On the 28th October 2012, Michael John McCreanor Junior (Beechy), a health 32 year old man, my Son, sustained a routine fracture from a rugby match playing for Boyne RFC. Having attended A&E on the 31st October 2012 with leg swelling too much for a full cast, a half cast was placed on his simple lower leg fracture. However, while under hospital care over a twenty two day period, he attended the hospital with clear medical indicators such as breathlessness, pain in his shoulders etc. Despite John displaying and reporting these symptoms to medical staff, he succumbed to his injury and died from a clot that formed from the fracture and resulted in a large saddle pulmonary embolus and CPR having been administered. John was a family man, a good father/provider, an accomplished sportsman/musician and an all-round character. Unfortunately, clots do not discriminate and this could happen to anybody at any age at any time. This issue could affect your family, friends, colleagues and wider community. Learn about your risks. Know the signs to watch for and get medical attention fast. Protect each other from this heartbreak.
Michael (John’s Dad)
I was asked to speak to you today following the circumstances and ultimately the death of our son Niall Comerford from a pulmonary embolism… and here is his story.
Niall was born the second of our four children and he was a very healthy happy child teenager and young man. Age 22 he was 6ft 2 was very fit and athletic focused and outgoing. He was very happy with his life and where it was taking him. At Waterford Institute of Technology he was doing legal studies (which he loved) and did extremely well in his first year exams he was looking forward to his second year which he had just commenced. Niall had lofty ambitions and was considering applying for a J1 visa to work in the U.S. He was also a very adventurous young man and just days before his surgery he had roped in some of his friends to do a parachute jump for charity which he also never got to achieve.
He was a great help to us at home and loved to help out where he could including me having problems with my laptop he would always have the solution. He had a wide group of friends and liked to socialise and was very popular amongst his peers. His main ambition was to finish his college education in legal studies and pursue a career in law which we have no doubt he would have excelled at. Sadly all of this was taken away from him by his untimely and preventative death and this has left a huge void in our lives and also on his wide circle of friends. The traumatic effect of Niall’s death on us his parents and his brothers and sister no words can describe and will continue for many years to come.
In 2010 while Niall was working at a part-time job he suffered an accident and came down on his left knee. A member of management brought him to a local hospital where he received medical assistance. He then underwent extensive physiotherapy for a number of months. Unable to mobilise his knee fully on extension he was then referred to University Hospital Waterford where an arthroscopy was performed this seemed uneventful and he was referred back for further physiotherapy and was only mobile with the use of crutches.
Niall eventually made a reasonable recovery but continued to suffer periodically with pain and discomfort this then resulted in him being referred back to the consultant in Waterford where a decision was taken to perform surgery on his knee. This surgery was scheduled to be performed on Monday 24th September 2012 On the morning of the surgery I brought Niall in to Lourdes orthopaedic Hospital Kilcreene Kilkenny at 7am for what was to be a day case procedure to remove the ossicle tibial.
I made an arrangement with him to collect him when he was discharged. He was brought down to theatre just after 1pm and was back in the ward at 1.45pm at 4.30pm he phoned me to collect him. On discharge he was given the following four a prescription for paracetamol a cert for college a discharge sheet and a tubic bandage this was to replace the crepe bandage after 72 hours he was instructed to return back to the hospital or to his GP after 10 days to have the 8 staple stitches removed. After 3 days at home he removed the crepe bandage as was instructed and replaced it with the tubic bandage he was given. Within a short time after putting on this tubic bandage he did mention that he was experiencing a feeling of pins and needles in the calf of his leg and he put this down to the returning of sensation in his leg. On the morning of the 30th September 6 days post-surgery he did comment on a discolouration to his leg. This seemed to fade after I said to him to raise his leg and see if that helped he also put this down to the after effects of the operation which seemed plausible to us also. HAD he been given an aftercare /information sheet to reference it could have highlighted any potential problems and made him aware of the possibility of a blood clot and he would have contacted the hospital where he could have received appropriate treatment.
On Sunday evening 30th September 2012 day 6 he said he felt well enough to return to his accommodation in Waterford and resume his studies the following day. I drove him down and told him I would collect him the following Thursday and said goodbye. This was the last time I saw him alive. On Monday 1st October the following day (7 days post-surgery) our lives changed forever. At 11 am I took a phone call from a nurse at Waterford Institute of Technology to say Niall had collapsed and was being brought by ambulance to University Hospital Waterford. Myself and my husband Walter and Niall’s sister Linda immediately drove down to the hospital (I can only leave it to yourselves to imagine the horror that unfolded when we were informed of his death) At a meeting with Niall’s consultant he explained to us that Niall developing a dvt was such an extraordinary rare occurrence in such a fit and healthy young man that the need for the awareness of developing a dvt was NOT highlighted to him. On 30th November 2012 an inquest was held into his sudden death and the coroner recorded his death as ‘Acute cardiac arrest, pulmonary embolism resulting from a dvt in calf of his left leg following recent history of surgery’.
Neither Niall nor we knew anything of deep vein thrombosis except for hearing of it in terms of long haul flights. I went on to research deaths occurring from blood clots and was shocked at what I discovered so many people were dying unnecessary and preventable deaths and thrombosis Ireland say that of the 4,000 hospital acquired deaths from vte’s that 1,900 deaths were preventable. This is very alarming and shocking.
The UK haematologist professor Beverley Hunt warns that thrombosis can affect both young and old and she further states that much more needs to be done to make sure that front-line medics properly recognise symptoms of deep vein thrombosis which, if not treated early is an indiscriminate and devastating killer.
We have been asked here today to share our story with you the past we cannot change we have lost our son and wish to God we hadn’t but you collectively can influence the future. Our message leaving here today is very important consultation information and the creation of awareness are the key factors in the prevention of deep vein thrombosis/pulmonary embolism which is the cause of so many unnecessary deaths. And just one more thing.
If Niall did not fit the profile of being a candidate for a blood clot then it is time that we stop profiling patients and look at every patient as a potential candidate for developing a dvt and the death of our son Niall should be the example and reason for doing this. For some he might be just a statistic but to us he was and always will be our son Niall.
Niall’s Mam Joan Comerford
In early 2009 my mum Susan, developed a lump on the side of her neck. She went to her GP who didn’t think it was anything to worry about. But the lump grew and so she was referred to hospital for investigations and a biopsy. We were worried of course but massively reassured when she was diagnosed with a branchial cyst, it wasn’t serious but would need to be removed surgically. Surgery was serious but it was okay, no one had said the C word.
Mum rang me from the hospital to say that cancerous cells had shown up and that they needed to find out where they had come from. And so it began… Mum had always kept diaries over the years, usually filled with the comical minutiae of daily life. I have subsequently found her diary entry from that day in the hospital. She had written – “the day the world changed.”
And the world had changed forever. I will preface the next part by saying that mum and I were more than mother and child. We were best friends, bickering partners, protectors, advocates and companions together. I was an only child, mum was married at 17 and separated at 20. In my mind it was my job to mind her, because she was trusting and kind and I was more of a survivor, more of a cynic. I lived in fear of the room door opening, that a doctor would come in and say something.
Eleven days later a doctor did come in and say something. And it was horrible and it was frightening. Mum was diagnosed with squamous cell carcinoma that had originated in her tonsil and was going to required further surgery, radiation treatment and chemotherapy. Mum was very brave. Very scared but very brave. And so we went into battle mode, we asked questions, we read all the booklets, we met the specialists and the focus became getting better. We latched onto every little scrap of positive information we could. When we left the hospital the doctor had filled in a long pink form, at the bottom of the form were written the words “highly treatable.” I read that part of the form every day, many times a day.
She had a second surgery in August and she was allowed to go on a short family holiday to Dungarvan. Next came all the arrangements for radiotherapy, which was like science fiction. Incredibly precise, tiny measurements were taken and a mask was made. She began radiotherapy and it soon became part of her routine. We were able to cross off the sessions, 35 due in all, and to see a light at the end of the tunnel. She tolerated chemotherapy less well and it was decided that it should be curtailed after three sessions, that in the doctor’s words, she’d “had enough.”
By early November the radiotherapy was taking a toll, she was tired and feeling down. On Friday 6th November she went Christmas shopping. She came home and complained of a pain in her lower leg. We put it down to a pulled muscle and thought no more about it. By Sunday evening she was having difficulty swallowing from the localised pain of the radiation treatment. She knew it was important to keep her strength up for the final few weeks of treatment so asked me to phone the hospital on Monday morning with the intention of being admitted.
We went in on Monday 9th November and they agreed to keep her in for the remainder of her treatment. That way they could finish out the radiotherapy while making sure she was eating and drinking enough. Again I haunted the hospital with my endless visits, keen to be there for any doctor’s rounds and eager to distract her with talk of the kids and Christmas, which was only around the corner.
On Wednesday 11th November mum’s leg was still in pain but now also looked swollen. She mentioned it to the nurse and a venogram was ordered. That afternoon mum was diagnosed with a DVT. And that was the day the world really changed, though we didn’t know it at the time. The diagnosis came as a complete surprise, this was something people were diagnosed with after long haul flights. How did this happen? It was only then that we became aware of the connection between cancer and DVT. I was horrified, why were we only hearing about this risk now?
She was started on daily treatment and the threat was played down, no one seemed concerned at all. The message from the professionals, the doctors, was that now they were aware of the DVT it was in hand, under control. We were reassured, to an unrealistic level. I was advised not to kiss or hug her in case I passed on anything.
I sat in a chair by the bed and we watched more TV and chatted. She was weak, had lost weight but was able to speak without discomfort at this point. During this time we were both extremely worried and scared but trying valiantly to hide it from each other. I have subsequently read her hospital files from then in which the nurse’s often mention the patient crying, stating that she is frightened, the patient appears anxious++.
On Monday 30th November I made my usual visit, the nurses were used to me and my questions. She had a Russian phlebotomist with whom she had been discussing Anna Karenina while he took samples. By about 5pm I was due to collect my kids from my in laws and so decided to leave. Mum was due to have her final dose of radiotherapy that Wednesday and then plans were to be made for her to come home. We joked that she could eat everything around her over Christmas as she was advised to put weight on.
I stood at the door of the room and asked could I hug her, she said best not to as the nurses said no. We had to be careful of infection. I closed the door and stood there, unable to leave. I opened the door again and looked at her, my wonderful, kind, funny, vulnerable mum. I didn’t want to go. But I left as I had every other day and told myself that I was being silly and that everything would be fine. The treatment was nearly over, she would be home, we would enjoy Christmas, she would be safe.
Just before 10pm that night we had our usual goodnight chat, we were both watching I’m a Celebrity Get Me Out of Here, she asked me to bring her in some shampoo the next day. We said goodnight and I told her I loved her best in the world, and she said the same. At about half ten the phone rang. It was one of the nurses at the hospital. She told me that my mother was extremely anxious and couldn’t breathe properly. She asked me what I thought was wrong. I suggested a panic attack. She told me that an ambulance had been called to transfer mum to a hospital with an emergency room.
When I arrived at the A&E department of the other hospital I was told that mum had arrested and that her pulse was absent in the ambulance. CPR was carried out for 40 minutes during which time they insisted that I go in and look to see that they were trying to save her. A machine that looked like a jackhammer was pummelling down on my mother, who had been cut out of her pyjamas and was wearing a hospital gown. They told me that there was no point in carrying on, that I had to identify her body and that they weren’t sure whether I’d be entitled to apply for a funeral grant. My mother, Susan Jones, was declared dead at 12.20 am on the 1st December 2009. It was surreal, I went outside and vomited.
Two doctors came to see me in a side room. I was in deep shock. I asked what could have happened. They told me that it was highly likely to be related to the DVT. They had her file from the other hospital. No of course it couldn’t be, I thought, they knew about that, they were treating that. I signed the forms for an autopsy, desperate to know what had happened. When the results were sent to me it was confirmed: her cause of death was a bilateral pulmonary embolism caused by DVT.
I have been desperate for answers to the question, how did this happen? Was this preventable? Were we adequately informed of the risks? It quite possibly was preventable and we were not made aware of the seriousness of DVT and its potential to prove fatal. I am so sad and so angry, and the passing of time in no way lessens that. My mother may have died anyway but we weren’t given the facts or armed with the information to possibly change the horrible course that this DVT took. When a loved one is diagnosed with cancer that becomes your focus, that becomes the fight. Every family in the world knows that. But the elephant in the room, the DVT, was the real threat. My mum endured so much to beat this, all the components of getting well, all the treatment, all the technology, all the precision. It was all for nothing.
Since mum died I feel like the shine has gone off the world. The loss is huge for me and for my children but the greatest loss is hers. She was a wonder, kind, witty, smart and the best person I ever knew. She had a lot of life to live and the world is a duller place without her. Everyone says their mum is great, but my mum was really, really great.
I feel that I wasn’t given the opportunity to look out for her best interests because the diagnosis of the DVT was downplayed so much. I completely took my eye off the ball because I didn’t know that this could, and would, go on to kill her. If you take one thing from listening to me today, and I want to thank you for taking the time to read this.
When someone is diagnosed with cancer they and their families are already scared, if informing them about the risks and complications of Blood Clots scares them more then scare them some more. It can literally make the difference between life and death.