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A 34-YEAR-old man died of blood loss due to a nosebleed described by a doctor as ‘torrential.’
Joao Carlos Araujo (34) from Elton Court in Leixlip, Co Kildare died at Connolly Memorial Hospital in Dublin in July 2016.
“These are usually spontaneous, they just occur. There seems to be no real reason behind them,” state pathologist Prof Marie Cassidy said of the fatal nosebleed.
Consultant in emergency medicine at Connolly Hospital Dr Niamh Collins said she had ‘never seen anything this extreme.’
Mr Araujo, originally from Portugal, went to the emergency department twice on July 6,2016, the day before his death. Dublin Coroner’s Court heard he told staff he’d heard a hissing sound in his right ear before the bleeding began.
He first arrived in the emergency department at Connolly Hospital at 9.10am.
The man was discharged at midday after the bleeding stopped without intervention.
He returned to hospital at 12.50pm. This time he was spitting blood and doctors inserted a nasal pack to stop the bleeding.
Doctors contacted an ear, nose and throat specialist who advised the nasal pack be left in place for between one and two hours with observation of the patient following removal of the pack. The bleeding stopped and the 24-year-old was discharged with the advice that he should contact his GP or go to Beaumont Hospital if required.
‘Full of pain’
He stayed at home overnight and the bleeding continued, according to his partner Marcia Pereira.
“He was really tired, full of pain, unable to eat. He had a headache,” she said.
Pereira said her house was full of blood stains as the bleeding continued through the next day.
“There was drops of blood all over the house,” she said.
At 6pm that evening she saw her partner collapse, with blood coming from his nose and mouth.
She phoned an ambulance. Mr Araujo was rushed to Connolly Hospital in cardiac arrest. The emergency medical team battled to save his life for three hours.
“The bleeding was torrential, it was like turning on a tap, despite him being in cardiac arrest,” Dr Collins said.
‘Devastating’
She said the team did everything possible to save him.
“Other than blocking his artery, I had exhausted everything I knew how to do. Everything we did as a team, did not work,” she said.
The man was pronounced dead at 10pm.
“All of us involved found his case devastating… I have never witnessed anything this extreme,” Dr Collins said.
An artery at the back of the nose was identified as the source of the bleeding.
Prof Cassidy gave the cause of death as hemorrhage and shock due to a nosebleed with obstruction to the airway due to blood as a contributory factor.
The pathologist said the only other fatal nosebleed she had dealt with during her career was forty years ago. Coroner Dr Myra Cullinane returned a narrative verdict setting out the facts of the case.
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Shocking, why wasn’t a scan carried out on one of the occasions the poor young man presented at A&E? Ignorance.. ignorance.. ignorance…there were plenty of clues to indicate an abnormal nosebleed, not even cauterisation , just packing.. where was the consultant prior to the ‘torrential flow’ did the patient of 40 years ago die? RIP and yes god love his partner, what a horror story …
@helen walsh: and what’s your qualification?
@helen walsh: what would a scam show? Nothing. Do you know what the term ignorance means? Try cauterizing in a field of blood. If the bleeding seemed to stop with packing as the vast majority will then packing is appropriate first line treatment. I suspect a haemopholia type disorder – abnormal clotting factor.
@helen walsh: My daughter suffers from chronic nosebleeds and we’ve ended up in a&e a few times. Cauterization is a temporary fix. If the bleeding recommences it just breaks through another capillary immediately
@helen walsh: stupid question.
@helen walsh: Yes, a magic scan, that’s the answer to everything. Wind yer neck in, you don’t know what you’re talking about.
@Tom Tom: she’s being logical unlike yourself…imaging studies would have been prudent..now back on your forklift good lad
@Craig De Barra: easy to think logically when all your own job likely entails is picking your hole at a slow pace…
@David Forde: I’d offer a retort but what’s the use trying to argue with a howareya
@Craig De Barra: Ok Craig, what imaging studies would you recommend in epistaxis then?
@David Forde: What’s that got to do with anything? you clown. The so called medical professionals had qualifications and still failed to diagnose. People are and should be asking questions. Now please go away.
@Tom Tom: sorry for the delay sir, just saw your post.. did you research nosebleeds from your phone whilst taking a dump?
@Craig De Barra: Nope. Did you answer the question yet?
Emergency medical teams have everything thrown at them and most of the time the come out on top or if they don’t they have tried their absolute hardest. They are the toughest medical professionals out there. I’m in no doubt they did everything they could for this poor man.
I had the same thing happen to me 5 years ago. My nose just opened up out of nowhere. Thankfully I was in London and was admitted to an ENT hospital after collapsing in A&E and wasn’t sent home until the whole mess had cleared up, which included surgery and 4 days in hospital. They told me I had a burst artery in my nose. Reading this article scares me.
Jesus, that story made me go cold. What an appalling tragedy.
How terrifying it must have been for this man and his partner. RIP x
Holy f u c k… poor lad and God love her
Jeez poor guy. Prone to nosebleeds myself since I was a kid. Had several bad ones for the first time in a while when I had a cold recently. It can get pretty worrying.
@ed w:
I had to visit the A&E during my most severe nose bleed as a kid. I got them often but this one wouldn’t stop. My mother sat me on her lap with a blood soaked towel on my lap. My nose must have been bleeding for at least 2 hours.
I remember the doctor sticking something that looked like a matchstick up my nose to seal it. Thankfully it worked.
He said I had a weak blood vessel.
My sons also suffer with nosebleeds my daughter not so much. One boy gets them at least 3 times a day at least 4 days a week.
Forgot to mention massive clots kept coming out and I was vomiting up blood too. Very messy indeed!
I knew Joao through work and was very friendly with him. It might be a platitude but you couldn’t meet a nicer guy.
I find this article in the Journal and a lot of the comments underneath it to be unnecessarily sensational and lacking in sensitivity. Please think of the grief of his partner and family.
Harrowing. How can this just happen ? Where were the signs and what observations were made in hosp? Poor man
I hate blanch hospital it’s a joke, there’s no care anymore, your just another number, left sitting on a seat all night and then thrown out after 10/14 hours of waiting, poor lad & bios poor partner
Interesting related medical article on intervention with cauterization.
@Fintan Untan: Did you do it together or something??. You are aware that would come out ya??? Thought not.
Not a medical expert but wouldn’t the mention of a hissing sound indicate to these medical professionals that it might be an artery that was bleeding? I mean from a layman’s perspective it makes sense to me….like a hissing sound on a bike wheel indicates a puncture somewhere. Of course though they were probably over worked and under staffed so I’m not judging.
Nose bleed for that amount of time should have been investigated further. INR should have been checked and the cause of the bleed investigated. Mistakes like this very rarely happen in the US due to the sue culture so everything is triple checked to cover themselves. It’s a failure on the hospital and the doctors and really should never happen again. The man went to the hospital twice on the same day and the issue was not investigated properly. If this was a country with a world class health care system he’d be still alive.No reason ether why we shouldn’t have a world class health system because we spend more than enough. The government need to fix the problem once and for all. Open up walk in Clinics/Non emergency centres. All scans scheduled for 24hr 7 days a week backlog is crazy
So sad and so frightening !! I’m sure everyone involved did there best .. god love his family and the people who tried to save him
So sad and so frightening !! I’m sure everyone involved did there best .. god love his family and the people who tried to save him
I had a weak vessel with terminal nose bleeds that we could never stop, and was always told when I had a bad nose bleed that nothing will ever come of it…. I thought different… was so bad one time the ambulance crew told me I wasted their time calling them and joked at me in the A@E for going to there with a nose bleed, just goes show my instincts are proven right now… poor man rip.
@Fintan Untan: Don’t be a dick.
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