A 34-year-old woman who lay dead in the toilets of University Hospital Galway for up to twelve hours died as a result of a lethal level of alcohol intoxication, an inquest into her death heard.
Ewelina Cieślak, a Polish national who had been a resident at Galway Simon’s high-support accommodation in Newcastle, was found dead in a disabled toilet at the hospital’s Emergency Department on Monday morning, August 7, 2017.
In evidence given to the inquest, Housing Support Assistant with Galway Simon, Nadine Hughes, said Ms Cieślak had addiction problems with alcohol, but had been sober on the Sunday afternoon when she left her accommodation in Hazel Park.
“Ewelina had been drinking on Saturday, August 5, but had been sober when I was talking to her on Sunday, August 6,” Ms Hughes told Coroner for Galway West, Dr Ciarán MacLoughlin.
“She told me she was going out but she did not say where. We had agreed to keep in contact by phone, as per our protocol,” she continued.
Ms Hughes explained that residents were not obliged to stay with them if they did not want to, but they were always encouraged to return at night.
Several attempts were made to contact Ms Cieślak throughout Sunday night, August 7, but her phone was switched off – something Ms Hughes said was not unusual for Ms Cieślak.
Ms Cieślak was found by security staff at UHG behind the locked door of the disabled toilet at 6.30am the following morning.
Security guard at the hospital, Keith Moggan, told the inquest that he had entered the toilet when an unrelated “suspicious male” he had been watching went missing sometime before 6.30am.
“When I discovered the disabled toilets were locked, I went to get the keys from the office and on opening the door, I discovered a female who I now know to have been Ewelina Cieślak.
“I sent a security officer who had followed me to get help,” said Mr Moggan.
He said that as the toilet was in full view of patients outside, he closed the door before checking for a pulse. He said he could not find one and that the body was cold to the touch.
Ms Cieślak was rushed to the resuscitation room where staff at the hospital attempted to revive her but she was pronounced dead at 6.43am.
Mr Moggan said he checked CCTV footage of the area a short time later from which he could identify Ms Cieślak entering the toilet at 6.57pm on Sunday evening.
Nobody had accessed the toilet in the hours between Ms Cieślak’s entry and his opening of the door at 6.30am the following morning.
“At approximately 6.45am, a member of the nursing staff ordered that I open the toilet and we searched it,” said Mr Moggan.
Their search uncovered four empty 200ml bottles of vodka discarded in the waste and sanitation bins.
Noonan, the company contracted to provide cleaning services for the Saolta Hospital Group, were represented by Account Director, Rachel Naylor.
Ms Naylor said it was their policy to check the toilets at least every two hours.
On the night in question, Ms Naylor said attempts had been made to access the toilet where Ms Cieślak was found on three separate occasions – at 6.30pm, 9pm and 11pm.
She said because of the staff member’s inability to gain access, it had been assumed the toilet was out of order.
“There have been occasions in the past when hospital security would lock the toilets as they may require a maintenance person to attend.
“This has happened in the past and no ‘out of order’ sign was placed on the door,” said Ms Naylor.
She said staffing levels were normal on August 6 and 7, 2017, and that it had been standard procedure to make a note of failure to access toilets and inform a senior manager upon their arrival at 7am.
Since the death of Ms Cieślak, Noonan and hospital management have added a new regulation to their procedure requiring cleaning staff to contact security if they cannot gain access for an extended period.
“If a toilet is occupied for a period of 30 minutes or more, security must be notified to see if the occupant is safe,” said Ms Naylor, adding that Noonan cleaning staff do not have keys to enter once the door is locked from the inside.
Coroner, Dr MacLoughlin, reading into evidence the report of Consultant Pathologist, Dr Yi Ling Khaw, said that Ms Cieślak’s blood alcohol level was 576mg per 100ml.
“Alcohol levels may be toxic from 100 to 450mg, while lethal is between 400 and 600mg.
“Ewelina Cieślak died on August 7, 2017 at University Hospital Galway. The cause of death, in accordance with the medical evidence, is alcohol intoxication,” said Mr MacLoughlin.
He said that another significant condition that was contributory, but not the cause of Ms Cieślak’s death, was a diseased and fatty liver.
Members of Ms Cieślak’s family had travelled from Poland to attend the inquest and speaking through an interpreter, Dr MacLoughlin extended his condolences to her mother, Joanna, and daughter, Greta – as well as members of her immediate family and friends.
“The inquest is not in a position to make any recommendation as the cleaning company and the HSE have learned from the tragic circumstances of Ewelina’s death and have put in place protocols to avoid it happening again,” concluded Dr MacLoughlin.