Dáil Éireann Debate, Wednesday - 6 March 2013
246. Deputy Denis Naughten asked the Minister for Health if he will outline the investigations that have taken place at Mayo General Hospital following concerns (details supplied) as a result of the death of a patient with a STEMI; the steps that have been put in place to ensure the prevention of a similar occurance in the future; and if he will make a statement on the matter. [11847/13]
View answerFirstly, I wish to offer my sincere condolences to the relatives of the person who died.
Under the Acute Coronary Syndrome Programme, patients with symptoms and ECG findings indicative of a STEMI-type acute heart attack are treated according to the National STEMI Protocol, which was officially launched in October 2012. It has been in use in the west of Ireland since July 2012. Under the protocol, if patients can be transported to a primary PCI centre providing 24/7 treatment of STEMIs within 90 minutes of diagnosis, then they are brought directly to that centre. The primary PCI centre in the west of Ireland is the cardiology centre in University Hospital Galway (UHG). This unit has 2 cardiac catheter laboratories and a dedicated team of interventional cardiologists, nursing, technical and radiography staff on call 24/7. Based on international best practice, a unit such as this will serve the population of the west of Ireland for management of STEMI.
If transport to UHG within 90 minutes is not feasible, then STEMI patients are taken to the nearest emergency department equipped to stabilise patients, such as Mayo General or Portiuncula Hospitals, for thrombolysis (administration of clot-bursting drugs) to stabilise the situation. They are then transferred to UHG for assessment as to whether further immediate intervention is needed. This is accepted international best practice for management of STEMI patients, particularly in remote areas. In addition to the national protocol, the Code STEMI Protocol, approved by the Medical Director of the HSE National Ambulance Service (NAS) and through the HSE Clinical Care Programmes, outlines the actions required by hospital and NAS staff when a STEMI patient is to be transferred from a hospital to a PCI centre.
Following the death of a patient who had self presented at Mayo General Hospital with a STEMI, a number of steps were taken. The NAS reported the incident to the National Incident Management Team of the HSE at national and regional level for review. The NAS carried out an internal review and in parallel requested an independent review, which was conducted by the State Claims Agency. A review was also conducted between the NAS and Mayo General Hospital to ensure that the CODE STEMI protocol is followed for this type of incident. The clinical programme lead of the Acute Coronary Syndrome Programme, and the Director of the National Ambulance Service, have been made aware of the outcome of these reviews and actions highlighted by the reviews have been implemented. These include training of staff, additional auditing of calls within the Ambulance Control, a written protocol between Mayo General Hospital and the NAS and the recirculation by the NAS of the Code STEMI protocol.
