Baby died after standard haemophilia op, court hears

BABY Pierce Nowlan died three days after a standard medical procedure to assist the management of his haemophilia, Dublin City Coroner’s Court heard yesterday.

Stephen Nowlan, Carrigmore Green, Saggart, Co Dublin, described how his only child, who had severe haemophilia, went into hospital on his second birthday.

Three days later, October 14, 2004, he identified his body at Our Lady's Hospital for Sick Children, Crumlin, after the boy had been declared brain dead.

Evidence was given that during attempts to insert a canula into the subclavian vein the artery was punctured, resulting in severe blood loss.

This procedure is used to enable the blood clotting agent Factor 8 to be administered by the patient's family at home.

Consultant anaesthetist Dr Martina Healy said the hospital now no longer used the so-called 'blind needle' procedure, following an internal review after Pierce's death.

She described how she attempted to insert the needle into the vein that afternoon but failed. During the evening, the boy looked pale and after intensive monitoring of his condition, she informed the parents he had suffered a cardiac arrest.

She had performed this procedure on children for 10 years and previously on adults for 10 years. It was not her decision to use the 'blind needle' technique in this instance.

"I was asked by the surgeon to locate the vein," she said.

Questioned why the operation was not carried out earlier in the day when more medical people were available, Dr Healy said that following the hospital's internal review they now had a policy not to do these operations after 12 noon.

Mr Nolan and his wife Jean listened closely as coroner Dr Brian Farrell sharply criticised the present legal position. A Supreme Court decision now limits medical evidence to inquests to just two witnesses.

Under the Constitution, he said, there was a right to natural justice, fair procedures and due process but it could not be accommodated under this "unwarranted restriction".

That meant they could not have a full and fair hearing at inquests. This was not in the interests of the family, hospital or the doctors and it certainly was not in the public interest.

Dr Farrell then urged that an amendment be brought forward by the Government to remedy the present situation.

Dr Michael McDermott, who performed the autopsy, said Pierce died from brain damage from being deprived or oxygen, or blood, or both.

When he carried out the autopsy, three days after the death, a one millimetre puncture wound was identified on the subclavian artery.

There was considerable haemorrhaging in the surrounding areas on the left side of the chest.

The inquest was adjourned until September 28 when further evidence will be heard.