Operation on child necessary, inquest told

AN operation carried out on a young haemophiliac, who died three days after surgery at a Dublin hospital, was necessary for his continued treatment, an inquest heard yesterday.

Pierce Nowlan was admitted to Our Lady’s Hospital for Sick Children, Crumlin,on October 11, 2004, to have a device fitted into a vein that would have allowed the regular injections of a blood-clotting agent.

But the two-year-old lost one-and-a-half times his blood count following surgery after an artery was punctured as medics attempted to insert a canula.

Professor Owen Smith, a consultant paediatric haematologist, said the procedure was necessary as gaining access to little Pierce’s veins to insert the required injections had become difficult.

The inquest heard little Pierce was one of the first children with severe haemophilia A with inhibitors to have the procedure carried out in the unit at the Crumlin hospital.

Professor Smith told the Dublin City Coroner’s Court the decision to insertthe device to access veins was made as Pierce had an increased bleeding mortality risk due to his growing activity levels.

Coroner Dr Brian Farrell heard that six to eight attempts were made to insertthe device on the vein in the children’s chest by consultant anaesthetist Dr Martina Healy resulting in the puncture of an artery.

Noelle Mansfield, a nurse, said there was concern over Pierce’s state from the minute he entered the recovery room. She said: “I noted Pierce was very pale.”

Ms Mansfield said she does not recall being made aware the subclavian arterywas punctured.

The inquest, which was adjourned until today, to hear further evidence from the anaesthetist involved, heard Pierce died three days after the procedure.