Savita doctor admits failures in care

A consultant who treated Savita Halappanavar has said she would have started terminating the foetus regardless of a heartbeat if she had been aware of a junior doctor’s note that the patient was suffering from sepsis.

Obstetrician Dr Katherine Astbury admitted at an inquest into the Indian dentist’s death that on the day she miscarried, Oct 24, she did not know a junior colleague had put on her chart at 6.30am that he suspected Mrs Halappanavar was suffering from sepsis caused by chorioamnionitis, an infection of the foetal membrane.

She said that when she examined Mrs Halappanavar at 8.30am in University Hospital Galway, her vitals had dropped and she believed she had sepsis, not severe sepsis, and admitted her registrar Dr Anne Helps did not read the earlier entry reporting a foul-smelling discharge, a sign of chorioamnionitis.

Dr Astbury insisted had she known this, she would have started the steps for a termination then regardless of a heartbeat, instead of ordering tests to check for a urine infection and deciding to terminate at 1pm when severe sepsis was diagnosed.

Mrs Halappanavar, 31, delivered a dead baby daughter on that Wednesday and died the following Sunday of a heart attack caused by septicaemia due to E.coli.

Dr Astbury also admitted she was unaware of blood test abnormalities as they had not been passed on to her team from the weekend staff on-call and that Mrs Halappanavar’s clinical signs were not checked every four hours, in breach of hospital policy, after her membranes ruptured in the early hours of Monday morning.

The coroner, Ciaran MacLoughlin, rejected claims by Dr Astbury that the notes on her care gave continuity. “That didn’t work,” he said, looking at Mrs Halappanavar’s chart. “Nobody pointed out to you that the doctor at 6.30am had a very serious and very pertinent finding.”

When asked by the coroner if there had been a systems failure, she said “yes”.

Dr Astbury said she refused to terminate the pregnancy two days after she was admitted as there was not a risk to her life.

“She was well. There was no risk to her life.”

She has denied making a reference that “Ireland is a Catholic country”.

Dr MacLoughlin asked if there was confusion over the interpretation of the guidelines on abortion. “There’s no law to tell you what is permitted or not permitted,” she said.

Dr MacLoughlin said: “So it’s a question of law?”

“Yes,” Dr Astbury replied.

Meanwhile, a senior midwife apologised for telling Mrs Halappanavar she could not have a termination in Ireland because it was a “Catholic thing”.

Ann Maria Burke admitted she made the remark but insisted she meant it in kindness.

The senior midwife said she used the reference to Catholic teaching after Mrs Halappanavar said she was Hindu and she would have ended her pregnancy in her home country.

Ms Burke said she regrets making the statement, which the coroner said “went around the world”.

“I’m sorry that I said it,” she added