By Sorcha Crowley
The family of a young farmer who died from multiple blood clots on his lungs after a bull attack believe a CT scan would have likely “averted the tragedy of his death” if it had been done several days before he died.
A verdict of “medical misadventure” was recorded on Monday (April 3) at Sligo Coroner’s Court in the death of 31-year-old part-time farmer and electrician Anthony Cull of Castlefore, Keshcarrigan, Co. Leitrim on February 14, 2019.
He had been attacked by a bull on his father’s farm at Bunail, Keshcarrigan, Co. Leitrim 12 days earlier.
Pathologist Dr. Clive Kilgallen said in his opinion Anthony Cull died from “bilateral pulmonary emboli” (blood clots on both lungs) after a recent injury by a bull.
The young farmer’s parents, Gerard and Dympna Cull, younger sister Nicola and best friend Kevin Scollan were present in court.
The Health Service Executive (HSE) did not object to the verdict.
Speaking after the inquest, solicitor for the Cull family Gabriel Toolan, said Anthony Cull had been preparing to take over his father’s farm and had been expected to fully recover from the bull attack.
He said the HSE had formally apologised to the family and confirmed legal proceedings were now “in train”.
Inquest
The inquest heard tha Gerard Cull and his only son, Anthony, were cleaning out two bull pens in a calving shed on February 2, 2019.
They had one pen cleaned out and Anthony went to let the bull into the clean pen, when his father heard a “squeal like a pig” come from the bull and the bull turned on Anthony. He shouted at his son to get out of the pen.
“Anthony started to run for the barrier but the bull had hit him before he got to the barrier. I ran over and picked up the grape and started hitting the bull who was now trying to knee on Anthony but the bull continued to hit Anthony with his head with serious force,” Gerard Cull said in his statement read out by Sgt. Derek Butler.
“The bull stopped hitting Anthony with his head when Anthony fell to the ground, the bull went to go for Anthony again but I jumped the barrier with the grape and tried to keep the bull away from Anthony. I managed to grab the gate and got the bull out of the pen.”
Cull then raised the alarm and his son was airlifted to Sligo University Hospital where he was treated for multiple blunt injuries to his chest, right shoulder and left leg.
Dr. Zia Janjua said Anthony Cull was given the anti-clotting agent Enoxaparin while in hospital but it was “not a standard practice” to send patients home with blood thinners. He discharged Anthony Cull on February 7.
Two days later, on February 9, Anthony Cull collapsed at home and was taken by ambulance back to Sligo University Hospital arriving at 7:43a.m.
Just over two hours later at 9:47a.m, Anthony Cull was again sent home after registrar, Dr. Edward Herridge concluded his symptoms pointed towards “simple fainting episodes.”
He said an electrocardiogram (ECG) showed “no signs… of blood clots on the lungs”. The inquest also heard from Gerard Cull that after he was discharged on February 9, his son was so weak they “had to get a wheelchair to bring Anthony to the car”.
Taking to his feet at this point in the inquest, solicitor for the Cull family, Gerard Toolan told Sligo County Coroner, Eamon MacGowan, that the Cull family “do not accept the findings of Dr Herridge’s statement”.
“They are of the firm belief that Anthony Cull should have undergone detailed investigations and a CT pulmonary angiogram on 9 February,” the solicitor said.
“It would have revealed the pulmonary embolism and should have been afforded to Anthony Cull. This, it is considered, would have, in all likelihood, have averted the tragedy of his death.”
On February 14, Anthony Cull fainted multiple times again and was rushed back to Sligo University Hospital for the third time since the bull attack.
Dr. Karen Harris said in a statement that she assessed the young farmer that day and was “immediately worried about him”.
A CT pulmonary angiogram revealed “a large pulmonary embolism” on both lungs.
Anthony Cull went into cardiac arrest “very quickly” and despite an hour of resuscitation, died at 4:08p.m with his family present.
Verdict
Dr. Harris concluded that she felt his death “was caused” by blood clots. She said that it was “likely” that Anthony Cull’s symptoms on February 9 “were related to blood clots” as patients returning to hospital after a recent stay are “at a higher risk of problems”.
She said “Mr. Cull should have been readmitted to hospital” that day. She added that Sligo University Hospital “unfortunately did not have a formal protocol in place at that time for these situations and he was not admitted”.
Solicitor for the HSE, Declan Hegarty, told the court that Anthony Cull’s death had been “most traumatic” for the family and if the jury returned a verdict of medical misadventure, “the HSE would have no objection to that”.
The jury of two women and four men returned a verdict of medical misadventure. Addressing the court, Gerard Toolan said there were “no words that can describe the depths of their loss”.
“It’s indescribable what they’ve had to endure. It is a source of reassurance for them to learn that protocols have been put in place which will hopefully prevent this from happening again,” he said.
Speaking to reporters afterwards, the solicitor said the Cull family welcomed the verdict of medical misadventure. “They think it’s the correct verdict. It’s been a very harrowing experience for the family,” he said.
“At this stage, to learn that lessons seem to have been recognised and protocols implemented is a source of some solace to the family, but obviously nothing can replace the intense loss and grief which the family have experienced over the past four years.
“Anthony was an extraordinary young man. He had developed his own electrician’s business. He was very successful, very popular. His best friend was here today, Kevin Scollan who also has experienced great loss.
“Anthony had helped his father throughout his life on the family farm and they were in the process of transferring the farm and Gerard was looking forward to a retirement and all of that,” the solicitor added.
“In every way the unexpected nature of this… whilst there was the initial trauma of having suffered quite a serious injury on the farm, all the expectations were that he was going to recover and he was expected to recover. It was just unthinkable that something of this magnitude could occur,” he concluded.