The family of a 31-year-old part-time farmer, who was taken to Sligo University Hospital three times after being gored by a bull, believe if an angiogram had been done the second time, it would have shown up blood clots on his lungs and “in all likelihood” averted his death, an inquest heard on Monday.
A verdict of medical misadventure was returned by a jury at Sligo Coroners Court in the case of Anthony Cull of Castlefore, Keshcarrigan, Co Leitrim who was attacked by a bull on the family farm on February 2nd, 2019.
He was admitted to the Sligo hospital that day, and was discharged on February 7th. The jury heard he collapsed at home two days later, was brought back to the hospital but was released after just over two hours in the emergency department.
When he fainted at home on February 14th his family called an ambulance and he was readmitted to the hospital but died there later that day.
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Family solicitor Gabriel Toolan, who described Mr Cull as “an extraordinary young man”, told coroner Eamonn MacGowan that the Culls were of the firm belief that if a CT pulmonary angiogram had been done on February 9th, it would have revealed the blood clots in his lungs and would “in all likelihood have averted the tragedy of his death”.
The cause of death, according to pathologist Dr Clive Kilgallen, who carried out the autopsy, was bilateral pulmonary emboli after injury by a bull.
After the inquest Mr Toolan confirmed that legal proceedings against the hospital were in train.
In a statement to the inquest, Dr Karen Harris, a consultant in emergency medicine at the hospital, said Mr Cull “should have been readmitted” on February 9th. She said that unfortunately the hospital did not have formal protocols in place at that time for such situations.
The jury heard that on the day he was attacked, Anthony, an electrician who regularly helped out on the farm was working with his father, Gerard, cleaning out pens in a cattle shed where there were two bulls. Gerard Cull said his son had been letting one of the bulls into a clean pen “like we had done every week”. He heard the animal squealing “like a pig”. The bull turned on Anthony and he shouted at him to get out of the pen but the bull was hitting his son with his head “with serious force”. Mr Cull recalled how when Anthony fell to the ground he jumped the barrier with a grape and tried to keep the animal away from his son. He managed to get the bull out of the pen and Anthony was removed by air ambulance to Sligo hospital.
He was discharged on February 7th but after collapsing in the bathroom at home he was taken by ambulance back to the hospital on February 9th. When he was discharged that day he was so weak the family had to get a wheelchair to get him to the car. “We were told Anthony had low blood pressure and to raise his legs up higher than his head if he felt unwell,” Mr Cull recalled.
The jury heard that the family called an ambulance on February 14th. As he walked to the ambulance Anthony collapsed and lost consciousness for 15-20 seconds.
Dr Harris said she had been on call the day Mr Cull was admitted after being attacked by the bull. She was told he was complaining of pain to his right shoulder, chest and left thigh. An X-ray and CT scan of his right shoulder showed a dislocation of the joint. Blood tests indicated muscle injury.
Dr Harris said Mr Cull returned to the hospital by ambulance on February 9th, after collapsing at home, arriving at 7.43am. He was reviewed by a registrar and discharged at 9.47am.
When he was brought back in on February 14th she assessed him and was “immediately worried about him”. She thought it likely that he had a pulmonary embolism. A CT scan was done and treatment started. When his condition deteriorated he was treated with a “clot buster” drug but “he went into cardiac arrest very quickly”.
Dr Edward Herridge, a registrar in emergency medicine who treated Mr Cull on the morning of February 9th, said the 31 year old had told him he was in pain overnight, had felt nauseous and had collapsed twice when he got out of bed, briefly losing consciousness. He complained of pain to his right shoulder and left thigh following the injuries sustained when he was crushed by the bull a week earlier.
The doctor said he formed the impression that the patient’s symptoms pointed towards vasovagal syncope or fainting episodes, triggered by pain.
The inquest was attended by Mr Cull’s parents, Gerard and Dympna, and his only sibling his sister Nicola.
Mr Toolan, who confirmed the hospital had apologised, said what the family had to endure was indescribable but it had been a source of some solace for them to learn that protocols had been put in place at the hospital.