Anti-abortion and pro-choice groups clash over report
Catholic thinktank the Iona Institute said the report highlighted the need “to introduce clear guidelines concerning the diagnosis and treatment of septicaemia”.
There may also be a case for clearer guidelines on when a life-saving termination can and cannot take place, the institute said.
However, spokeswoman Breda O’Brien said nothing in the case “illustrates any need to introduce abortion on the grounds of suicidal intention”.
Action on X said the leaked report was “hard, tangible evidence” that abortion legislation must be introduced without delay.
“Doctors need clear laws so they know they can perform life-saving abortions without criminal penalties. And women need clarity because now we know for sure their lives really are at stake,” said spokeswoman Ailbhe Smyth.
She said they were calling on Labour and Fine Gael to publicly commit to passing X case legislation by the summer. No legislation has been introduced despite a Supreme Court ruling in 1992 (the X case), establishing the right of Irish women to an abortion if a pregnant woman’s life was at risk because of pregnancy, including the risk of suicide.
Fianna Fáil health spokeman Billy Kelleher urged Health Minister James Reilly to immediately publish the leaked report.
“We cannot have a situation where an issue as sensitive and serious as this is being reported on in the media, based on a partial leaking of the document, and the family concerned, and the public, do not have access to the full facts.”
Enda Kenny told the Dáil the report was not finalised and had not been seen by Dr Reilly. The Taoiseach said there were three investigations ongoing and it was his view that Mr Halappanavar should be the first to be briefed on the issue.
Dr Reilly said he had “no report on my hands, nor has my secretary general, nor has my chief medical officer and I am not sure what those assertions relate to — whether it was an earlier draft. Whether, in fact, it is genuine at all in the first instance.”
Dr Reilly said he could not make any comment until he got the report because there could be legal issues.
Leaks from the report show a litany of failures in the Ms Halappanavar’s care, including blood tests taken on the day she was admitted which showed she was at risk of septicaemia. Sepsis is a potentially deadly medical condition caused by the immune system’s response to serious infection, most commonly bacteria, but also fungi, viruses, and parasites in the blood, urinary tract, lungs, skin, or other tissues.
The symptoms of sepsis are not caused by the germs themselves. Instead, chemicals the body releases cause the response. A bacterial infection anywhere in the body may set off the response that leads to sepsis.
Common sites of infection in hospitals include intravenous lines, surgical wounds, surgical drains, and sites of skin breakdown.
The report also found a miscarriage was so likely that staff should have considered a medical termination even before the couple requested it.
Timeline from the draft report leaked to the Evening Herald:
*Sunday, Oct 21, 9.35am: Savita Halappanavar is admitted to the gynaecology ward with lower back pain.
*Sunday, Oct 21, 3.20pm: She reports feeling “something coming down” after attending a bathroom. A staff midwife told the HSE report: “I immediately thought she would miscarry.”
*Sunday, Oct 21 (no clear time noted): Medics believe a miscarriage is imminent without any aid. They do not note any infection concerns. A staff member told the HSE report: “Looking back there was no reason I could find to suggest the patient could contract infection.”
*Monday, Oct 22, 12.30am: Ms Halappanavar vomits and her waters break. She experiences vaginal bleeding.
*Monday, Oct 22, 10.30am: An ultrasound finds a foetal heartbeat.
*Monday, Oct 22, 10pm: A day after her waters broke, Ms Halappanavar has yet to miscarry. She is taking oral antibiotics every six hours.
*Tuesday, Oct 23, 8.20am: The Halappanavars ask for help to induce a miscarriage. They are told: “Under Irish law, if there’s no evidence of risk to the life of the mother, our hands are tied so long as there’s a foetal heartbeat.”
The staff member told the HSE report team if Ms Halappanavar had been at greater risk at the time, a termination would have been possible.
*Tuesday, Oct 23, 9pm to Wednesday, Oct 24, 8.25am: Staff asked to check on Ms Halappanavar are dealing with busy caseloads and cannot. She is finally checked at 4.15am and is found to have a low temperature.
No blood pressure or heart rate is taken, with a staff midwife stating: “There were no signs she was septic to me… I didn’t think she was unwell enough.”
The draft report said her low temperature was a sign of needing immediate help as an infection/sepsis was present but not yet identified.
She is found to be suffering from this condition by a doctor at 7am and, at 8.25am, swabs are taken.
A staff member told the HSE review team the Halappanavars were informed that if the source of the infection was not found, the pregnancy might have to be terminated.
*Wednesday, Oct 24, 1.20pm: Ms Halappanavar is found to be suffering from septic shock — an overwhelming infection that can lead to life-threatening low blood pressure.
*Wednesday, Oct 24, 3.15pm-4.45pm: She suffers a miscarriage and is transferred to the high dependency unit “alert and responsive”.
*Thursday, Oct 25, midnight-3am: She deteriorates, needs more oxygen, is put on ventilation, and is transferred to the intensive care unit.
*Sunday, Oct 28, 1.09am: Ms Halappanavar is pronounced dead.
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