'If they had come when I rang, she could still be alive"

A widower has told a coroner"s court that he will never know if his wife would still be alive if an on-call doctor had called to their house as he had wanted. An inquest in Drogheda this week heard how 37-year-old Margaret Courtney died in her bedroom at home in Laytown as her husband and five children waited for an ambulance to arrive to bring her to hospital. Coroner Ronan Maguire was told that, since her death, the North-East Doctor-on-Call (NEDoC) service has started to improve the way notes by doctors are available to those on shift after them. Drogheda Coroner"s Court heard that Thomas Courtney had rung NEDoC twice in 12 hours looking for help for his wife and it was only when he rang their GP that an ambulance was dispatched. Tragically, it was a few minutes from their home when it was diverted to another more urgent call in the same area. When a second ambulance was despatched, it arrived at the Courtneys" home at Alverno Court minutes before she died. Pathologist Dr John Ryan found evidence of pneumonia but concluded Mrs Courtney died from disseminated group A streptococcus infection with septicaemia. He said this is normally preceeded by a viral infection and the symptoms come on 'abruptly." Mr Courtney said that, during the night of 1st-2nd February 2006, his wife"s bellybutton had become 'the size of my fist" and the skin around it was purple. She had gone to her GP, Dr David Madden, on 30th January where he diagnosed 'flu-like symptoms and prescribed painkillers. On the evening of 1st February, Mr Courtney rang NEDoC where he spoke with Dr Muireann Banim. He told his wife had pains in her lung area and a sore throat and was not eating or drinking. Dr Banim said she was also told Mrs Courtney had completed the medication prescribed by her GP and had not taken any that day. He said the symptoms were the same as when she went to her GP, 'but they were worse.' She advised Mrs Courtney to take Solpadeine. She said she had told him he could attend the on-call centre but there could be a delay and he could call the service back. 'I would not refuse to see somebody,' she said. Dr Dermot Daly was on call the following morning when, at around 7.15am, Mr Courtney rang the service and explained his wife"s stomach had gone black. He mentioned previous surgery she"d had for an ulcer. Dr Daly said Mr Courtney also told him his wife had aches and pains and had been coughing during the night. She had no complaints related to her gastro-intestinal system and he recommended she be seen by her doctor that morning and he arranged to contact Dr Madden. Dr Daly said he was aware Mr Courtney had contacted the on-call service the previous evening but 'I did not physically have Dr Banim"s sheet (notes) to hand', he added. Mr Courtney claimed Dr Banim told him he could be 'sitting for hours' at the on-call centre if he brought his wife there. He also said Dr Daly told him the service finished at 8am and, between then and 9am, GPs were on-call. Mr Courtney rang his GP at 8.13am, telling him he had twice rung NEDoC and got telephone advice. He insisted that his wife had to be seen and that she had got much worse. He told Dr Madden she was too weak to bring to hospital so the doctor said he would call for an 'urgent" ambulance which would be there within an hour. He rang NEDoC for an ambulance and, half an hour later, Mr Courtney rang him to say his wife was now unconscious. Dr Madden said the call was then upgraded to 'an emergency" and the ambulance crew rang him at around 9.15am to say Mrs Courtney had suffered a cardiac arrest. She was pronounced dead in her home at 9.23am. It emerged at the inquest on Monday the first ambulance was dispatched at 8.32am and, at 8.38am, there was an emergency or '999" call for an ambulance to go to Inse Bay estate, which is also in Laytown. As this was an 'emergency", it was given priority over Mrs Courtney and the ambulance was 'stood down" and diverted to Inse Bay instead. A second ambulance was dispatched at 9am and arrived at her house at 9.13am. While en route, it was upgraded to an 'emergency." Another GP in practice with Dr Madden had just arrived and pronounced Mrs Courtney dead at 9.23am. Coroner Ronan Maguire returned an open verdict. He said there was no evidence of pneumonia when she was at her GP. 'I don"t know if she had been seen on the morning (of her death) if anything could have been done, if it was too late,' he remarked. Mr Courtney told the court: 'I rang the Doctor-on-Call and they didn"t come. I feel if they had come when I rang in the morning, she could still be alive.' He added: 'I will never know if it could have been prevented. I cannot put my hand on my heart and say the doctors did all that they could. They didn"t come out to see her on two occasions. I did ask them to come. When you can"t go to them, they are supposed to go out to you.' It is his opinion that his pleas to NEDoC on the morning of 2nd February was 'very near' to the service finishing at 8am and 'they didn"t want to come out. That"s the way I feel; that"s the way the kids feel.' Speaking after the verdict, Mr Courtney welcomed the fact that 'now the notes will be available to the doctors coming on later. If it had been (at the time), you might not have my situation happening. Hopefully it won"t happen to anyone else.' Mr Courtney and his late wife have five children - Jonathan (21), Jason (16), Michael (14), Richard (12) and Megan, who is 10. 'She misses her mum, being the only girl,' Mr Courtney said. Mrs Courtney"s sister-in-law, Gillian, added: 'It has hit her the hardest.'