Sunday, November 25, 2012

Woman 'denied a termination' dies in hospital - The Irish Times - Wed, Nov 14, 2012


“The doctor told us the cervix was fully dilated, amniotic fluid was leaking and unfortunately the baby wouldn’t survive.” The doctor, he says, said it should be over in a few hours. There followed three days, he says, of the foetal heartbeat being checked several times a day.
via Woman 'denied a termination' dies in hospital - The Irish Times - Wed, Nov 14, 2012. http://www.irishtimes.com/newspaper/frontpage/2012/1114/1224326575203.html
KITTY HOLLAND and PAUL CULLEN, Health Correspondent
Two investigations are under way into the death of a woman who was 17 weeks pregnant, at University Hospital Galway last month.
Savita Halappanavar (31), a dentist, presented with back pain at the hospital on October 21st, was found to be miscarrying, and died of septicaemia a week later.
Her husband, Praveen Halappanavar (34), an engineer at Boston Scientific in Galway, says she asked several times over a three-day period that the pregnancy be terminated. He says that, having been told she was miscarrying, and after one day in severe pain, Ms Halappanavar asked for a medical termination.
This was refused, he says, because the foetal heartbeat was still present and they were told, “this is a Catholic country”.
She spent a further 2½ days “in agony” until the foetal heartbeat stopped.
Intensive care
The dead foetus was removed and Savita was taken to the high dependency unit and then the intensive care unit, where she died of septicaemia on the 28th.
An autopsy carried out by Dr Grace Callagy two days later found she died of septicaemia “documented ante-mortem” and E.coli ESBL.
A hospital spokesman confirmed the Health Service Executive had begun an investigation while the hospital had also instigated an internal investigation. He said the hospital extended its sympathy to the family and friends of Ms Halappanavar but could not discuss the details of any individual case.
Speaking from Belgaum in the Karnataka region of southwest India, Mr Halappanavar said an internal examination was performed when she first presented.
“The doctor told us the cervix was fully dilated, amniotic fluid was leaking and unfortunately the baby wouldn’t survive.” The doctor, he says, said it should be over in a few hours. There followed three days, he says, of the foetal heartbeat being checked several times a day.
“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.
“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.
“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.
“The next morning I said she was so sick and asked again that they just end it, but they said they couldn’t.”
Critically ill
At lunchtime the foetal heart had stopped and Ms Halappanavar was brought to theatre to have the womb contents removed. “When she came out she was talking okay but she was very sick. That’s the last time I spoke to her.”
At 11 pm he got a call from the hospital. “They said they were shifting her to intensive care. Her heart and pulse were low, her temperature was high. She was sedated and critical but stable. She stayed stable on Friday but by 7pm on Saturday they said her heart, kidneys and liver weren’t functioning. She was critically ill. That night, we lost her.”
Mr Halappanavar took his wife’s body home on Thursday, November 1st, where she was cremated and laid to rest on November 3rd.
The hospital spokesman said that in general sudden hospital deaths were reported to the coroner. In the case of maternal deaths, a risk review of the case was carried out.
External experts were involved in this review and the family consulted on the terms of reference. They were also interviewed by the review team and given a copy of the report.
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