Dhara Kivlehan, 29, originally from India, died in Belfast’s Royal Victoria Hospital on September 28, 2010 after being airlifted from Sligo hospital where she had given birth a week earlier and suffered a severe strain of pre-eclampsia.
The inquest at Carrick-on-Shannon courthouse heard consultant anaesthetist Dr Seamus Crowley spoke to her husband Michael on the maternity ward the day after she underwent an emergency Caesarian section.
Dr Crowley said he openly questioned if Mrs Kivlehan could have partial Hellp syndrome — the severe and rare variant of pre-eclampsia she was ultimately diagnosed with — 24 hours after the birth of baby Dior.
The consultant said the confrontation with Mr Kivlehan took place as he was discussing his wife’s case with two other doctors from the obstetrics team, Dr Hind Al Husain and Dr Raouf Sallam.
“I noted his demeanour was confrontational and angry and had tried to explain to Mr Kivlehan that there was no immediate acute indication to admit Mrs Kivlehan to the ICU,” Dr Crowley told the inquest.
He said he had been called to the maternity ward to assess Mrs Kivlehan for admission to ICU and what potential other treatments she needed.
Dr Crowley told the hearing he directed Mrs Kivlehan be cared for on the maternity ward with regular observations and blood tests taken.
“I noted Mr Kivlehan had made frequent references to not trusting doctors and that he had spent time at King’s College Hospital which he said enabled him to understand the blood test results,” the doctor said.
Mr Kivlehan, 35, from Dromahair, Co Leitrim, had been treated in the London hospital for several months after suffering injuries in a road accident, while living in the UK.
In his statement to the inquest, Dr Crowley added: “He accused me of patronising him when I openly questioned what ICU care would have to offer over the current care that she was receiving on the ward.”
The consultant said he tried to reassure Mr Kivlehan that he was “simply thinking out loud” to inform him of his thoughts.
The consultant said he would agree Mrs Kivlehan was suffering an “ongoing acute kidney injury” on September 22 — the day after the C-section. Dr Crowley said kidney failure was a diffuse term that he would not use at that stage.
Mrs Kivlehan was battling five problems including kidney failure, liver dysfunction and issues with her blood, water and urine in the days after the C-section.
The inquest heard HSE guidelines state that a patient suffering with problems affecting two organs should be cared for in an intensive care unit.
Mr Kivlehan is attending the hearing with his mother and father, Michael Snr and Susan. The couple’s son Dior had his fourth birthday on Sunday.
A jury of five men and two women are hearing several days of evidence on how his wife died.
Mr Kivlehan and his son were awarded almost €1m last year after the HSE apologised for shortcomings in her care.
Twelve doctors and seven midwives were involved in Ms Kivlehan’s care in Sligo, as well as a number of doctors and nurses in Belfast.
The inquest was moved to the Republic of Ireland after Attorney General Máire Whelan intervened to ask Belfast coroner Dr John Leckey if he would agree to a change in jurisdiction.