Ireland hears that sepsis treatment delays may have cost a life
An inquest in Limerick has heard that delays in administering sepsis treatment after a miscarriage may have contributed to the death of 33-year-old Leona Cusack. The coroner’s court was told that sepsis and cardiac issues were evident, but timely antibiotics were not given, potentially altering the outcome at University Maternity Hospital Limerick (UMHL) and University Hospital Limerick (UHL).
The timeline of alarming symptoms
Ms Cusack, five weeks into an IVF pregnancy, first presented to UMHL in the early hours of February 15 after bleeding and cramps. Blood tests were carried out, but she was sent home. The following day she returned with vomiting, headaches and chest pain. A consultant gynecologist, Dr Suhaib Akhtar Birmani, recommended admission, but staff reportedly indicated there were no beds available, and the couple left with the implication that she would be monitored.
According to the inquest, Dr Birmani believed Ms Cusack should have been admitted immediately. He later said he suspected sepsis and sought to activate the hospital’s sepsis protocol. A broad-spectrum antibiotic, the standard early treatment for sepsis, was not administered before her transfer to UHL later on February 16.
Transfer and continued concerns at the second hospital
Upon arrival at UHL, Ms Cusack was assessed by cardiologist Dr Cormac O’Connor. Her sister, an advanced nurse practitioner, described discussions in which Dr O’Connor reportedly acknowledged her sister’s “heart of a lion” and suggested her cardiac condition was being addressed, while indicating that any infection-related heart rate increase would be managed if identified as such. Family members said they were not given a clear explanation for the lack of concern about possible infection.
Despite elevated heart rate and raised temperature noted at UMHL, questions remained about whether sepsis was adequately prioritized when Ms Cusack reached UHL. The inquest heard that while the medical team at UHL was trying to locate a source of infection—given that scans did not reveal one—the patient’s condition deteriorated, ultimately leading to her death on February 18, just three days after her initial presentation.
Professional reflections on standard of care
Legal counsel for Ms Cusack’s family argued that there were “clear indicators of sepsis and cardiac issues” that were not aggressively treated at the critical juncture. The family’s solicitor, Damien Tansey, described the situation as haunting for the relatives: the sense that delays in recognizing sepsis and the failure to administer antibiotics within the recommended one-hour window contributed to the fatal outcome.
Medical witnesses acknowledged that the correct management of sepsis includes rapid administration of a broad-spectrum antibiotic. However, it was stated that the antibiotic was not administered before Ms Cusack left UMHL, and the transfer to UHL occurred thereafter. The coroner’s court is examining whether better early intervention could have altered the trajectory of her illness.
What families are seeking from the inquiry
Ms Cusack’s husband, Conor Cusack, and her sister have urged a thorough review of the care pathway to ensure that similar tragedies are not repeated. They want clear explanations about how decisions were made, what guidelines were followed, and whether system pressures—such as bed shortages—contributed to delays in receiving essential treatments.
The inquest is expected to consider whether the hospitals adhered to sepsis protocols and whether timely antibiotics and escalation of care could have changed the outcome. The medical team involved, including Dr O’Connor and other hospital staff, is due to provide further evidence in subsequent hearings as the coroner weighs the complex clinical picture of sepsis intertwined with potential cardiac complications.
The broader implications for maternity and emergency care
Observers note that sepsis remains a leading cause of maternal mortality in many settings, underscoring the need for rapid recognition and treatment. The inquest in Limerick highlights how gaps—whether due to symptom interpretation, bed pressures, or delays in escalation—can have devastating consequences. The ultimate focus is on improving pathways so that women presenting with sepsis indicators receive immediate, protocol-driven care.
What comes next
The coroner will hear further testimony from clinicians, including Dr O’Connor, as part of ongoing proceedings. The family continues to seek accountability and learning that could prevent future fatalities in similar circumstances.
