Savita Halappanavar inquest hears three requests were made for termination

Tuesday 09 April 2013 06.45
Savita Halappanavar died following a miscarriage (Pic: The Irish Times)
Savita Halappanavar died following a miscarriage (Pic: The Irish Times)

The inquest into the death of Savita Halappanavar at Galway University Hospital last October began in Galway today.

At least 16 witnesses from the hospital, as well as expert witnesses, are scheduled to give evidence before the coroner, Dr Ciaran McLoughlin.

The inquest was adjourned this evening after a full day of evidence and will resume tomorrow morning. It is expected to last at least a week.

Arriving at the inquest, Savita's husband Praveen Halappanavar said he believed the inquest would get to the truth.

He said it may be the last chance to get an explanation as to what happened.

Mr Halappanavar told the inquest that his wife made three requests for a termination over two days.

He said the first request was made after a foetal heartbeat was detected following an ultrasound scan on the morning of Monday 22 October.

Mr Halappanavar said his wife could not take the pain of looking at her baby on the monitor after being told the pregnancy was not viable.

He told Eugene Gleeson, who is representing him, that Savita said: "How can a mother wait for her baby to die?"

A second request was made to consultant obstetrician Dr Katherine Astbury minutes later.

Mr Halappanavar said Savita was very insistent and wanted an answer to her question.

He said Dr Astbury, who had said a termination could not be carried out because Ireland was a Catholic country, then said she would check the situation and come back with an answer.

Mr Halappanavar said no response or clarity was forthcoming and that a third request was made by his wife for a termination the following day. 

On that occasion she asked a midwife, who called Dr Astbury to check to see if there were any developments. He said his wife was told "it's a Catholic thing and we won't be able to help you".

Declan Buckley SC for the hospital and the HSE said there are differences between what Mr Halappanavar says happened and what the hospital says.

In response, Mr Halappanavar told the inquest that there were "retrospective entries" made in the medical notes.

The inquest has been told that the evidence from Dr Astbury will be that there was only one discussion about a termination of pregnancy and it was on Tuesday 23 October.

Dr Astbury says a termination was not warranted at that time, as there was no threat to Savita's life and so no reason to consider an abortion.

The inquest heard that when Mrs Halappanavar attended Galway University Hospital on 21 October, doctors found her cervix was open and she was told the baby would not survive.

She was told it would be all over soon.

Mr Halappanavar said his wife was moved to a room on her own and started crying and said sorry.

He told her it would be okay, it was God's will and "we can have more babies later".

Later in her hospital bed, he said she was shivering. He said some staff checked the heater and said it was not on.

Sepsis management programme in place

The inquest has heard that a sepsis management programme was in place at Galway University Hospital since July last year.

Earlier, Mr Halappanavar told the inquest that Savita found Ireland so peaceful and loved the country.

Mr Halappanavar said he came to work in Ireland in 2006 as an engineer at Boston Scientific in Galway.

He had known Savita as they had met in the same area of the south of India.

The couple married in India in 2007 and Savita joined him in Ireland three months later when she got a visa. He said Savita had worked as a dentist in India for two-and-a-half years and sought work in Ireland.

He described his wife as a very popular person in India and Ireland.

The couple were delighted when she became pregnant in July 2012. He told the inquest she was athletic, was in excellent health and did yoga. The baby was due on 30 March this year.

Mr Halappanavar said that during the pregnancy she suffered lower back pain.

He said she shed tears of happiness seeing the baby on an ultrasound monitor at the hospital.

Doctors and nurses to give evidence

For the first time, the doctors and nurses who cared for Mrs Halappanavar will be identified and will give evidence under oath and be cross-examined.

Former Master of the National Maternity Hospital Dr Peter Boylan is among five expert witnesses to be called.

Swearing in the jury, Dr McLoughlin said he was obliged to have a jury as the inquest was looking into matters that could be corrected to prevent similar events occurring.

He said that 67 statements have been given, but not all witnesses will be called.

The primary role of the inquest is to determine key facts concerning the death of Mrs Halappanavar on 28 October following a miscarriage.

Mrs Halappanavar was 17 weeks' pregnant at the time.

The HSE's draft clinical review into Mrs Halappanavar's death, given to Mr Halappanavar over a week ago, has yet to be published.

Reilly hopes inquest brings 'some closure'

Elsewhere, Minister for Health James Reilly has said he hopes the inquest gets to the truth in a way that not only gives some closure to the Halappanavar family, but also to every woman in Ireland that it has a safe maternity service.

Mr Reilly said he will await the comments of Mr Halappanavar or his solicitor about the report before he can present that report to Cabinet and publish it.

Speaking in Clare, he said his understanding is that Mr Halapanavar's representatives will meet with the chair of the report committee "at some stage", but that plans had not yet been made to do so.

Mr Reilly said he does not believe he will be in a position to present the report to Cabinet or publish it this week.

First maternal death at UHG in 17 years

In a statement this evening, University Hospital Galway said it had apologised to Mr Halappanavar and his family for the events related to his wife's care that contributed to her tragic, unexpected and untimely death.

It was the first direct maternal death at the hospital in 17 years.

The hospital said that from the beginning, it had followed all of the legal and medical requirements arising from such a tragic incident and has cooperated fully with Mr Halappanavar's legal representatives, with the Coroner, the HSE and HIQA investigations.

It said that the untimely death of a young expectant mother caused deep upset among hospital staff, particularly those who were directly involved in her care who were saddened and shocked by her tragic death.

It said the distress of some of these staff members has been exacerbated by verbal and written abuse from members of the public and by the behaviour of some members of the media, albeit a very small minority.

The hospital said that overall, the media through the individual journalists who have covered this tragic event have been respectful of the staff involved.

It said that individual staff will be giving evidence at the inquest but will not be making any comments to the media, as is normal practice.

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