Inquest hears scans failed to identify neurological issue

A verdict of medical misadventure has been recorded in the death of a mother of three young children who had suffered severe headaches for several weeks but was told by doctors that scans had failed to identify any neurological problem.

However, one consultant who subsequently reviewed two scans on the patient told an inquest that they showed signs of cerebral oedema (swelling of the brain).

Stacie Bailey, aged 33, a married mother of three from Whitefield Manor, Bettystown, Co Meath, died at Beaumont Hospital in Dublin on 23 November 2023 shortly after undergoing emergency surgery to drain fluid from her brain.

The civil servant, who was originally from Skerries, Co Dublin, was the subject of an urgent transfer to Beaumont from Our Lady of Lourdes Hospital, Drogheda, Co Louth where she had collapsed and suffered a cardiac arrest.

The inquest heard Ms Bailey had attended the hospital's emergency department four times in the space of a fortnight shortly before her death.

Stacie felt 'like her head was being crushed'

Ms Bailey’s mother, Julie Radford, who formally identified her daughter’s body to gardaí, told the hearing how Stacie had complained that she felt "like her head was being crushed".

The deceased’s husband, Darren Bailey, gave evidence of how his wife became very unwell in mid-October 2023 and had attended her GP and an out-of-hours service with headaches as well as nausea and vomiting.

The inquest heard Ms Bailey had a history of Addison’s disease – a rare disorder of the adrenal glands – for which she had been attending an endocrinologist since 2017.

Mr Bailey said his wife’s headaches continued into November despite being prescribed various painkillers and she attended the emergency department in Our Lady of Lourdes Hospital on 9 November 2023 for assessment and tests.

"They were satisfied that there was nothing critical, nothing sinister," Mr Bailey recalled. "We were told that her CT was clear and that there were no signs of an oedema and there were no issues."

Ms Bailey returned to the emergency department the following day when she was crying with the pain of her headaches but left without being seen by a doctor due to lengthy waiting times in the hospital.

She went back again on 14 November 2023 where she was sent home with a prescription for Tylex after a wait of over 16 hours.

Mr Bailey told the inquest that his wife rang him at work around 11am on 21 November 2023 when she complained she was feeling really bad and unable to move.

He described how he needed to get a wheelchair to bring her into Our Lady of Lourdes Hospital and how she could not respond when a triage nurse tried to take her medical history.

The inquest heard she fell out of the chair and collapsed a short time later.

Mr Bailey, who became emotional during the reading of his statement, said he was informed that his wife had suffered a cardiac arrest and needed a CT scan.

He was subsequently told that the scan was done and "everything looks ok" but a further scan was conducted which showed fluid on the brain.

"The possibility of recovery was slim," he added.

'No brain function'

Mr Bailey outlined how his wife was transferred to Beaumont Hospital in Dublin for emergency surgery after which a consultant informed him that the operation had been unsuccessful and there was "no brain function".

"After this I had to go home to tell my three children, aged 7, 10 and 13 that the doctors weren’t able to make mammy better and that she was dying."

"We sang to her, held her hand, told her how much we loved her and cried so hard," he said.

The inquest heard evidence from a number of consultants and doctors from Our Lady of Lourdes Hospital who had treated Ms Bailey who all stated that tests had failed to identify what was causing her headaches.

One possible diagnosis was that she had developed migraines from taking too many medicines, while another doctor felt she might have suffered a tension headache.

Ms Bailey’s consultant endocrinologist, Tomás Ahern, said he did not believe the patient had suffered a hypoadrenal crisis (a life-threatening adrenal gland condition) at any stage.

A consultant radiologist, Tamer Salem, who examined the results of a CT scan taken of Ms Bailey on 21 November 2023 remotely while working for a private medical company, said the images were of suboptimal quality because it was difficult to keep a comatose and intubated patient still.

Dr Salem said Our Lady of Lourdes Hospital radiology department only provided raw data without additional processing and reconstruction which limited his ability to interpret the images, especially where a patient may not have been positioned correctly.

The radiologist admitted he had relied to some extent on an earlier CT scan performed on Ms Bailey on 9 November 2023.

Dr Salem confirmed that he found no evidence of any intracranial abnormality, although he had considered the possibility of brain oedema but did not include it in his report because of the quality of the images.

The consultant said another scan carried out four hours later showed evidence of brain deterioration including swelling.

A consultant anaesthesiologist at Beaumont Hospital, Caroline Larkin, gave evidence of reviewing two scans performed on Ms Bailey which, while reported as normal, she thought had shown cerebral oedema.

Although Dr Larkin acknowledged that she was assessing the images with the benefit of hindsight, she still felt some "mild" swelling was evident in them which would typically result in a need for further tests.

In reply to questions from coroner Clare Keane, she said she thought the patient might have been suffering from an Addisonian crisis or some sort of chronic meningitis.

Dr Larkin said there was almost no prospect of Ms Bailey’s condition being reversed by late on 21 November 2023.

In a closing submission, counsel for the deceased’s family, Doireann O’Mahony BL, said doctors at Our Lady of Lourdes Hospital had placed "a significant reliance on images which were reported as normal" which had led to a tragic deterioration in the patient’s condition.

Recording a verdict of medical misadventure, Dr Keane said Ms Bailey had died primarily from a swelling of the brain in what was "a very complex case".

The coroner stressed that her finding was "a neutral verdict" which did not attach blame.

Dr Keane said she did not see the need for any recommendations but expressed hope that some of the questions of the deceased’s family had been clarified.

"It was very difficult evidence," said Dr Keane. "I’m extremely sorry for your loss."