Coroner: Procedural failures, late diagnosis could have taken Savita's life
GALWAY, April 11, 2013 (LifeSiteNews.com) – A consultant microbiologist said in today’s testimony at the ongoing inquest into the death of Savita Halappanavar that delays in blood sample analysis were of concern, but that the correct antibiotic regimen was already in place for the type of infection the patient was suffering.
Consultant Dr. Deirbhile Keady said that the right antibiotics were administered even before the results showing the presence of infection became known. In her statement, read out in the Galway courtroom, Keady said that sometimes patients die even when doctors act correctly.
Asked by lawyers for Savita’s husband, Praveen Halappanavar, why his wife succumbed to the infection, Keady replied, “Patients have different outcomes. We don’t always know why.”
With the inquest in its fourth day, coroner Dr. Ciarán MacLoughlin has identified a number of systems failures that could have negatively affected Mrs. Halappanavar’s response to treatment. These include failure to monitor her condition regularly and delays in processing blood tests that could have led to a correct diagnosis of the septic infection. A nurse testified that when Mrs. Halappanavar complained of cold, an early symptom of severe infection, staff blamed a malfunctioning radiator in her room.
Asked about a delay in analysing blood samples, Dr. Keady said that blood samples taken at 7 a.m. on October 24, did not reach the lab until after 10 a.m.
Dr. Keady said she received a phone call with the results between 8:30 pm and 9 p.m., and that it was normal for such tests to take seven hours to culture.
She admitted that the sooner the samples are tested the better, but said that antibiotics had been administered by lunchtime that day.
In her testimony, Mrs. Halappanavar’s obstetrician, Dr. Katherine Astbury, agreed with the coroner that the patient’s clinical signs were not checked every four hours after her membranes ruptured, as required by hospital guidelines.
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She also confirmed that she had received only one request, from Mrs. Halappanavar, for a “termination,” but had responded that since there was no indication at that stage of a life-threatening condition, she said the law would not allow it. She said that later, as sepsis set in and the patient’s condition worsened, a termination would have been allowed under Irish law that says there must be a “real and substantial risk” to the mother’s life. By the time Dr. Astbury had made the determination, however, the child had already died.
Dr. Astbury’s testimony says that the question of “termination” came up only once in an initial discussion with Mrs. Halappanavar alone. She told the inquest that she informed Mrs. Halappanavar that “in this country it is not legal to terminate a pregnancy on the grounds of poor prognosis for a fetus.”
Praveen Halappanavar, however, continues to claim that the couple had both made a total of three requests over two days after they learned the child, a girl, was not viable.
She said she told Mrs. Halappanavar that “in this country it is not legal to terminate a pregnancy on the grounds of poor prognosis for a fetus.” She said that at the time of the discussion, the patient was suffering from the emotional distress of miscarrying but that there was no medical reason to “terminate.”
Dr. McLoughlin also asked Dr. Astbury not to use the “emotive term” of termination, which, he said, referred to the deliberate killing of the unborn child. In this case, he said, the family were asking for a pre-term inducement of labour. Dr. Astbury responded that she understood the expression “termination” meant giving a patient drugs to induce labour while there was still a foetal heartbeat.
Dr. McLoughlin, however, quoted from Irish Medical Council guidelines that say that it may be necessary to intervene to save the life of the mother “while making every effort to save the baby’s life.”