loughney's death.