The chief clinical director of the Limerick hospital where a teenager died in “avoidable” circumstances in 2022 was placed on leave due to “an immediate and serious risk to the safety, health and welfare of patients”, court documents show.
Prof Brian Lenehan was placed on temporary administrative leave last month in the wake of an investigation into the death of Co Clare teenager Aoife Johnston who had presented at University Hospital Limerick’s emergency department (ED) with treatable sepsis in December 2022.
He is seeking an order from the High Court that he be returned to his role in the hospital “forthwith”. Court documents show he has described the decision of HSE chief executive Bernard Gloster to suspend him as one that “no rational or reasonable decision-maker could take”.
The documents show that Mr Gloster wrote to Prof Lenehan on September 16th last raising concerns about him continuing as chief clinical director of the hospital.
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“I believe that your continuation in the role of chief clinical director may give rise to an immediate and serious risk to the safety, health and welfare of patients under the care of UHL and its emergency department,” Mr Gloster told him in the letter cited in an affidavit Prof Lenehan submitted to the court.
“Given the extent of my concerns, and the most exceptional circumstances arising, together with the seniority, significant [sic] and nature of your role as CCD, I believe that it is appropriate to direct you to take a period of immediate administrative leave on full pay, from your role as chief clinical director, pending investigation into my concerns.”
In support of his case, Prof Lenehan submitted another affidavit, from the deputy chair of the hospital’s medical board, Dr Joseph Devlin, who says in the sworn statement that he has not identified “any act or omission on [Prof Lenehan’s] part that could conceivably give rise to any rational concern that he poses a serious and immediate risk to anyone”.
In his affidavit Dr Devlin quotes from a transcript of a meeting with Mr Gloster on September 11th to discuss the proposed suspension of Prof Lenehan.
During the meeting he urged the HSE chief not to make a decision that is “unjust and destructive” and “will almost certainly exacerbate the hurt” felt by Ms Johnston’s family.
Dr Devlin told the HSE chief that suspending Prof Lenehan could damage the participation of clinicians in senior leadership roles and quoted to him Mr Gloster’s own view that “individual staff should not be held accountable for system failings over which they have no control”.
Prof Lenehan, clinical director of the University of Limerick Hospital Group, made an application to the High Court last month for an order that he be returned to his role pending the outcome of a disciplinary investigation. The case was adjourned to allow the HSE to file a response. The affidavits submitted by Prof Lenehan when making his application have not been previously reported.
Last month Mr Gloster, speaking on RTÉ, said six people at the hospital were at various stages of a disciplinary process and four were on administrative leave. He did not name any of the people affected. Prof Lenehan is a consultant orthopaedic surgeon at Limerick Hospital and has not been suspended from that role. He played no role in the treatment of Ms Johnston.
In his affidavit Prof Lenehan quotes from a recent report by former chief justice Frank Clarke that found Ms Johnston died in circumstances that were “almost certainly avoidable”. Among other issues, the report refers to overcrowding at Limerick Hospital.
Prof Lenehan said the hospital’s executive management team, of which he is a member, had approved an escalation protocol designed to alleviate pressure in the emergency department at times of overcrowding but that a unit of the HSE had “strongly opposed” the protocol in July 2022, leading to it being ended. Problems in the emergency department during the autumn of 2022 led to the restoration of the protocol.
“The decision to reimplement the escalation protocol was vigorously opposed by the Irish Nurses and Midwives Organisation,” Prof Lenehan said.
“During the week preceding Ms Johnston’s death, the emergency department had become overcrowded, the escalation protocol had been implemented to the letter. Regrettably, and for reasons unknown to me, the escalation protocol was not implemented on the evening of December 17th, 2022.”
Prof Lenehan said a letter he received from Mr Gloster in July 2024 outlined 22 concerns about his discharge of his duties as clinical director, 21 of which specifically reference the weekend when Ms Johnston presented at the hospital.
“None of the concerns reference any specific action or inaction on my part,” he said.
“Mr Gloster has failed to identify any act or omission on the part of my office which caused or contributed to her death,” Prof Lenehan added in his affidavit.
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