A consultant endocrinologist has told the trial of a driver alleged to have caused a fatal car crash on the M50 four years ago that it is his view the man didn’t make a “conscious decision” to get into the car and drive that day.
Gerry Daly (57) Derby Lodge, Brownstown, The Curragh, Kildare, has pleaded not guilty at Dublin Circuit Criminal Court to dangerous driving causing the death of Jacqueline Griffin (39) at junction five of the M50 on January 24th, 2019.
Dr Kevin Moore told Roderick O’Hanlon, defending, that he is a consultant endocrinologist working in hospitals in Naas and Tallaght. He said his work includes looking after a “large number” of patients in the country with Type 1 diabetes.
He gave evidence on Monday that he has been supervising Mr Daly for “over 10 years”.
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He said that Mr Daly is someone who is “proactive” about managing his condition. He added the defendant “self-funded” a monitor at a time when it wasn’t routinely available and would have undertaken regular testing daily.
He said it is his view that Type 1 diabetes is the “greatest burden of a disease that can be imposed on anyone” as people with this condition must monitor their blood glucose levels multiple times a day as well as take injections of insulin before meals and on other occasions if blood glucose levels rise unexpectedly.
Dr Moore said low blood sugars are an “everyday occurrence” for someone with Type 1 diabetes and their levels of blood glucose may frequently “dip” towards hypoglycaemia.
He said patients “have to walk a tightrope of not having blood sugar too high or low”.
He noted that continuous monitoring is “wonderful” and “progress”, but does not make the condition easier to manage.
Dr Moore said someone experiencing a severe hypoglycaemic event may show signs including disorientation, confusion or appear to be sweating.
He said a reading of between 4 and 10 is the “ideal range” of blood glucose before a meal. He said a reading below 3.0 is considered a “critical level below which brain function becomes compromised”.
He noted this is not consistent and can vary between individuals, depending on several factors. He said people can sometimes function well with low glucose.
Dr Moore was then taken through a graph of Mr Daly’s blood sugar readings and asked about evidence already heard by the jury about a phone call the defendant made.
He expressed the view that these were consistent with Mr Daly having gone into a lower level of glucose which can “impair cognitive function”.
He said it is his view that Mr Daly was already in a severe hypoglycaemic state and “wouldn’t have understood” if he carried out a scan after getting into the car that morning.
He said the defendant would have been “confused” and “disorientated” which reflected a “severe cognitive impairment” because there was “not enough glucose” in the brain.
He said it is his opinion that Mr Daly’s judgment was impaired and he “didn’t make a conscious decision to get into the car and drive”.
When asked about Mr Daly’s driving, the crash and its aftermath, Dr Moore said: “It is my opinion that his brain was barely able to function at that point and had been struggling for the duration of the car journey.
“In reality, he was on the edge of going unconscious or having a seizure.”
He said Mr Daly would have been able to function on “autopilot” and carry out basic functions such as driving or walking “just about – badly, erratically and unsafely”.
Dr Moore said it is his view that Mr Daly’s recollection of that morning would be “extremely unreliable”.
When asked by Mr O’Hanlon, Dr Moore said Mr Daly “met the criteria” to be permitted to drive and in his view, a collision with a roundabout 10 years earlier had “little or no relevance” to events on the day in question.
“I don’t think he could have anticipated this episode. I don’t think he is responsible for driving the car. Tragically, I don’t think he knew what he was doing getting into the car.
“His blood glucose was steadily low for sometime before he got into car. Unfortunately, he had eaten but it wasn’t sufficient to rectify the situation and as result, his blood glucose dropped as he drove and brain function continued to decline.”
Garnet Orange, prosecuting, put it to Dr Moore that Mr Daly gave a clear explanation to gardaí about why he was driving on the M50 during a later interview. Dr Moore agreed, but reiterated his view that Mr Daly’s decision-making on the day and recollection of events would have been impaired.
CCTV footage of Mr Daly’s car driving on the M50 was shown to the witness. He agreed with Mr Orange that the footage was consistent with someone exercising control over the vehicle, though he added he is not an expert in driving and has not been in a car with Mr Daly.
Dr Moore said “it would be my view that Mr Daly doesn’t normally drive like that” but it was due to the fact that he was in a severe hypoglycaemic event.
He expressed the view that this is an example that Mr Daly’s “judgment was impaired” and he was “acting irrationally”. He suggested if Mr Daly recognised what was happening, he would have taken glucose. However, “that critical thought process didn’t happen as he had slipped beyond the point where he could recognise” it.
Dr Moore suggested to Mr Orange that the fact that Mr Daly did not immediately stop his car following the crash was further evidence that he was not behaving rationally.
“My interpretation is that his behaviour is abnormal, that he didn’t stop is an odd behaviour which I think reflects his impairment.”
Dr Moore agreed that he met Mr Daly in February 2019, likely as a consequence of the crash.
The trial continues before Judge Elma Sheahan and the jury.