The family of a young Longford woman who suffered a fatal kick in the head from her horse claim staff at the Midland Regional Hospital in Mullingar repeatedly insisted her condition was “not bad enough” to be transferred for specialist treatment in Beaumont Hospital in Dublin.
The parents of Bryonny Sainsbury told an inquest about their mounting concern at their daughter’s deteriorating health over three days in the hospital in Mullingar after she was brought there following an incident at a riding stables in Keenagh, Co Longford on August 26th, 2021.
Ms Sainsbury (25) a hairdressing salon owner from Briskil, Newtownforbes, Co Longford, died in Beaumont Hospital on August 31st, 2021.
A consultant neurosurgeon at Beaumont, Donncha O’Brien, said his medical team were “completely powerless” to act to treat Ms Sainsbury as they were not informed about her deteriorating condition in Mullingar until she was suffering “prolonged seizures and in a critical condition.”
Scans
Several scans taken over a number of days in Mullingar, which were assessed remotely by radiologists based outside Ireland working for a private company, were regarded as showing the patient’s condition as “stable.”
However, Professor O’Brien, who reviewed the scans, said he believed they showed increased swelling on her brain which had not been recognised at the time.
He said his medical team in Beaumont had not been kept updated about the results of these scans as well as the fact Ms Sainsbury was complaining of persistent headaches and vomiting.
The neurosurgeon said he would certainly have arranged for the patient’s immediate transfer to Beaumont if he had been aware of such information.
The inquest at the Dublin District Coroner’s Court on Tuesday also heard that no blood tests, which could have detected critically low sodium levels in the patient, had been carried out on Ms Sainsbury for over 48 hours in Mullingar, despite being told by staff in Beaumont that they should be taken regularly.
They also advised they should be informed of any change in her condition.
“We were completely powerless to act as none of this information was available to us,” said Prof O’Brien.
'Completely gobsmacked'
He told the coroner, Cróna Gallagher, that he was under the impression that Ms Sainsbury was in “good” condition in Mullingar and was “completely gobsmacked” at what had happened.
Prof O’Brien said he believed that the situation was “still salvageable” if the patient had been transferred a few hours earlier to Beaumont on August 29th, 2021.
However, counsel for the Midland Regional Hospital in Mullingar, Caoimhe Daly BL, said it was not correct to suggest that there was no contact between the two hospitals over the course of a weekend based on the evidence of other witnesses.
The deceased’s mother, Alison Sainsbury, told the inquest that she was alerted to the incident in the stable where her daughter kept her horse and recalled hearing paramedics discuss whether she should be brought to Beaumont or Mullingar with the latter hospital being chosen.
Ms Sainsbury said she was unable to see her daughter until the evening of August 28, 2021 when she was “in and out of consciousness.”
She stressed that she had repeatedly asked why Bryonny was not being transferred to Beaumont as her condition seemed to worsen.
“She was not bad enough. That’s what they kept saying,” said Ms Sainsbury.
Transfer
Ms Sainsbury said her daughter’s condition continued to deteriorate the following day and she was “rolling around the bed in pain” when there was “a mad rush” to transfer her to the hospital’s intensive care unit before she was subsequently transferred to Beaumont.
“I don’t know why she was left in the state that she was,” Ms Sainsbury remarked.
She recalled being told by a neurosurgeon at Beaumont that her daughter was brain dead as a result of several fractures to her skull and a blood clot on the brain.
The inquest heard that two males had benefitted from her family’s decision to donate her kidneys for transplant.
Ms Sainsbury told the coroner that staff in Mullingar claimed they were being guided by specialists in Beaumont.
Her husband, Chris, told the inquest that his daughter kept falling onto him when she tried to stand up on August 29th, 2021.
“I was told that was a sign of her brain healing. We know now that was the opposite,” Mr Sainsbury added.
Screaming
He recalled that his daughter was “screaming in agony” as she was being transferred to the hospital’s ICU.
“I hear that every night for the last two and a half years – her screaming in pain,” said Mr Sainsbury.
A consultant surgeon on call in Mullingar at the time, Shahbaz Mansoor, said Ms Sainsbury was not his patient, but he was available to treat her if requested.
Professor Mansoor said he had seen the patient while doing his rounds on October 28th, 2021 and believed she was deteriorating with obvious signs of swelling on her brain.
However, Prof Mansoor said that while aware of her condition, he would not interfere with the patients of other consultants as it would be “insulting”.
Prof Mansoor said he was “100 percent sure” that other doctors were in contact with each other about Ms Sainsbury.
A consultant radiologist in the Midland Regional Hospital, James Slattery said there was nothing on the patient’s scans which had warranted any urgent situation as the results appeared “stable.”
Dr Slattery said there was nothing unusual about a lack of continuity in scans of a patient being assessed by different radiologists.
The inquest heard several nurses in Mullingar had raised concerns with doctors about Ms Sainsbury’s deteriorating condition.
A consultant anaesthetist in the hospital, Kamal Abouhajar, who examined Ms Sainsbury on the morning of October 29, 2021, said she did not need to be transferred to an ICU as she appeared stable.
However, Dr Abouhajar, said he would have recommended such a transfer if he was aware she had a low sodium level at the time.
He disagreed with the suggestion that he had been involved in a heated discussion with a nurse about the patient on the day.
Horse
A vet, Nathalie King, gave evidence that she was attending the stables as Ms Sainsbury’s horse had been choking on his food.
The inquest heard that Ms Sainsbury was standing at the horse’s side in a wash bay while the vet tried to place a tube into the animal’s mouth when the horse “exploded and jumped backwards.”
Ms King said she heard a loud noise of hooves stomping and saw Ms Sainsbury lying on her back on the ground unconscious and unresponsive.
She said the injured woman regained consciousness and was able to walk to a stretcher after paramedics arrived.
Ms King told the coroner that she had performed the same procedure with a tube around 10 times and did not feel the animal needed any more restraint.
Asked by counsel for Ms Sainbury’s family, Esther Earley BL, if it would be more routine to put a horse into an animal crush, Ms King replied: “I was trained to do the procedure exactly how I did it.”
The owner of the stables, Geoffrey Hall, said he was worried about the victim’s injuries but did not believe they were life-threatening.
He agreed with Ms Earley that using a crush would have been the safest place but also noted the same procedure had been carried out in the past in the wash bay.
The hearing was adjourned and will resume on Wednesday.
