# Inquest into Fatal Choking Incident at Dublin Hospital A jury returned a verdict of misadventure following a patient's tragic death by choking. - **Source:** [The Irish Times – News](https://www.irishtimes.com/ireland) - **Published:** 2026-11-10 - **Topic:** [health](https://brifing.si/c/health) - **Original article:** - **On Brifing:** https://brifing.si/s/1b022f3c-73ec-4859-8596-29a333ced62e ## Fatal Choking Incident Details Derek Adamson, a 66-year-old retired taxi driver, died at Tallaght University Hospital on May 2nd, 2024. The inquest revealed he suffered hypoxic-ischaemic encephalopathy after choking on a piece of meat on April 19th. Despite being on a prescribed soft food diet, he received standard hospital meals, leading to the fatal obstruction. ## Dietary Protocol Failures Adamson required a level six diet consisting of soft, bite-sized food due to swallowing difficulties. Specialist therapist Stephanie O’Connor confirmed this plan was documented in his charts and on a notice board. However, catering staff stated no modified meal plan was visible for him on the day of the tragic incident. ## Inadequate Mealtime Supervision Medical recommendations mandated that Adamson receive supervision during mealtimes and consume water after every mouthful. Despite these clear instructions, he queued for standard food at lunch. Staff only intervened after noticing him struggling at a milk trolley, by which time the obstruction had already caused a critical loss of oxygen. ## Emergency Response and Outcome Following the incident, staff attempted the Heimlich manoeuvre and CPR after Adamson collapsed. Assistant director of nursing Keith Barter successfully removed a three to four-centimetre piece of meat from his throat. Adamson was transferred to the ICU but never regained consciousness, passing away two weeks later from his severe brain injuries. ## Hospital Systems Analysis Findings Dr. Thomas McMonagle, the hospital's clinical director, reported that an external systems analysis generated 22 recommendations to improve safety. While most have been addressed, three remain outstanding. The review highlighted a critical lack of speech and language therapy resources, noting that a business case for increased staffing has not yet succeeded. ## Jury Verdict and Recommendations The seven-person jury at the Dublin District Coroner’s Court returned a verdict of misadventure. They formally recommended that Tallaght University Hospital increase its speech and language therapy provision and enhance supervision levels in dining areas. These measures aim to prevent similar preventable deaths occurring within the facility's inpatient care system. ## Family Impact and Grief Adamson’s daughters, Linda, Elaine, and Amanda, expressed the profound emotional toll of their father's final days. They described the experience as incredibly difficult, citing the distress and uncertainty they witnessed. The family continues to mourn the loss of a father who was preparing for discharge to a nursing home before the accident. ## Institutional Accountability and Regret Tallaght University Hospital issued a formal apology, expressing deep regret for the circumstances leading to Adamson’s death. The institution acknowledged the tragic nature of the event and the failure to uphold the necessary care standards. This case highlights the ongoing challenges hospitals face in managing high-risk patients with complex cognitive needs. ## Sources covering this story - https://www.irishtimes.com/crime-law/courts/2026/11/10/death-of-man-who-choked-on-meat-at-dublin-hospital-tragic-and-traumatic-inquest-hears/ — --- _Summary written by Brifing from the original reporting. Copyright in the original article belongs to its publisher; read the full piece at the link above._