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Pensioner died following teeth extractions

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A 71 years old man died after suffering a fatal reaction to the generic form of an antibiotic, which had been prescribed following the extraction of teeth in UHG last summer, an Inquest into his death heard.

Coroner for West Galway, Dr Ciaran MacLoughlin, explained to the man’s family that owing to his previous history of taking a similar drug, it could not have been predicted that death would result – none of the medical witnesses had ever experienced such an outcome when treating anaphylactic shock.

Patrick Naughton of 155 Corrib Park, Newcastle, walked to nearby University Hospital Galway on the morning of his death, May 23 last. He had an appointment for extractions at 8am, and was picked up by his daughter, Louise King, at 1.05pm.

She said he was in perfect health, and had no complaints apart from a tingling sensation in his tongue, as the local anaesthetic wore off.

They went shopping and picked up his prescription for an antibiotic, ‘Co-amoxiclav’ – a penicillin-based drug, which is better known by its trademark/proprietary name, ‘Augmentin’.

Being on a medical card, Mr Naughton was sold a generic form of Augmentin – of which there are many, the Inquest heard.

After his dinner, he took the antibiotic, lay down for a short time, and then came downstairs clutching his chest.

“His speech was impaired, and his tongue was severely swelled,” Mrs King recalled.

He was driven to A&E immediately, but died later that night.

Oral surgeon, Patrick McCann, told the inquiry that Mr Naughton’s existing medications – which had previously included Augmentin – were noted on his chart before the procedure, so it was well-documented that he had had no known allergy to penicillin.

“The allergic reaction was not predicted,” he said.

He added that the anaphylactic shock that ultimately caused the death was not a delayed reaction to the local anaesthetic and sedative given to Mr Naughton prior to the dental procedure.

The Inquest heard that when Mr Naughton presented to A&E his GCS – which measures brain function – was 15 out of a possible 15. He was given the standard treatment for anaphylactic shock, which included oxygen, antihistamines, steroids and adrenaline, but his condition deteriorated.

Despite his swollen tongue, Mr Naughton initially had 95% oxygen saturation, but this gradually decreased, and the last resort was to perform a tracheotomy – a difficult, but necessary, procedure to install a definitive airway.

However, the consultant anaesthetist on call, Dr Leo Kevin, said that owing to Mr Naughton’s already large – and now swollen – neck, it was impossible for emergency medical staff to identify the usual ‘landmarks’ such as the Adam’s Apple, so they could not perform the procedure there and then.

“The only safe way to do a tracheotomy in this situation is a slow dissection by an ENT surgeon in the operating room,” he explained.

However, within seconds of arriving, Mr Naughton had no pulse, and chest compressions were commenced. After one hour of CPR, resuscitation ceased, and he was pronounced dead at 10.30pm.

He said that Mr Naughton’s pre-existing medical problems had shortened the odds of survival.

“A young person with anaphylactic shock is more likely to be retrievable,” he said.

Mr Kevin told the Inquest that he suspected Mr Naughton had suffered a cardiac arrest on the operating table. He agreed with the Coroner, that the stress of the allergic reaction had likely caused him to go into heart failure.

However, consultant pathologist, Dr Michael Tan, said that he could find no convincing evidence, when examining the heart muscle under the microscope, to say that a heart attack was the cause of death.

He concluded that the anaphylactic shock was “most consistent” with a severe reaction to an antibiotic.

Dr MacLoughlin returned a verdict in accordance with the medical evidence, that death was caused by asphyxia, due to anaphylactic shock, due to a severe allergic reaction to Co-omoxyclav.

“You hear occasionally of people dying from a severe reaction to peanuts or wasp stings, this was the same kind of thing – normally, it is quite successfully treated,” the Coroner said.

“Because of his previous history of being given this chemical, doctors felt he had no known allergy, and couldn’t have expected this to happen.”

He offered his sincere sympathies to Mr Naughton’s children, in-laws, and other family members who attended the Inquest, on the tragic and unexpected circumstances of his death.

CITY TRIBUNE

Galway City Council turns down Mad Yolk Farm site

Dara Bradley

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An application to retain farming-related development on a site in Roscam has been turned down by Galway City Council.

The local authority has refused to grant retention permission to applicant Brian Dilleen for subsurface piping to be used for agricultural irrigation at ‘Mad Yolk Farm’ on Rosshill Road.

It also refused permission for the retention of a bore-hole well, water pump and concrete plinth; and two water holding tanks for 6,500 litres; and other associated site works.

In its written decision, the Planning Department at City Hall said: “The proposed development, would if permitted, facilitate the use of the site for the provision of sixty 15.5m high seed beds, which have been deemed by the planning authority not to be exempted development.

“Therefore a grant of permission for the proposed development would facilitate the unauthorised development and usage on the site, contrary to the proper planning and sustainable development of the area.”

The site has been the subject of enforcement action by the local authority.

A lengthy Appropriate Assessment Screening report, submitted with the planning application, concluded “beyond reasonable scientific doubt, in view of the best scientific knowledge, on the basis of objective information and in light of the conservation objectives of the relevant European sites, that the proposed retention and development, individually or in combination with other plans and projects, has not and will not have a significant effect on any European site”.

A borehole Impact Assessment Report concluded that the proposed retention development “on the hydraulic properties of the aquifer is considered negligible”.

It said that there was “no potential for significant effects on water quality, groundwater dependent habitats or species associated with any European site”.

Six objections were lodged by neighbours, including one from the Roshill/Roscam Residents Association, which argued the Further Information submitted by the applicant did “little to allay our concerns” about the impact of the development on an “extremely sensitive site”.

The applicant has until June 29 to appeal the decision to An Bórd Pleanála.

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CITY TRIBUNE

NUIG student accommodation firm records loss

Enda Cunningham

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The property company which operates student accommodation on behalf of NUI Galway recorded a €3.4 million increase in turnover in 2019.

However, Atalia Student Residences DAC (Designated Activity Company), which is owned by the university, recorded a loss for the year of €6,300.

Accounts for the company for the year ended August 31, 2019, show that while there was a loss, retained profits are at more than €1.6 million. The accounts are the most up to date available from the Companies Registration Office.

The previous year, the company made a profit of more than €460,000.

Atalia Student Residences operates the 764-bed Corrib Village apartment complex and the 429-bed Goldcrest Village.

The figures show that the company’s overall turnover jumped by 52% – from €6.4m to €9.8m.

Turnover for accommodation services was up from €5.2m to €8.4m; and from conferences and events was up from €850,000 to €1.1m. Turnover from shops was down from almost €328,000 to €290,000.

Outside of the academic year, both complexes are used as accommodation for conference delegates, while Corrib Village is also used for short-term holiday lets.

The accounts show fixed assets – including fixtures and fittings, plant and machinery and office equipment – valued at €1.5m. Its current assets were valued at more than €7m, including ‘cash at bank and in hand’ of almost €6.9m (up from €5.6m last year).

The company owed creditors €6.9m, including €5.2m in deferred income.

It employed 38 people (which includes its five directors) last year, up from 31 the previous year.

As well as operating the student accommodation complexes, the company also markets conference facilities and services on behalf of the university.

It pays rent to NUIG but the figure is not included in the company accounts. In 2018, the rent figure was just over €2.25m.

In Corrib Village, a single bedroom with a private en suite for the academic year costs €5,950. For Goldcrest Village, the figure is €6,760.

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CITY TRIBUNE

Call for two-way cycling under Galway City outdoor dining plan

Dara Bradley

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Bike users want the local authority to examine the introduction of two-way cycling on one-way city centre streets.

Galway Cycling Campaign has again called for cycling to be allowed both ways. It comes as Galway City Council prepares to cordon-off parts of city centre streets to traffic, and make Dominick Street Lower one-way, to facilitate outdoor dining.

The cycling organisation said that the proposed pedestrianisation plan at the Small Crane, and the one-way system on Dominick Street, will result in lengthy diversions for people on bikes.

It has pointed out that school children and their guardians who cycle along Raleigh Row, and turn right towards Sea Road, will probably continue to do so even when the Small Crane is cordoned off to traffic, because the alternative route – via Henry Street – is too long a detour.

Similarly, it has been suggested that food-delivery services on bikes are unlikely to go the ‘long way round’ via Mill Street and New Road to get from Bridge Mills to restaurants on Dominick Street and would be tempted to cycle the ‘wrong way’ down the proposed one-way street or on the footpath.

Shane Foran, committee member of Galway Cycling Campaign, said now would be an ideal time to introduce two-way cycling on some one-way streets.

“It’s not controversial,” insisted Mr Foran. “It’s a general principle in other countries, if you are putting in new traffic arrangements, you would try and keep access for people on bikes.”

The regulation is contained in the National Cycle Policy Framework 2009; and a specific objective was contained in two of the most recent previous City Development Plans.

He said a former minister and Galway West TD, the late Bobby Molloy, had the vision to change the legislation in the late 1990s – but it hasn’t yet been embraced here.

“Bobby Molloy, who couldn’t be classed as an eco warrior, changed the law in 1998, so that it is available to local authorities to put up a sign granting an exemption from restrictions for people cycling on one-way streets.

“The road stays one-way for cars, and two ways for bicycles. Clearly that’s not going to be a sensible to do everywhere, like Merchants’ Road. In those situations, you might need a cycle track or lane to segregate people from traffic.

“But if it’s a low traffic street, with low speeds or relatively lower volumes of cars, then it should be possible for people on bicycles to cycle in both directions and still have it one-way for cars, without it being a major safety issue. It works in other countries,” said Mr Foran.

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