The Health Information and Quality Authority may have to establish a further investigation into how pregnant women who are getting increasingly ill are cared for in Irish hospitals, following its inquiry into the death of Savita Halappanavar.

The authority, which this afternoon published the terms of reference for its investigation into the death of the 31 year-old pregnant woman at Galway University Hospital last month, said if it emerged that there may be “serious risks” to any other woman in a similar situation in the future, it may recommend “further investigation or ..a new [one] “.

Full article by Kitty Holland here

 
 
The Master of the National Maternity Hospital is a woman under pressure. When I arrive at the agreed time for an interview, I am told at the front desk of the antiquated building on Holles Street that there are others waiting ahead of me. The “others” sitting in the small entrance hall waiting for Dr Rhona Mahony include a significant one – the Minister for State at the Department of Health, Alex White.

When Dr Mahony arrives about 10 minutes later to greet White, an apologetic secretary says that she is not sure how long I’ll have to wait as the master also has to go down to theatre.

Being the head obstetrician at a hospital with 700 staff and where about 27 babies are born each day is an onerous responsibility. She wears the stress lightly, although with the country convulsed over the death of Savita Halappanavar and the issues arising from that, everybody working at the coalface of the maternity services must be particularly deeply affected.

Full article by Sheila Wayman here
 
 
The husband of Savita Halappanavar is considering lodging a complaint to the Ombudsman to assert his ownership of his wife’s medical notes, his solicitor has said.

Gerard O’Donnell said he had taken instructions from Praveen Halappanavar to seek direction from the Ombudsman on whether he or Galway University Hospital owns her medical records.

Mr Halappanavar has objected to the use of his wife’s notes in a HSE inquiry into her death. He has said he has no faith in a HSE-run inquiry and does not want her notes used in it.

Mr O’Donnell had asked that the hospital, where Ms Halappanavar died last month, hand over the original medical notes. However, the HSE has said it owns them.

A spokesman for the Ombudsman said last night it was unlikely her office would have a role in this dispute.

Mr Halappanavar met Minister for Health James Reilly for 25 minutes yesterday in Galway.

Ms Halappanavar died on October 28th, having presented a week earlier at the hospital with back pain. She had been 17 weeks pregnant and had been found to be miscarrying. Mr Halappanavar says she asked repeatedly for a termination and this was refused as the foetal heartbeat was present.

The Health Information and Quality Authority will publish the terms of reference of its inquiry into her death next week.

The investigation, for which no time span is indicated, will make use of outside expertise, a spokesman indicated.

In a statement, the authority said it would investigate the safety, quality and standards of services provided by the HSE at Galway University Hospital to “critically ill patients, including critically ill pregnant women, as reflected in the care and treatment provided to Savita Halappanavar”.

Mr Halappanavar said after yesterday’s meeting with Mr Reilly that he was pleased to finally meet a Government representative four weeks after his wife’s death. He said he stressed to the Minister that he did not believe the HSE or Hiqa investigations would be far-reaching enough. “I’m just glad that we met and he just passed on his condolences to the family,” said Mr Halappanavar.

Mr O’Donnell said his client was prepared to go to the European Court of Human Rights if an independent public inquiry was not set up. Galway University Hospital last night confirmed it would co-operate fully with the Hiqa inquiry.

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Mr Halappanavar objected to the inclusion on the panel of three employees of the hospital and within 24 hours they had been dropped amid concerns of a conflict of interest.

The replacements are: Professor James Walker, Professor and honorary consultant of Obstetrics and Gynaecology in St James Hospital in Leeds, Dr Brian Marsh, consultant in Intensive Care Medicine, Mater Misericordiae University Hospital and immediate past-Dean, Joint Faculty of Intensive Care Medicine of Ireland and Professor Mary Horgan, Consultant Physician in Cork University Hospital and Professor in the School of Medicine, University College Cork.

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VINCENT BROWNE

How anybody thought an investigation panel into the death of a person in a hospital controlled by the Health Service Executive could include medics from that hospital and a representative of the HSE itself would be beyond belief were it not devised by the hapless James Reilly.

So too is the absence of any clear legal basis for investigation, made worse by the absence of legal expertise on the panel.

A commission of investigation such as that constituted under Judge Yvonne Murphy to inquire into child abuse in the Dublin archdiocese should have been instituted. Such an inquiry, limited to the circumstances surrounding the death of Savita Halappanavar, would be brief, inexpensive, conclusive and credible.

If, following yesterday’s removal of the University Hospital Galway consultants from the panel, another cobbled-together panel proceeds, there are likely to be legal challenges, complaints about procedures, refusals to co-operate and, finally, a report (if the process does not collapse) that will have limited, if any, authority.

Whatever the Government does on legislation or otherwise on the X case judgment is also likely to be a fiasco, because the complexity of the issues to be addressed are such, largely because of difficulties with the Supreme Court’s judgment in the X case (if a possible suicide is a justification for abortion, then how is a possible death from other causes not a justification?).

And that complexity arises, in the first instance, from the terms of the 1983 abortion amendment. The case for amending this amendment is now compelling and this will require the Irish people to reconsider their mindset on abortion.

 
 
A SERIES of events has plunged the HSE probe into the death of Savita Halappanavar further into shambles.

The agency was forced to ask three doctors from Galway University Hospital to step down from the inquiry, and it has now emerged the man leading the investi- gation previously helped to write a report advocating abortion.

At the same time, Savita’s husband, in an interview with the Irish Independent, confirmed that he has no intention of co-operating with the HSE investigation.
 
 
The Health Service Executive has appointed Sir Sabaratnam Arulkumaran as chairman of the investigative team that will review the death of Savita Halappanavar.

He was chosen as an independent expert in obstetrics and gynaecology, and is internationally renowned in his field.
Sir Arulkumaran is professor and head of obstetrics and gynaecology and deputy head of clinical sciences at St George's University of London.

He is also the president of the International Federation of Obstetrics and Gynaecology - the global body dedicated to improving women and newborns' quality of life.

The internationally-respected professor has been in clinical practice for nearly 40 years and has also been involved in research and teaching for more than 25 years.

His main area of research involves foetal monitoring, intrapartum care, high-risk pregnancy, obstetric litigation and safety in maternity care.

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Medics involved in the care of a pregnant Indian woman who died after suffering a miscarriage will be interviewed over the next three days, health chiefs have revealed.

A seven-strong team, headed by professor of obstetrics and gynaecology Sir Sabaratnam Arulkumaran, will examine case notes and medical guidelines to establish whether she received the best possible care.
Savita Halappanavar, 31, died on October 28 after contracting septicaemia. Her husband has claimed she was denied an abortion as she miscarried 17 weeks into her pregnancy.

The Health Service Executive (HSE) said no overall timeframe has been set for the completion of a report, which will be sent to HSE national director of quality and patient safety Philip Crowley.

"We will obviously interview all the members of the local team who were involved in the care and clearly analyse every step of Mrs Halappanavar's care to ensure that we uncover the root causes of her untimely death," Dr Crowley said.

Full article here

 
 
THREE doctors from University Hospital Galway are part of the investigation team assembled to inquire into the death.

The chairman of the inquiry has defended their positions, saying they needed to inform the team about their standards of practice in treating patients at the hospital.

Sabaratnam Arulkumaran, an eminent obstetrician of 40 years experience who practises at St George's hospital, University of London, was unveiled as chairman. [...]

Mr Arulkumaran said the main reason to have three Galway hospital doctors involved is not for them to give specific directions, but to inform the team about their standards of practice in treating patients.

He said this would include whether "they have standard guidelines in the hospital, and if they have deviations why do they do so".

For example the type of antibiotics given to patients can vary from hospital to hospital.


Full article here

 
 
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"The husband of the late Savita Halappanavar wants employees of Galway University Hospital removed from the inquiry established by the Health Service Executive into her death.

Praveen Halappanavar said last night he would request through his solicitor that Prof John J Morrison, a consultant in obstetrics and gynaecology; Dr Catherine Fleming, consultant in infectious diseases; and Dr Brian Harte, consultant in anaesthesia and intensive care at the hospital, be removed from the inquiry."


More here.