On last night’s Tonight with Vincent Browne, Vincent was joined by UCD lecturer Ailbhe Smyth and John McGuirk to review the newspapers.
The discussion turned to Paul Cullen’s story in the Irish Times of staff in University Hospital Galway being disciplined in relation to the care of Savita Halappanavar.
Watch in full here.
Hospital staff in Savita Halappanavar case ‘disciplined’ after review (Paul Cullen, Irish Times)
Previously: When Dr Boylan Met Dr Kiely
The launch of Kitty Holland’s book ‘Savita – The Tragedy That Shook A Nation‘ at Dubray Books, Grafton Street, Dublin last night.
Kitty, the daughter of the late journalist Mary Holland and Eamonn McCann, broke the story of the death of Savita Halappanavar just over a year ago in the Irish Times.
From top: (l-r) Mary O’Rourke, Kitty Holland, Kitty’s daughter Rosie and Eamonn McCann; Eamonn McCann, Mannix Flynn and Vincent Browne; Mary O’Rourke and Vincent Browne; Eamonn McCann and Nell McCafferty and Kitty Holland.
(Laura Hutton/Photocall Ireland)
Meanwhile:
Andaneppa Yalagi, father of Savita Halappanavar, an Indian dentist who died in Ireland a year ago after being denied abortion, attributed credit to the media for the movement against the anti-abortion law that took place in Ireland and rest of the world.
He was speaking at a function to mark the first death anniversary of Savita Halappanavar, organized at the Prajapita Brahmakumaris’ Centre in Mahantesh Nagar . Andaneppa lauded Kitty Holland, a senior journalist with the Irish Times, who broke the news of Savita’s death.
He showed the book, ‘Savita – The Tragedy That Shook The Nation’, to the audience, written by Kitty Holland, which he received from the writer a week ago. He said the 300-page book has covered all major developments that took place after Savita’s death. “It highlights the complexities of the judiciary, church, parliament as well as the action and inaction by the citizens of Ireland,” he said.
A candlelit vigil outside St Stephen’s Green, Dublin this evening to mark the first anniversary of the death of Savita Halappanvar. Vigils are being held in various parts of the country.
Participants included Patrick Bowe (pic 2) and Hope Calloway.(pic 5).
(Sam Boal/Photocall Ireland)
(Consultant Obstetrician Dr Katherine Astbury who treated Savita Halappanavar, at Galway courthouse during Savita’s inquest in April)
The Health Information and Quality Authority (HIQA) report into the death of Savita Halappanavar released today found:
Of the care provided [to Savita] there was a:
General lack of provision of basic, fundamental care, for example, not following up on blood tests as identified in the case of Savita Halappanavar
Failure to recognise that Savita Halappanavar was at risk of clinical deterioration
failure to act or escalate concerns to an appropriately qualified clinician when Savita Halappanavar was showing the signs of clinical deterioration.
The consultant, non-consultant hospital doctors (NCHDs) and midwifery/nursing staff were responsible and accountable for ensuring that Savita Halappanavar received the right care at the right time. However, this did not happen. The most senior clinical decision maker involved in the provision of care to Savita Halappanavar at any given time should have been suitably clinically experienced and competent to interpret clinical findings and act accordingly. Ultimate clinical accountability rested with the consultant obstetrician who was leading Savita Halappanavar’s care.
Dr Astbury is the doctor, who according to Praveen Halappanavar, refused to terminate Savita’s pregnancy telling her “this is a Catholic country“.
During the inquest it was reported:
Mr Halappanavar accused consultant obstetrician Katherine Astbury of dismissing three separate requests for a termination because the foetus was alive.
“The consultant, Dr Astbury, came in,” he told Galway coroner’s court about the third request.
“Savita asked her ’can you terminate the baby?’
“Dr Astbury said ’unfortunately I cannot. This is a Catholic country, we are bound by the law. We can’t terminate because the foetus is still alive’.”
“Mr Halappanavar said his wife, who was 17 weeks pregnant, cried and told the doctor she was Hindu and not an Irish citizen.”
“Dr Astbury said ’sorry’ and she walked away,” Mr Halappanavar added.”
“The widower claimed a midwife also told his wife and her friend she could not have a termination because of the ‘Catholic thing’ after calling the consultant.”
“Barristers for the hospital and the medic told Galway coroner, Dr Ciaran MacLoughlin, that the consultant denies the allegations and disputes she ever made reference to the words ‘Catholic country’.”
Consultant accused of refusing Savita demands on ‘Catholic country’ grounds (Breaking News, April, 2013)
Laura Hutton/Photocall Ireland
(From left: Sir Sabaratnam Arulkumaran, Dr Philip Crowley and Dr Patrick Nash at today’s publication of the HSE report into the death of Savita Halappanavar)
Professor Sabaratnam Arulkumaran [who chaired the review team] believes legislative factors affected medical considerations in the case….and said this resulted in a failure to offer all options to the patient.
Prof Arulkumaran said that if it was his case, he would have terminated the pregnancy.
He said it is possible she [Savita] would still be alive today had her treatment been different.
At the launch of ‘The Final Report of the HSE investigation of Incident 50278 from the time of the patient’s self referral to hospital on 21st of October 2012 to the patients death on the 28th October 2012’
Meanwhile…
Praveen Halappanavar’s solicitor has said there is a strong likelihood that his client will take legal action in an effort to ascertain exactly why his wife died.
Gerard O’Donnell said the HSE clinical review went some way towards answering that question but that a number of issues were still outstanding.
He said there is still no clarity on why there was no medical intervention on the Monday or Tuesday that Savita Halappanavar was in Galway University Hospital.
(Sam Boal/Photocall Ireland)
The HSE Savita report.
Which finds
When Mrs Halappanavar and her husband Praveen inquired about the possibility of having a termination of pregnancy, this was not offered or considered possible by the clinical team until the afternoon of 24 October, due to their assessment of the legal context in which their clinical professional judgement was to be exercised.
From the time of her admission, up to the morning of 24 October, the clinical management plan for the patient centred on the approach to “await events” and to monitor the foetal heart in case an accelerated delivery might be possible, once the foetal heart stopped.
The report says that awaiting events is clinically appropriate – provided it is not a risk to the mother or the foetus.
It concludes that proper monitoring and evaluation of the changing clinical presentation along with investigations would likely have lead to reconsideration of the need to expedite delivery.
Delaying adequate treatment, including expediting delivery in such situations, can be fatal.
Gravity Of Savita Case Not Recognised (RTE)
Report here
(Laura Hutton/Photocall Ireland)
Too late.
Dr Peter Boylan responds to the eleven members of Opus Dei consultants that attacked his credibility yesterday.
The signatories then go on to assert their certainty that termination of pregnancy can be performed “where ruptured membranes are accompanied by any clinical or bio-chemical marker of infection”. This is a truly astonishing statement. It implies that an elevated white blood cell count, which is a non-specific marker of inflammation, on its own would justify a termination of pregnancy. Such an opinion would not surprisingly be welcomed by those advocating a complete liberalisation of the abortion law in Ireland because, if adopted, would truly “open the floodgates”. I suspect that many of our colleagues in active clinical practice would not subscribe to this view.
Previously: Toxic Culture
Peter Boylan And Breda O’Brien: The Transcript
(Laura Hutton/Photocall Ireland)
A letter from eleven consultants to the Irish Times today questions Dr Peter Boylan’s opinion at the inquest of Savita Halappanavar.
It repeats the line about the best maternal health care in the world also used by Enda Kenny at this morning’s protection of pregnancy press conference.
Sara Burke has long been championing the real statistics (see below) of maternal healthcare in Ireland.
In reality, we’re average.
Previously: Dr Peter Boylan and Breda O’Brien: The Transcript
Savita Halappanavar inquest (Letters, Irish Times)
Not the ‘best in the world’ (Sara Burke, Medical Independent)
“My agenda is the protection of the lives of women and equal respect for the unborn,” he said. “I take grave exception to people extrapolating from my wish to see women get the best care available to attempt to brand me as something that I’m not, which is pro-abortion.
“I’m as much ’pro-life’ as any obstetrician in this country, but I do recognise there are times when terminations of pregnancy need to be done.”
He praised the Government’s legislation as “very good” and would give the clarity needed.
“We need legislation in order to be able to our job. All this does is meet the requirements set out by the Supreme Court and by the European Court of Human Rights. It is no less or no more than that.
“I’m an obstetrician, not a psychiatrist, but I’m puzzled by what is meant about caring for a woman who is suicidal. I would be grateful if the people who are talking about it should clarify exactly what they mean and how far they are willing to go.
“No legislation on this issue will please everybody. That’s just in the nature of the issue. It’s the same all over the world. There is nothing unique about Ireland in that regard.”
Dr Peter Boylan also spoke on today’s ‘Morning Ireland’.
Listen here.
Letter ‘an attack on my professional opinion’, says obstetrician (Ronan McGreevy, Irish Times)
Earlier: Toxic Culture
#Savita jury verdict – Unanimous medical misadventure & endorses each of 9 of Coroner’s recommendations #RTE news
— Fergal Bowers (@FergalBowers) April 19, 2013
#Savita Inquest: Coroner tells Praveen. You showed tremendous loyalty & love to your wife. All of Ireland followed the case.
— Fergal Bowers (@FergalBowers) April 19, 2013
#Savita: Coroner says verdict does not mean deficiencies or systems failures contributed to her death.
— Fergal Bowers (@FergalBowers) April 19, 2013
Praveen Halappanavar, spoke to the media after the verdict. The following is a transcript of some of what he said. The reporters’ questions were inaudible from RTÉ’s report and therefore couldn’t be transcribed.
On remaining questions:
“There are still some questions that need to be answered. I’m still not convinced, or, you know, I haven’t got my answers yet why Savita died. I do have responsibility. I mean Savita’s parents, I owe it to them, I owe it to Savita. They want to know the truth so I will, I will get to the bottom of the truth and there is no way in looking back and I haven’t really thought about going back (to India) at the minute.”
On the inquest jury:
“Well, in fairness, you know, the jury is like a layman, people who don’t have any medical background or..I guess I am, you know, in a way, I know where they are coming from, it’s not that easy to understand the guidelines and you know to go through all that, you know? It’s been a full, busy week of inquest, so, yeah, I understand the complexity of it.”
On potential further action:
“Well, of course, as I said it’s not, you know I haven’t got all the answers yet so I will, you know, take it further.”
On accountability:
“Basically, that’s what the family wants, you know? I was talking to Savita’s father, he was asking me, somebody has to take the responsibility. When a patient walks in, you can’t just blame, you know, the midwife blames the consultant, the consultant blames the law. It’s never going to end, you know what I mean? So, somebody has to take the ownership of a patient when they walk into a hospital.”
On the gardaí, coroner and jury:
“Also I’d like to take the opportunity to thank the gardaí, the coroner and the jury. I know it’s been a very, a busy week and a very busy schedule aswell also. And also I’d like to thank all my friends, you know, I think I’ve been very fortunate enough to have some of the best friends. You know, I never thought I could come this far without the support from the guys. And yeah, thank you.”
Dr CVR, a friend of the Halappanavar family added:
“Just on behalf of Praveen and Savita’s friends, I’d like to thank the coroner and the jury and the gardaí for what they have done, for their time and patience and their effort. And, it’s still mind-boggling to all of us, how a person goes into a hospital, walking, and comes out in a box, for something that was an entirely preventable death. And as Dr Peter Boylan also stated, you know, her life would have been saved. The role of hospitals or medical personnel is to change the natural history of the disease and that didn’t seem to have occurred, you know? The …..without significant intervention. So, we don’t have Savita today. And, if she was treated properly, I mean this has nothing to do with pro-abortion or anti-abortion or anything like that. You know, all she wanted, all she needed was treatment. If she was treated properly, we wouldn’t be here. We would be doing something else today. Thank you.”
(Laura Hutton/Photocall ireland) (RTÉ)
