Nurse forced to 'watch helplessly' as inmate in Portlaoise prison died due to missing cell key
The incident happened on August 2nd 2021
A nurse in the Midlands Prison in Portlaoise was forced to “watch helplessly” as an inmate died because the key to his cell block was missing.
An inquest into the situation, which happened on August 2nd 2021, revealed that there was a 14-minute delay in opening the 59-year-old man’s cell.
He could not receive any medical treatment as the key for divisions E and G were with a member of staff who had locked the cell and then gone to the staff team room.
The staff member did not have a Tetra radio on them at the time, therefore missing the emergency call for help, according to the report.
An officer opened the flap on the cell door and could see that the man, referred to as Mr D, had a swollen face and tongue.
There was a handwritten note that Mr D was pointing to that stated, “I had a reaction to antibiotics.”
A nurse was alerted through the Tetra radio system, and subsequently had to watch the man die as she could not get into the cell to help him.
As officers were looking for the key, the nurse spoke with Mr D through the cell door flap.
She described him as panicked and struggling to speak and breathe.
She said he lay on his side in bed and then stopped responding to her.
Medical equipment was prepared for administration while they waited for the key.
14 minutes after the call was made, the door was opened, and an EpiPen was given, but Mr D was unconscious at that stage.
CPR, an oxygen mask, a defibrillator, and another EpiPen failed to return him to consciousness, and he was later pronounced dead.
It was noted in the report that Mr D had been prescribed antibiotics by a locum doctor, who failed to note why he was prescribing them.
No allergy information was recorded by the doctor either.
The Office of the Inspector of Prisons requested that measures be taken to avoid a scenario like this happening again.
The Irish Prison Service has since updated its key procedures in Midlands Prison, as there were none in place at the time of the incident.
A Standard Operating Procedure has been implemented to ensure that keys to the E and G key room are left with an Assistant Chief Officer during meal times.
Mr D was serving a five-year sentence in prison after being admitted in October 2018.