Coroner's Duties


Dolores Maxwell's post-mortem resulted in a Death Certificate six and a half months after her death. Members of provided information to the pathologist assigned to investigate Dolores' death. Unknown at the time, the post-mortem had already been completed. Some of this information was developed from documents secured under Ireland's Freedom of Information. A portion of this information is presented below.


RE: The Late Dolores Maxwell of [address redacted], Co. Wexford.
DOB: 24/04/1930. Date of Death: Nov. 28, 2010 at Wexford General Hospital.

Dear Dr. [name redacted]: I am the eldest daughter of Dolores Maxwell. I previously sent you information concerning my mother's prescription medicines, and a very brief note about the issue of Elder Abuse my mother suffered from her son Ethan Maxwell. Having received a portion of the documents I have sought under FOI, I feel it is very, very important to relate some of my concerns to you. I offer what I believe is compelling evidence that my brother Ethan Maxwell systematically exposed my mother to high levels of carbon monoxide. Please bear with me; I will try to be as concise as possible.

Sunday, September 26, 2010:
12:15am: A neighbour's daughter was visiting her parents directly across from my mom's house. That house has no windows that overlook my mom's house. The daughter stepped outside for a cigarette and observed my brother Ethan filling a skip with items from my mother's house. This skip had been delivered earlier Saturday. He was then observed pacing back and forth in my mom's bedroom talking to someone on his mobile. This witness also observed that every single window she could see in my mom's house was wide open, including the roof window which no one I have interviewed had ever seen opened before. This was so unusual and foreboding that the time and date were written down. The temperature at that time was 8 degrees.   [Editor's note: Equal to 48°F ]

2:25am: An ambulance arrives at Dolores' house. CareDoc seems to have arrived shortly before.
CareDoc's assessment: RR 30, BP 150/100, Pulse 126 very irregular, shortness of breath, chest pain, very drowsy.

EMT's assessment at 2:25am: RR 40, O2 Saturation 100%, Pulse 110 irregular, skin flushed, BP 132/97

EMT's assessment at 2:45am: RR 38, O2 Saturation 100%, Pulse 83 irregular

The EMT also notes shortness of breath, very drowsy, very irregular pulse, and that CareDoc reported that Dolores had stopped breathing for a few seconds at one point.

2:49am: Time of handover to Wexford General. The reasons for admission are confusion, drowsiness, chest pains, dry cough. Pulse 123, RR 24, O2 97%

I should note here that Ethan Maxwell listed himself as sole next of kin upon Dolores' admission. He directed the hospital staff to allow no family members to visit, and no information given to any family member or to anyone else. He had also claimed that all of Dolores' other nine children were out of the country. That was a lie. Two were in [country redacted], one in [country redacted]. The remaining seven children were and are resident in Ireland. He had also previously instructed my mother's GP office that no information was to be given to any other family member or anyone else. He himself never informed any of Dolores' children or her brother that Dolores was in the hospital, during either admission to Wexford General on September 1 and September 26. Ethan Maxwell identified himself to the HSE as my mother's sole carer. He claimed Power of Attorney over all my mother's affairs. This was also a lie. No PA of any sort was ever registered with the courts.

The family arrived on Saturday October 2 (having learned from Geoffrey Blair, HSE Elder Abuse of my mom's situation) from all across Ireland only to find they were prohibited from seeing their mother. He eventually allowed my brother Nathaniel and my sister Sophie to visit for no more than 20 minutes. My brother Conor and I were specifically refused “permission” to visit our mother under any circumstances. It being the weekend, I had no recourse but to wait at the hospital, praying that I would be able to see my mother before it was too late.

On Monday Dr [Dolores' doctor, name redacted] nullified Ethan's directives, and allowed Dolores' children to see her. Ethan was eventually banned from Wexford Hospital after being observed by three witnesses (at separate times) physically hurting my mother by slapping her head and squeezing with force her recently broken shoulder and hands as she lay helpless and defenceless in her hospital bed. He was also observed calling her offensive names and speaking in a very derogatory manner to her. My mother would become quite agitated during and after his visits, and indeed would physically shrink from his presence.

On the evening of September 26, the date of my mother's admission, as my mom lay in the CCU, Ethan Maxwell called my mom's home carer, Vivian Chase (she was scheduled for half-hour visits every morning during the week). Ethan informed her that he was on his way to Dublin and that Dolores was with him in his car, and would be in Dublin for the week.

Public Health Nurse Helen Jackman received notification of Dolores' hospitalisation on September 29. She informed Geoffrey Blair, senior caseworker HSE Elder Abuse Wexford. He informed my brother Conor and me on October 1, and we in turn notified our siblings and relatives.

PHN Helen Jackman had also noted weight loss and depression in my mother, along with PHN Jackman's difficulty dealing with Ethan Maxwell, contacting my mother, and seeing her without either Ethan or his associate Lloyd Montgomery present. PHN Jackman also made a referral to Elder Abuse concerning my mother in February 2010.

The home carer's daily log book of visits, which is kept at the patient's home, has never been found and is presumed destroyed. PHN Jackman made several attempts to locate it.

Recent events prior to September 26:

August 8, 2010: My mother's shoulder was broken. She had cuts on her face and bruising. This was reported as occurring during a "fall." Ethan was present during this “fall.” During her admission of September 26, an injury to her cheek bone was noted. Ethan Maxwell explained it was as a result of this "fall" some seven weeks before. This injury to her cheek bone is not noted in any of the records prior to her admission, including her previous admission on September 1. It has been discovered that Ethan Maxwell has a long history of violent beatings of my mother, father, and other family members going back to at least when he was a teenager. He is now in his mid-thirties. Please note that even in the most horrific beatings, my mother would commonly describe the cause as a fall.

September 1, 2010: My mother was transported to Wexford A&E, presenting with a very flushed face, bruises, confusion, amnesia, and heart irregularities. It was reported by her son that she had been confused for three days, experienced LOC [Editor's note: Loss Of Consciousness] while watching TV, she thought he was her brother, and that her speech was slurred. She was later discharged fully cognisant on September 8 able to self medicate, and in fine form. She actually returned to Rosslare by bus.

September 23, 2010: Ethan made an appointment for my mother to see her GP. At least he told her he did. The GP's office was closed at the time he “made the appointment” for. It is their weekly half day.

September 24, 2010: My mother saw her GP with abdominal discomfort. She was reported to be in fine form otherwise.

I believe that multiple non-accidental CO poisoning must be considered for the following reasons:

  1. Symptoms of dry cough, confusion, drowsiness, LOC, flushed face, hallucinations, chest pain, shortness of breath, amnesia, abdominal pain, irregular heart rate, fatigue, slurred speech, unsteadiness and depression. The majority of these were present at both admissions. All are known symptoms of CO poisoning.
  2. Dolores was discharged from her early September hospitalization fully aware, able to self-medicate, and in fine form. She took the bus home from Wexford to Rosslare.
  3. Less than 48 hours before her admission on September 26, both her GP and neighbour reported she was in fine form, fully aware. She talked about politics and the recent marketing plan of a hotel in Rosslare.
  4. The fact that all the windows in my mother's house were wide open while the temperature was 8 degrees, two hours before the arrival of medical help.
  5. The bizarre scenario of Ethan Maxwell filling a skip after midnight, two hours before help was sought for my mother.
  6. The fact that Ethan Maxwell was observed by a witness pacing back and forth over and over in my mother's room, once again two hours before medical help was sought.
  7. The unmistakable smell in my mother's house when my brother Nathaniel, my mother's solicitor, the HSE Elder Abuse caseworker and I finally were able to enter it in November 4, 2010. It was a smell of plaster, paint, solvents and kerosene.
  8. The fact that my mother's house was "sanitised" by Ethan Maxwell. Correspondence, bank statements, utility bills and personal items were gone. Many larger items like furniture and appliances and a glass greenhouse were gone. Other than her clothes, there was scant evidence my mother ever lived there.
  9. Although my mother's O2 saturation was 100%, or close to it, as you know a pulse oximeter will misrepresent elevated levels of carboxyhemoglobin as oxyhemoglobin. According to EMT's I have contacted, pulse oximeters are used; not CO-oximeters or multi-wave oximeters. I believe the same pulse oximeter type is used in the hospital. ABG tests were not ordered during either admission.[Editor's note: An Arterial Blood Gas test would have revealed Dolores' true oxygen saturation level. See the Wiki here. Carbon monoxide binds to hemoglobin at an affinity 250 times greater than oxygen. Guyton A C: Medical Physiology 12ed. 2010, page 502.  It seems curious that an elderly woman exhibiting heart problems, drowsiness, irregular heartbeat, shortness of breath, and who had indeed stopped breathing at one point would have a 100% oxygen saturation level.]
  10. The inability and frustration of the medical staff at Wexford General to define an underlying cause of Dolores' confusion, unresponsiveness and mental state, especially given her good condition when discharged earlier in September. They stated to me their puzzlement and described being "baffled."
  11. My mother's appliances were all electric. Her furnace is outside, and the house is heated via hot water radiators, mitigating the possibility of accidental carbon monoxide poisoning.
  12. Ethan Maxwell had been doing a painting project on Dolores' house.
  13. Statements to a witness on August 14 by Ethan Maxwell that Dolores would “not be around much longer.”
  14. Upon her admission of Wednesday, September 1, my brother Ronan reported that my mother had been confused for three days. Ethan's routine was to go to my mother's house on Friday evening and remain there until Sunday evening.

I sincerely believe my brother did this. I don't know how. Maybe he closed the chimney flue while burning coal or something in my mother's fireplace. Perhaps he brought in a barbeque and burned charcoal. I think it more likely that he used some sort of solvent. As you know, CO intoxication can occur by inhalation of methylene chloride vapours, common in solvents and paint removers.

The smell in the house leads me to think that was the more probable explanation. More heartbreaking is a witness report that Dolores was found tied up in flex in her room. She had eventually been able to free herself just enough to reach an alarm which alerted a neighbour in the early morning hours that she needed help. With much difficulty the neighbour freed my mom from the flex. My mom was so weak that she and her neighbour went downstairs slowly and laboriously one step at a time on their bums. I have no idea how long she was restrained like that. I do know that she lost a lot of weight prior to her admission on September 26. The neighbour has since stopped talking, refusing to offer any more information, saying over and over that she doesn't “want to be involved.”

If my mother was restrained in a like manner as this, she would have been unable to resist inhalation of CO no matter how it was generated or administered.

I think you should know that my parents were not well off. Dolores was a housewife and my father was a quantity surveyor. They raised ten children. My parents sold the family house in 2005, and realised a huge financial gain. Evidence supports the fact that Ethan Maxwell since that time has been in receipt of over €500,000 from my parents' assets. From another elderly victim he sought over €40,000, although how much he received is not known at present. He used my mother's credit card for paying his utilities in Bray and also for purchases before and after her admission on September 26. He controlled her ATM card. These are classic indicators of Elder Abuse.

Dr [name redacted], since December 3, 2009 I tried to prevent the abuse and isolation my mother was suffering. Sadly and regretfully, I was unsuccessful. I know there was a lot more I should have done, and more things I should have tried. I made several unsuccessful attempts as evidence mounted to interest the Gardai in this, even while the abuse was actively happening. Geoffrey Blair also was involved in seeking Gardai attention after Dolores was admitted to the hospital. Even so, witness reports of abuse suffered by my parents and a victim's statement of child abuse perpetrated by Ethan Maxwell were not entertained or investigated by the Gardai.

From the history I have uncovered, I know that Ethan Maxwell is a serial predator. It is too late for my mother, but I have to think about other people he has hurt, and is hurting and victimising to the present day. I understand you are solely concerned with understanding the medical reasons my mother died, and that you do not in any way assign responsibility or exoneration to anyone.

Please contact me if you desire any copies of whatever records I have. The material I received after repeated requests and appeals under FOI is incomplete and redacted, but I will certainly make it available to you. I have a large amount of evidence indicative of Ethan's abuse towards my mother and others, as well as other crimes.

Please feel free to contact me at anytime for any questions you may have.

I hope you will consider this, and I thank you very much for your time and your efforts to understand the cause of my mother's death.


Saoirse Maxwell


World Elder Abuse Awareness Day UN Declaration of Human Rights European Year for Active Ageing and Intergenerational Solidarity Towards a Society for All Ages