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Inquest told car dealer may have been misdiagnosed

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The inquiry into the unexpected death of a well-known car dealer heard that he may have been misdiagnosed in a private hospital, which could ultimately have reduced his chances of survival.

The late JJ Fleming (60), of Blackrock, Salthill, walked into the Galway Clinic on November 6 2013 complaining of numbness in his legs, but died in Bon Secours Hospital on December 8 – where he had been transferred, at the request of his wife.

“If he’d seen a neurologist straight away, and had the appropriate treatment, we would not need an inquest,” Maria Fleming told the inquiry at Galway Courthouse on Thursday. “Why did it take nine days for them (Galway Clinic) to seek a neurologist’s opinion?”

The father of four had been on holidays in Spain in November 2013 when he began to feel unwell. He went home early to attend an out-patient’s appointment with consultant urologist, Dr David Boucher Hayes, in the Galway Clinic, as he was heading away himself the following day.

His wife said that he had an uncomfortable night at home on November 5, however, and was advised to pack an overnight bag so that he could be admitted to the Clinic for routine tests.

He walked in the following day, and was told that he did not have prostate or urological problems – as he had been told by his GP and hospital staff in Spain – but rather five trapped nerves in his back.

“I arrived back on November 9, and was alarmed to hear that he needed surgery,” Mrs Fleming said.

Urgent decompression was required, she was told, as his condition was deteriorating daily, his legs were weakening, and he now walked with a limp.

She questioned why the surgery was not performed until November 13 – a full week after being admitted. And, she said that his condition actually got worse after the operation.

Her husband complained all day after the surgery of a burning sensation in his legs, but was told that it was normal.

She said that it was not until a year later, when she received a claim form from the VHI, that she found out he had been brought back to the operating theatre the following day as an MRI had confirmed a bleed.

“Nine days after surgery he was essentially paralysed… He questioned his care, and voiced his concern,” she said.

He was seen by Dr Michael Hennessy, a consultant neurologist visiting from the Bon Secours Hospital, and diagnosed with mononeuritis multiplex, which is damage to one or more peripheral nerves – the nerves outside the brain and spinal cord.

On Dr Hennessy’s advice, and on the requests of Mrs Fleming, her husband was transferred to Bons Secours Hospital on November 25, where he was admitted under a new team, put on steroids, and a marked improvement followed.

“There was a total transformation, and his mood improved greatly – they were all so much more positive about his recovery,” she said.

Their daughter had set a date for her wedding in August 2014, and Mr Fleming was determined that he would be able to walk her up the aisle.

“It gave us great hope,” his wife said. “I was advised to make changes to our home, as he would be coming home in a wheelchair.”

However, his condition deteriorated in the early hours of December 5, and he became unresponsive.

“When I arrived, he was motionless in the bed, the neurologist said that he had suffered a major brain haemorrhage… he looked like he was asleep,” Mrs Fleming recalled.

He passed away on December 8 and, when his wife called to the Bons Secours Hospital in March 2014 for the results of the post-mortem examination, she was told by the consultant that her husband may have been initially mis-diagnosed; that the inflammation of his spinal nerve roots could only have been detected by a neurologist.

“He said that he had not required the initial treatments (operations), that it would have been steroids (treatment) – which is what he had in the Bons,” she said.

“I was shocked that he’d had two surgeries in the Clinic that he had not required.”

However, Dr John Burke, an orthopaedic surgeon at the Galway Clinic told the inquiry that Mr Fleming’s symptoms “fitted with Cauda Equina Syndrome (CES)…”

This condition affects the nerve roots in the lower end of the spinal cord, and needs to be dealt with urgently, as it would have worsened with time. He added that compressed nerves were discovered when Mr Fleming went under the knife.

However, he acknowledged that this may not have been a correct diagnosis. “When he began to worsen, I knew it was another factor, and called in Dr Michael Hennessy,” he said.

This initial diagnosis was shared by other consultants, who had assessed Mr Fleming while he was a patient in the Galway Clinic – among them, Dr Ronan Kavanagh, an expert in the area of inflammatory diseases, and Mr Fleming’s rheumatologist since 2010.

Former Consultant Neuropathologist at Beaumont Hospital, Professor Michael Farrell, carried a post-mortem examination on the brain, and submitted a report to the Inquest, which was read into the record.

He concluded that death was due to a stroke, most likely caused by “extreme” arteriolar sclerosis, which is common in diabetics, from which Mr Fleming suffered for 30 years.

His findings in relation to what caused the initial complaints, while on holidays, were at odds with some of the other medical evidence given on the day, and Mrs Fleming’s legal team requested that Prof. Farrell would attend the Inquest at an adjourned date in September.

Connacht Tribune

Minister rebuffs calls to lower air fares for islanders

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Efforts to extend reduced public transport fares to Galway’s offshore islands have been rebuffed again.

Galway West TD Éamon Ó Cuív (FF) has been campaigning for months to have reduced passenger fares that apply to public transport on the mainland, introduced to the islands.

The former Gaeltacht Minister had lobbied Minister for Rural and Community Development Heather Humphreys on several occasions to extend the reduced fares to the Aran Islands and Inishbofin.

In the latest response to a Parliamentary Question tabled by Deputy Ó Cuív, Minister Humphreys has again resisted calls to extend the discounted fares to islanders.

In the reply she said that residents of Ireland’s 19 offshore islands already enjoy ferry fares that are at least 20% cheaper than visitors.

Minister Humphreys said, “any unilateral action to alter the terms of the existing contracts could represent a breach of contract and bring the entire procurement process into disrepute”. This, she argued, “could have a detrimental impact on the ongoing operation of these vital services”.

Minister Humphreys said that her Department, “will continue to examine ways of ensuring affordability and sustainability of island transport, both within existing contracts and in future”.

Deputy Ó Cuív suggested he had been led on a merry dance over the past few months and said the Minister never intended to reduce fares for islanders.

“It is now clear from this reply that the Minister, on advice from the Department, never intended reducing the passenger fares to the islands in line with the reduction in the rest of the country and that all the replies I got were just a push off without basis.  One of the things mentioned in previous replies was that subsidised services could not be in direct competition with non-subsidised services.  It is clear from the reply that the Department do not even know if such a situation exists,” Deputy Ó Cuív added.

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Connacht Tribune

Galway must ‘sort itself out on the tourism front’

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Galway risks losing its reputation as a go-to destination for Irish tourists unless the city’s ‘overall package’ is revitalised.

That’s according to a local councillor who says sky-high hotel prices and anti-social behaviour problems in the city were serving as a deterrent for would-be visitors.

Cllr Mike Crowe (FF) said as people became more prudent with their spending amid a cost-of-living crisis, few would be willing to fork out €500 for a weekend in Galway.

“People want to feel that they are getting some value and they’re certainly not feeling it this year.

“While it’s not only Galway where this is an issue, the prices are too high and people are more concerned with what they’re spending at the moment,” said Cllr Crowe.

A survey of available hotel rooms carried out by the Connacht Tribune this week showed that for two adults to share a double room in Galway City for the weekend of August 26 to 28, the average cost was €560.

The cheapest room available was at a hotel 7km outside the city centre, at a cost of €409 for the same two nights.

By comparison, the average room cost for the same weekend in Limerick was €450 – including a stay at a five-star hotel.

Dublin prices remain way above any of the regional cities, with punters expected to come up with more than €700 for even the most basic property for the last weekend in August.

However, Cllr Crowe said Galway had to stop the rot before the good work done to attract tourists prior to the pandemic was lost for good.

“The vast majority of people are not going to stay in any city where an ordinary weekend in August will cost them more than €300, not to mind €400 and €500.

“Put simply, people want to get a fair product for a fair price,” he said.

A proportion of hotel rooms were facilitating refugees from Ukraine and elsewhere, he said, which was reducing the overall number available and this was having an impact on supply, said Cllr Crowe.

In addition, the city had struggled to compete with the on-course entertainment provided for racegoers in July, with city centre businesses struggling as a result, he continued.

“What we’re offering here at the moment is not at the level it needs to be at. Ultimately, the rooms are too dear but that is just one factor – the city is too dirty as well.

“From an experience point of view, if you’re walking from Bohermore or College Road down through the spine of the city as far as Salmon Weir Bridge, the city is dirty. There are neglected buildings, gangs are drinking at various corners, there are issues with begging and all of that is acting as a deterrent,” said the Fianna Fáil councillor.

Galway was fortunate that representatives had worked for years to protect the business element in the city centre core, said Cllr Crowe, avoiding the problems faced by cities like Limerick and Cork where their shopping core was now located outside the city at suburban shopping centres.

“We have been lobbied for decades to ensure that the shopping experience was kept in town and we have done, but now all business owners need to step up and do their bit to keep the areas around their premises.

“The Environment Section in Galway City Council also needs to get the finger out and make sure the city is clean,” he said.

Cllr Crowe called for a joined-up approach, to include city councillors and the Council Executive, Gardaí, the tourism industry and local businesses.

“We all need to come together and look at what we’re offering as a city and I think if everyone was honest, they would say what we’re offering at the moment is not up to standard.

“We need to do it because if we don’t, the great progress that was made in the past will be lost,” he said.

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Connacht Tribune

Tesco urged to go for full Irish on new supermarket

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British retail giant Tesco has been urged to provide Irish-language self-service checkout tills at its new Galway Gaeltacht store.

The company acquired nine Joyce’s Supermarkets across Galway earlier this year and is in the process of rebranding and redesigning them as Tesco stores.

Among the supermarkets is ‘Siopa an Phobail’ in Indreabhán, in the Conamara Gaeltacht.

Conradh na Gaeilge this week urged Tesco to provide an Irish language self-service checkout at its Indreabhán store, which is the first-ever Tesco in the Gaeltacht.

Bearna-based Irish language news agency, Tuairisc.ie reported that Conradh na Gaeilge has recommended Irish-language self-service checkouts be installed in Indreabhán, similar to those available in Welsh-speaking areas of Wales.

Tesco has bilingual signs at its Galway City stores and issues bilingual press releases.

A spokesperson for Tesco Ireland confirmed to the Connacht Tribune that it has engaged with Údarás na Gaeltachta about taking over the Indreabhán shop and petrol station.

“We have begun the process to rebrand and redesign the Joyce’s Supermarkets as Tesco stores across Galway which will take place on a phased basis over the coming months. We’re delighted to confirm that in line with our community ethos, we will continue to operate Siopa an Phobail at Indreabhán.

“We are engaged with Údarás na Gaeltachta to ensure we’re responding to the needs of the Gaeltacht community and how best to support our new colleagues and customers as our integration begins,” a Tesco Ireland spokesperson said.

She said that services provided at Indreabhán, including the petrol filling station will be retained.

“During the transition process, we will be delighted to welcome employees from Joyce’s stores to the Tesco team.

We will continue to keep customers and communities updated on the impact of refurbishment on store operations. We look forward to opening our Tesco store at Indreabhán later this year and thank the customers and communities for their patience while refurbishment works are carried out. We look forward to serving the community for many years to come,” she added.

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