Cancer patient ‘in extreme pain’ left on wheelchair for eight hours in LUH

A cancer patient ‘in extreme pain’ was left waiting in a wheelchair for eight hours in the Emergency Department of Letterkenny University Hospital (LUH).

The hospital has been reviewing pathways for cancer patients who require emergency admission, but for the foreseeable future such patients will have to continue being seen by general medical doctors in its Emergency Department (ED), outside of “standard working hours”, Councillor Gary Doherty has been told.

At a meeting of the HSE Regional Health Forum West, held in Galway, he gave an example of the plight one patient had to endure. 

Cllr Doherty said: “I know one patient who has tumours in her liver, spine, lung and bones, who was in extreme pain recently, which meant that she was unable to move her head or even to open her mouth, never mind present at ED. 

“That patient was left in a situation, where she had to sit in a wheelchair for a period of around eight hours before she was admitted. 

“When these patients present to ED, the general medical doctors who treat them in the emergency will readily admit themselves, I think, that oncology is not their speciality and when a patient that attends at ED who is in extreme pain, these doctors they don’t know the patient's history.

“They can’t make a judgement on the differences that there may be in scans or xrays . . . when the patient attends at ED and indeed what existing medication and what medicines they are precluded from taking as a result of their oncology treatment.”     

In his question, Cllr Doherty had queried what plans, if any, are currently in place to implement an Emergency Department Cancer Pathway in LUH, at Tuesday’s meeting, his first meeting to attend as a member of Donegal County Council.

He was told by Ann Cosgrove, Interim CEO of the Saolta University Health Care Group:

“LUH are currently reviewing their pathways for the management of Medical Oncology and Haematology patients who require emergency admission as inpatients with a view to reducing the requirement for these patients to have to wait for prolonged

periods within the Emergency Department. 

“It must be noted that the current medical staffing levels within Medical Oncology and Haematology do not allow for a full 24/7 on call cover and for the foreseeable future it is envisaged that outside of standard working hours patients will have to continue being seen by the general medical doctors working in the Emergency Department.

“For all other sites specific cancer patients, their care will continue to be managed by the relevant specialty teams who provide 24/7 cover in the Emergency Department (ED).”

Responding to the answer that he received, Cllr Doherty added:

“Firstly, I wish to acknowledge the acute oncology nurse phone lines which have been a huge help to cancer patients since it was launched.

“However, there are limitations to that service, and it’s only available 8am-4pm, Monday to Friday in LUH and I think the purpose of those phone lines and the appointment of those specialised oncology nurses is to ensure that oncology patients are triaged and receive the most appropriate care where possible and to avoid attendance at ED.”

He noted from a related answer from another question of his, that “a designated unscheduled room on the oncology ward” was available at University Hospital Limerick (UHL).

“This is certainly a service that we desperately require in LUH,” he said.

He acknowledged that while there were not enough staff to give 24 hour coverage for cancer patient emergency admissions, “these are among the most vulnerable  patients presenting at ED and to subject them to sitting for hours on end, on hard chairs, when they are already undergoing chemotherapy and often in extreme pain, is something that I don’t think that we should have to accept”.