The woman who died to become a mother
Jacqueline Rushton and the five embryos she made with her husband Danny were blessed and laid beside her side, in her coffin.
She went into a coma, just days after doctors removed her eggs for fertilisation. Just as her dream had come true, her life was about to be taken away.
The Raheny-born woman died in controversial circumstances on January 14, 2003, after receiving In Vitro Fertilisation (IVF). An independent Health Service Executive report this week criticised a “lack of senior control” and “accountability” of her care at Dublin’s Rotunda Hospital.
Its master, Dr Michael Gaery, rejected this. The criticism of Jacqui’s care, however, and the stories of her family’s heartache searching for answers has refocused attention on the lack of rules governing assisted reproduction in Ireland.
Between 500 and 1,000 IVF children are born in Ireland every year.
Nearly 30 years ago, the world witnessed the first successful IVF treatment when a five-pound, 12-ounce baby girl was born. The blue eyed, blonde haired Louise Joy Brown was a hope to millions of couples who could not conceive.
Three decades later, Ireland’s legislation for IVF treatment lies in a limbo. This could be a costly affair for the State. It has already been an emotional one, for many.
In other countries, there are support groups established for IVF children who are trying to trace the original sperm or egg donor. This dilemma in
Ireland could see hundreds of children when they are older, tracing their biological origin. Do donors remain anonymous? Can an IVF offspring sue if records of their biological origin are wiped or left blank? These questions remain unanswered.
But while the Government here leaves its head in the sand on the issue of assisted reproduction, IVF is growing, just like its offspring.
With falling sperm counts, rising rates of STDs and women having children at a later age, the assisted reproduction process is more popular than ever.
When the Dublin based SIMS fertility clinic opened its doors a decade ago, around one in six couples were experiencing infertility. This has changed, according a David Walsh, a consultant gynaecologist at the clinic.
I think most specialists would agree that figure is closer to one in five. Some experts say in ten years time, it may be as many as one in four.”
According to the Irish Women’s Council, specialists in IVF at present follow guidelines issued by the Irish Medical Council. However, none of their practices are covered by law.
A Government report commissioned seven years ago recommended radical rules to govern assisted reproduction in Ireland.
The report was finished over two years ago. None of these suggestions have come to fruition.
For the family of Jacqueline Rushton, the vacuum in regulation and laws governing IVF techniques made their search for answers around the 32-year-old’s death more unbearable.
Jacqui’s mother, Angela Hickey, this week said there was a “veil of silence” around the medical profession when the family sought answers.
“Our journey for the truth has been a very difficult one, fraught with many obstacles,” the mother told a packed press conference in Dublin.
Jacqui’s treatment began to go wrong when her oestrogen levels rose too fast after she had taken a drug to help stimulate her egg growth.
She developed Ovarian Hyperstimulation Syndrome (OHSS). This can be common, present in around 10% of IVF cases. Its symptoms include abdominal swelling, nausea and vomiting. By December 10, 2002, just a few days into Jacqui’s treatment, the disorder turned severe overnight, which only occurs in about 1% of IVF cases.
It was a life-threatening situation. Hospital notes show in just a few days her body swelled. It became waterlogged. Her weight rose from 54 kg in a week to 60 kg.
In the same period, the girth of her abdomen went from 89 cms to 104 cms.
The HSE report found the Rotunda Hospital had failed to follow guidelines in draining extra fluids building up in Jacqui’s body.
There was “inconsistent compliance” with these procedures, independent UK consultants concluded.
This added to claims in the inquiry that there were problems with “management” of her care at the hospital.
Documentation obtained by the Irish Examiner backs the report’s claims.
Jacqui essentially became one of the sickest females in the Rotunda Hospital in those weeks leading up to the Christmas period. This began not long after she was brought in for the removal of her eggs on Sunday, December 8.
However, the master of the Hospital Dr Michael Geary was not aware of her case until December 16. This was the day that, because of her seriously deteriorating condition, that Ms Rushton was transferred to the Mater Hospital.
Documentation shows Dr Geary only became aware of her that day, the day he returned from annual leave.
That morning, Dr Geary also did not speak to the man who had led the Rushton’s IVF treatment, Professor Robert Harrison. There was also confusion over who transferred her to the Mater Hospital.
However, after this week’s criticism, Dr Geary stressed the care involved for Ms Ruston was thorough, adding, “At all times the consultant team, the master, and ultimately the board, are accountable for the care of all patients in the care of the Rotunda Hospital”.
Jacqui’s case will undoubtedly keep pressure on the Government and clinics to prove and guarantee standards across the board. Inspections of clinics have finally begun, thanks to a new EU directive for those handling human tissue.
But the process will take some time. For Jacqui’s family, no amount of time will change their mind that the life of a young woman, a happily married wife, could have been saved.
