Sally Maaz was 17 years old when she died at Mayo University Hospital in Castlebar, County Mayo. She died at 2.30am on 24 April 2020 in the dead of night – in a Covid ward.
While Tony Holohan publishes his “memoir” today (21 September 2023) – I believe it is Sally’s story that must be heard. Because Sally’s story is not just her story, but the story of countless others who died in Covid wards and nursing homes across Ireland. Tony Holohan directly oversaw and implemented a strategy which saw vulnerable people denied medical treatment, drugged on sedatives, neglected by management and senior staff, and then tagged as Covid cases before they died.
Under Holohan’s orders, hospital and nursing home visits were banned, scores of hospital beds were locked away, staff numbers fell drastically due to “Covid testing” and “Covid leave” – and new procedures were implemented which left patients and residents voiceless, defenceless and ultimately victims of untimely deaths.
Families were told a deadly virus had killed their loved ones.
I met Sally’s family just days after she died. They agreed to an interview with me which was published (in part) by the Connaught Telegraph. As I listened to Sally’s story I became increasingly concerned.
Sally Maaz, a vulnerable child with heart complications since birth, was moved to a Covid Ward though she had tested negative for Covid.
On 6 May 2020, at the NPHET Press Conference, I questioned Tony Holohan on this practice of moving non-Covid patients to Covid wards.
He said my “line of questioning” gave rise to “concerns that [were] unfounded.”
Just eight days later, a resident was found by his wife in Kilbrew Nursing Home in County Meath with an open head wound infested with maggots. Wearing a jumper belonging to his late son (who had died in the same nursing home days before) and somebody else’s shoes, the side of Mr Meehan’s face was black with congealed blood and his nails were long and black from scratching at his facial tumours. He died two weeks later, a victim of criminal neglect. His case was publicised widely. Holohan never acknowledged the tragedy.
In TLC Carton, a nursing home in Coolock, North Dublin, a care worker reported that residents were denied food and water, abandoned and left to die in their own excrement, with 75% of deaths avoidable. When the situation was publicised and a protest organised outside the nursing home management were said to have responded by requiring staff to sign non-disclosure agreements.
At Cahercalla nursing home in Ennis, Co. Clare residents were found abandoned after it was revealed all members of the management staff were on ‘Covid leave’ and 30 members of staff were absent due to an ‘outbreak’. An agency staff member said she was told to “ignore the call bell.” Non-Covid patients were consigned to Covid areas. One patient was found with “two huge scabs on her back.” An outbreak of scabies was reported. The total death toll was redacted from an official government report.
24 elderly people lost their lives in Ballynoe Carechoice nursing home in Glanmire, Co.Cork. Staff lied to family members in the immediate aftermath of a victim’s death. Veronica Coyle’s husband was told she had just had a “nice walk” before she died on 8 February 2021 - but Veronica had not walked in years and used a wheelchair. Medical records were falsified, detailing temperature checks that never happened. Possessions of the deceased were “lost”, including a gold wedding ring. Staff refused to provide medical records to family members of the deceased, forcing at least one family to report the home to An Garda Síochána.
At Dealgan House nursing home in Dundalk 23 residents died over a matter of weeks. On Easter Monday 2020 71 residents were “completely dehydrated.” Both the Manager and Director of Nursing were ‘out sick’, with almost 70% of staff absent. Phone calls from family members went unanswered. On one night a junior nurse was responsible for 69 residents. Tony Holohan was notified directly of the unfolding carnage. Nothing was done with urgency. Normal conditions only began to resume after almost half of the residents died.
All of these healthcare institutions will say that they were following public health advice, or in other words, the dictates of Tony Holohan – the public face of Covid.
Meanwhile, it emerged that Catherine Donohue, General Manager of Mayo University Hospital (where Sally Maaz died) had issued a gagging order to staff in March 2020 threatening disciplinary action if staff discussed “hospital business” outside the hospital.
This included “any issues relating to … patient groups.”
Multiple issues arise from Sally Maaz’s story – issues that cannot be ignored and must be addressed.
Why was Sally sent home from the Intensive Care Unit when she was still seriously ill?
Why was Sally, on her return to the hospital, moved to a Covid Ward when she had tested negative for Covid?
Why was Sally suddenly moved off her heart medication, Ramipril, on her first day back in hospital?
Why was Sally given an opioid, Palexia, on her first night in the Covid Ward, a drug which caused an immediate reaction of vomiting, choking and breathlessness?
Why was Sally flagged as “not for resuscitation” and “not for ICU” without her parents’ knowledge?
Why did Professor Tom O’Malley insist on testing Sally for Covid, doing so until he received a positive result?
Why were her parents only allowed to visit their daughter when she had tested positive for Covid and staff had told them Sally was dying?
Why were her parents never informed that she was actually on “palliative care?” (“Consideration for palliative care team review” was recommended by Dr Cyril Rooney on Sally’s first full day in the Covid Ward).
The Coroner for the District of Mayo, Patrick O’Connor, conducted a purported inquest into the death of Sally Maaz following the widespread dismay in County Mayo and across the country at her death. He refused to call key witnesses, blocked certain evidence, attempted to restrict public attendance at the hearings and, just before the full hearing commenced announced that Sally’s cause of death – Covid – was “agreed” and not up for discussion.
At one time (at an inquest hearing) he said: “I am not prepared to take any criticism of Professor Tom O’Malley” (Prof. O’Malley sat on the Covid-19 Management Committee of Mayo University Hospital and also had responsibility for the Elderly Medicine and Stroke Unit).
Patrick O'Connor, Coroner for the Mayo District, in Swinford Co. Mayo during the Maaz inquest.
The role of a Coroner is to establish the facts from the evidence and thereby establish the cause and circumstances of an unexplained death.
As I attended multiple court hearings it became clear that Patrick O’Connor never intended to conduct a genuine inquest into the death of Sally Maaz.
He attempted to bully and intimidate me into not attending the hearing saying I had “no interest in this inquest” and that he would “deal with me” after I had “the cheek to contact him.”
The following account is the true story of Sally’s final days in Mayo University Hospital.
On the 21st of March 2020 Sally Maaz was admitted to the Intensive Care Unit of MUH with a serious lung infection. She needed supplemental oxygen (Airvo) to help her breathe. Sally had lived with a heart condition all her life.
Just a few days later, while under the care of consultant Professor Tom O’Malley, Sally Maaz was sent home; straight from the Intensive Care Unit (ICU) to her sitting room couch in Ballyhaunis, County Mayo. Her parents were told to collect her.
Sally was seriously ill. She had not finished her treatment course of intravenous antibiotic injections of Tazocin, a powerful hospital antibiotic used to fight serious infections. Sally's Tazocin treatment could not be continued at home as it involved intravenous injections. Her oxygen levels were below normal.
A nurse told Mrs Maaz she did not know why Sally was bring discharged – saying “maybe due to Covid.”
On the morning of 14 April 2020 Sally’s father Abdullah Maaz found her at 5.30am sobbing in her bedroom. Usually averse to hospital visits, Sally begged to be taken to Castlebar. She was experiencing severe pain in her back, a symptom of her untreated lung infection. Sally returned to hospital in a critical condition.
When she arrived, hospital chiefs blocked her re-admission to the Intensive Care Unit.
At the inquest into Sally’s death Consultant Tom O’Malley said: “I think … there may have been a lot of pressures on the ICU but you know – I don’t know what the pressures were exactly.”
HSE figures show that the Intensive Care Unit was not full at the time.
Tom O’Malley worked in the Covid Ward and Stroke Unit – both areas were on the same floor as the ICU and about 10 steps away. It must be asked, why did Professor O’Malley suggest there were “a lot of pressures” on the ICU when he had to have known how quiet the floor was?
Half of the beds in the Intensive Care Unit were empty. And on the day Sally died – the 24th of April 2020 – every single bed in the ICU was vacant.
Sally was not treated in the Intensive Care Unit. She was moved to the Covid Ward without her parents’ knowledge. She had tested negative for Covid and was a highly vulnerable patient with severe back pain and an exacerbated lung infection.
At this time, the 14th of April, medics also ceased Sally’s medication for her heart condition (Ramipril) – which she had taken all her life – and marked her as “Not for Resuscitation” on hospital files.
Her parents were not informed.
Little did Mr and Mrs Maaz know on the 14th of April – as they drove home to Ballyhaunis – that Sally had been effectively moved to death row.
A “Not for Resuscitation” order meant that hospital staff were not to act to save Sally’s life in the event of a cardiac emergency. If her heart “stopped” they would not try to resuscitate her.
Dr Eoin Keating formally documented on 21 April that Sally Maaz was "not for resuscitation." He said that the decision was made "earlier on admission." It is unclear who exactly made this decision.
A staff member later told Sally’s sister that Dr Oslizlok, Sally’s cardiologist (since birth) in Crumlin Children’s Hospital had approved the decision to withhold her heart medication, Ramipril. However Dr Oslizlok called the family days after Sally died, expressing apparent surprise at her death.
He said he did not even know Sally was in hospital.
Questioned at the inquest, Professor Tom O’Malley said: “As far as I am aware somebody did contact a person and I don’t know if any return call occurred.”
Strangely, the Coroner for County Mayo, Patrick O’Connor, did not require Dr Oslizlok to give evidence at the inquest into Sally’s death.
The Coroner went to great lengths in front of the family to excuse Dr Oslizlok’s absence from the inquest. He said he knew Oslizok was with his family in the Middle East and to connect him remotely would be “quite complicated.” He added: “I would have to get Detective Sergeant Michael Doherty to explain the technical difficulties. But the bottom line is he cannot be available tomorrow.” He reminded the family that Dr Oslizlok is “a very busy man with patients on his lists.”
A report from Dr Oslizlok’s office was read into the record but not accepted as evidence. It did not address the issues raised regarding the stoppage of Ramipril. Dr Oslizlok was spared the prospect of giving evidence under oath.
Johan Verbruggen of Callan Tansey Solicitors acted on behalf of the Maaz family at the inquest.
It became clear that Verbruggen had advised the family to cooperate with a Covid diagnosis. He glossed over the Ramipril matter, saying that “a deposition (statement) might clarify the matter entirely.” He never requested for Dr Oslizlok to be summoned as a witness to give evidence, which was significant given the clear indication that the Castlebar hospital had lied to the family on this issue.
Johan Verbruggen (left) of Callan Tansey consulting with Padraig Brennan, solicitor for the HSE, outside the inquest in Swinford, Co. Mayo.
At the inquest Professor Tom O’Malley attempted to excuse the stoppage of Sally’s Ramipril. He claimed her potassium levels were so high (6.0) her life was at risk and Ramipril was contributing to the high potassium levels.
It became quite clear at the inquest that Professor Tom O'Malley and his team had agreed to use high potassium levels as a plausible excuse for stopping Ramipril. This argument fell down when Sally's medical records from her first admission to Mayo University Hospital were scrutinised. Sally’s potassium levels were also high (5.5) on her initial admission to Mayo University Hospital in March when she was treated in the Intensive Care Unit and sent home unexpectedly. At that time her Ramipril was not stopped.
On the night of Sally’s re-admission to Mayo University Hospital on 14 April 2020 she was critically ill. Consigned to the Covid Ward, denied her Ramipril treatment and suffering from a serious lung infection (she was now back on intravenous antibiotics) – she must have felt very alone. Sally was also in great pain.
A nurse, Aisling Byrne, ranked Sally at 11 on the hospital’s NEWS (National Early Warning System) score card of 1-10 for clinical emergencies. Dr Rizman was alerted – but told Nurse Byrne to wait for Sally’s oxygen levels to drop lower before contacting the on-call consultant again.
Sally’s oxygen levels did drop lower – from 84% (on admission to the Covid Ward) to 82%. This was dangerously low.
Dr Rizman arrived back and administered 50g of Palexia, an opioid drug. Sally was known to be adverse to opioids due to her heart condition.
The reaction was almost instant. Sally began vomiting and choking. She tried to alert the nurses but no one came – and it appeared Rizman had left.
Her mother’s phone rang in Ballyhaunis. Rula Maaz said she heard Sally crying: “Mummy, I’m very tired, I need help – help – help!”
Abdullah Maaz testified months later that his daughter later told him she thought she was going to die.
Rula told me that nurses came to Sally’s aid only after Rula called the Covid ward in a panic, begging them to go in.
A different doctor, Dr Keating, arrived on the scene. He described Sally as “hypoxic”, “very drowsy” and with a “blue tinge appearance to her face and lips” as well as “elevated breathing,”
He ordered that Palexia should not be given to Sally and commenced her on “more advanced oxygen therapy” to help her breathe. It also appears that he suggested Sally should be moved to the ICU.
However a note on Sally’s file from Professor O’Malley made it clear that Sally was “not for medication or escalation beyond ward level [Covid Ward] care.”
The decision was final – Sally was not going back to ICU.
A CT scan the next day – the 15th of April – showed evidence of clotting in Sally’s lungs. A doctor called the family and told them the Palexia dose the night before was a mistake.
Opioids are known to cause blood clots.
Sally was now dangerously ill. Her mother begged that Sally be moved to a non-Covid Ward. Arrangements were made – however within hours Professor O’Malley directed she be moved back to the Covid Ward.
A nurse’s note from that day, the 15th of April, read: “Covid-19 not detected … CT angiogram, positive for pulmonary embolism [clot]… seen by Professor O’Malley, registrar, not for ICU.”
It would seem that O’Malley’s constant focus was to ensure Sally tested positive for Covid before she died.
At the inquest he said that Palexia is “not totally an opioid” and repeatedly attempted to contribute the blood clots to Covid.
He said: “When you come across somebody with a pulmonary embolism (blood clot) you definitely would think we need to be sure that the underlying reason for this is Covid. The fact that a pulmonary embolism had come into the make-up of the case meant that the suspicion of Covid was raised and that’s why the repeat swabbing happened. I requested it.”
That afternoon – the day after the Palexia crisis – Sally’s oxygen levels dropped again to 82% on five litres of oxygen. An on-call doctor made enquiries about stating Sally on Airvo (a machine that helps a patient to breathe). He was refused.
Dr Rooney, the “Covid” consultant, recommended “palliative input.”
Neither Sally or her family were informed.
On Friday the 16th of April, a new note: “Seen by O’Malley. Covid still likely.”
The same nurse who wrote this note said in sworn evidence: “I remember her consultant [Professor Tom O’Malley] arrived prior to, or just after 9am and immediately suspected Covid-19 was still likely. I remember my assigned nurse informing me to close the curtain around her bed … The Consultant wanted a re-swab of Covid-19 …”
After multiple re-swabs Sally was told she might have Covid. Her test result was apparently unclear.
On Saturday, another Covid test. This time it was positive. Sally cried at the news.
Sunday, the 19th of April: plans were initiated for a “syringe driver” to be installed at Sally’s bedside to pump sedatives into her bloodstream. A syringe driver is a common sight at death beds.
Sally’s parents were now allowed to visit her for the first time in five days. They had been refused access up until this point. Now, after Sally had tested positive – they were told to come quickly.
In the Covid Ward, Sally was almost too weak to talk. A doctor took the Maaz parents aside and told them that Sally would die very soon. Covid, he said, made everything more difficult. It had come “on top of the lung infection” and it was too much for Sally to fight.
Mrs Maaz told me she cried, “Maybe God will give her energy.”
She said the doctor replied: “No, don’t think that.”
Sally’s parents were told not to touch their daughter and to stand two metres away from her bed.
On Monday, the 20th of April, the syringe driver continued to pump sedatives into Sally’s bloodstream. A doctor’s note reiterated that she was “not for ICU.”
Sally was fading away fast – drugged on higher and higher doses of powerful sedatives.
On one occasion, Rula Maaz, unaware of the purpose of the syringe driver, questioned the doctor on the ward as to whether Sally was sedated. Sally always seemed very tired when her family arrived.
The doctor told her Sally was on painkillers to make her “comfortable.” He did not tell her the syringe driver contained Midazolam and Alfentanil (30 times stronger than morphine).
Rula only discovered the truth many months after Sally died.
The Maaz family never knew that Sally was on a “palliative pathway.” They never heard the word “palliative” in conjunction with her care at MUH.
Nurse Aisling Byrne said: “I spoke to the family regularly I suppose … and I don’t recall but when I would have spoken to them on the phone I’m sure that would have came up. I – I don’t remember exactly.”
Two days before Sally died the Maaz family received a call from Crumlin Children’s Hospital advising them that an oxygen support machine was now available for Sally. This had been requested by the family over two weeks prior when Sally was first discharged by Mayo University Hospital. At their wits end they had called Crumlin for help.
Now this sudden phone call came as a shock.
How could Crumlin be unaware that Sally was dying in Castlebar? Had Dr Oslizlok in Crumlin not approved the stoppage of Ramipril, Sally’s heart medication?
Sally died on the 24th of April in the early hours of the morning.
Nurse Margaret Casey Burke called Rula Maaz at 2.41am.
When the family arrived Margaret Casey Burke went to great lengths to observe Covid protocols. This appears to have been an effort to leave an indelible imprint in the minds of Sally’s parents that the 17-year-old’s death was caused by Covid.
Burke described the family’s final visit in a statement almost chilling in its clinical tone: “Two adult males, one adult female and one young male were brought upstairs by security where I met them outside the C-Ward … I handed them their PPE gear. I supervised and instructed them … I assisted the female in tying up her gown as the males did them themselves. The two adult males proceeded to enter the room first. The other two adult female and male entered afterwards … I waited until they were leaving the room and instructed them how to [clean down] properly and use the hand gels before leaving the separate room. I then accompanied them out of the ward.”
In her evidence to the Coroner’s Court Ms Burke argued that Sally’s death was sudden and that the Maaz family would have been “no benefit” to Sally in her final hours as they would have had to to “stand outside in the hallway” anyway because it was a Covid Ward.
A doctor recorded: “Ms Maaz unfortunately passed at 2.30am on the 24th of the 4th and was … given Covid status.”
It remains unclear as to the meaning of “Covid status.”
However within days, Sally Maaz was the front page Covid story for the Irish Independent and the Maaz family were inundated with requests for interviews.
Staff from Mayo University Hospital hide their faces as they leave the Sally Maaz inquest in Swinford, Co. Mayo.
Detective Sergeant Michael Doherty attended Sally Maaz’s inquest along with Detective Garda Declan Sweeney and Superintendent Joe McKenna.
Martina Burke and I had contacted Castlebar Garda Station on 30 April 2020, the same day I conducted the interview for The Connaught Telegraph which was published on 5 May 2020. I had informed Abdullah Maaz, Sally’s father, that I would be reporting Sally’s death to the guards. We met both Sergeant Doherty and Garda Sweeney the following afternoon for a meeting in Castlebar Garda Station.
Sergeant Doherty arrived with Medical Council forms and argued that it would be “more appropriate” if the Gardaí did not get involved. This was in spite of the immediate risk to other patients accessing Mayo University Hospital.
Sergeant Doherty told us it was for the doctors and nurses to determine if what happened was wrong. He stated that he and Garda Sweeney did not have the power to go into the hospital that night.
The Coroner Patrick O’Connor announced at a preliminary hearing that he would be taking into account a “comprehensive statement” from Sergeant Doherty in terms of how he “approached” the inquest.
Tony Holohan was Ireland's Chief Medical Officer from 2008-2022
Sally Maaz is just one of the many thousands who died under Holohan's tenure.
In the months that followed March 2020, Tony Holohan was the face of death. His daily announcements of the death toll, delivered in a polished manner, held the nation to ransom.
Ministers have fawned over Holohan and media figures have prostrated before him in obsequious admiration.
But the lonely gravestones dotted around Ireland tell a different story. The shattered lives, the families torn apart by the trauma of unspeakable horrors, the loved ones cruelly taken before their time – these speak the hard truth.
Tony Holohan has titled his book We Need to Talk.
A terrible irony.
For months Holohan talked freely on prime-time television as cameras rolled – while hospital staff were gagged from speaking out.
His words dominated the airwaves as phones rang out in nursing homes and victims died without a voice.
Sally Maaz lost her life - but her story speaks truth to the real Tony Holohan.
Please share her story with everyone you know.
Jemima Burke is from Castlebar in Co. Mayo.