Critical blood tests never performed on little Aibha (6) six months before her death, inquest hears
Published 23/09/2015 | 18:44
Critical blood tests were never performed on young Aibha Conroy six months before she died, a leading doctor claimed today.
Additionally, on the night of her death, six-year-old Aibha did not receive the standard dose of dextrose that is usually given to hypoglycaemia patients, leading paediatric endocrinologist Dr. Susan O’Connell told the Coroner’s Court in Dublin today.
The expert’s comments came as Aibha’s primary school teacher confirmed that the girl’s mother fully expected to receive a referral to Crumlin Children’s Hospital in Dublin for the blood tests, although this referral was not received.
Aibha, from Gowla, Connemara, Co. Galway, died at Temple Street Children’s hospital in Dublin on 14 December 2011. Four days previously, she had been admitted to Galway University Hospital suffering from hypoglycaemia, or low blood sugar, weakness and vomiting.
Shortly after her admittance to Galway University Hospital on 11 December 2011, Aibha experienced a respiratory arrest, and suffered brain damage. Although she died on 14 December 2011, brain stem death was confirmed shortly after she arrived at Temple Street on the afternoon of 11 December.
Speaking before the inquest, Dr. O’Connell, who is based in Cork University Hospital and is one of an elite number of paediatric endocrinologists in the country, conveyed her condolences to the Conroy family.
She emphasised the significance of the fact that Aibha suffered a prolonged episode of hypoglycaemia on the night of 10-11 December.
There is a ‘high probability’ that Aibha’s hypoglycaemia was related to the cerebral oedema, or brain damage, that she suffered on 11 December, Dr. O’Connell said, although she emphasised that the relationship between hypoglycaemia and cerebral oedema is not totally understood.
Dr. O’Connell emphasised that prolonged hypoglycaemia ‘is not good for the brain’.
Referring to Aibha’s admittance to hospital on 11 December, Dr. O’Connell said, ‘This child was profoundly unwell when she presented at University College Hospital Galway.
Dr. O’Connell also pointed out that no successful critical samples were ever carried out to determine whether Aibha had an underlying metabolic or endocrine issue.
These critical samples are a series of blood tests that must be carried out while a patient is suffering from hypoglycaemia. They are critical in the investigation of hypoglycaemia, said Dr. O’Connell.
Dr. O’Connell said it appeared that limited investigations were undertaken during Aibha’s visit to GUH in August 2011, when she suffered from kenotic hypoglycaemia for the second time while in hospital.
Dr. O’Connell said that there remains no clear reason as to the cause of Aibha’s hypoglycaemia. ‘Regrettably, we have no clear answers for the cause of the hypoglycaemia in this case,’ said Dr. O’Connell. ‘It’s very difficult to come to terms with that.’
Aibha only received an IV infusion of five per cent dextrose – used to treat patients with low blood sugar – when she was admitted to GUH on 11 December 2011 suffering from hypoglycaemia. Dr. O’Connell told the inquest that the standard dose in such situations would be 10 per cent dextrose.
Caroline Ni Chonghaile, Aibha and Sorcha’s primary school teacher also spoke before the inquest yesterday (Wednesday). She said that, at the start of the school year in September 2011, Aibha’s mother, Kathleen Conroy, mentioned that she was expecting referrals for Aibha to Crumlin hospital very shortly. Because of this, she was expecting that she would have to take both Aibha and her sister out of school for a few days with little or no notice in order to make the visit to Dublin.
Ms. Ni Chonghaile said that, on the first day of term that autumn, Mrs. Conroy also told her about Aibha’s health issues, and requested that the school keep a bottle of Lucozade on the premises for Aibha, because it helped her feel better when she felt unwell. The school follows a healthy food policy and so fizzy drinks are not normally allowed but Ms. Ni Chonghaile and her principal decided that in this case, they could make an exception.
Later that day, and on three other occasions, Aibha became unwell. On all these occasions, she complained of a headache, became flushed and her ‘eyes were very glazed, very watery’ said Ms. Ni Chonghaile. On all these occasions, Aibha was given some Lucozade and recovered within about 30 minutes.
Aibha’s death was very upsetting to herself, the school and community, said Ms. Ni Chonghaile. She said members of the community are very close and most of them would use Irish as their primary language – Aibha was fluent, as is her sister.
Kathleen and John Conroy, accompanied by their daughter – Aibha’s younger sister – were again present for the entire proceedings today. Their solicitor, Damien Tansey, said the family is ‘expecting answers’ from this inquest.
Those present in the court today were reminded of the personal tragedy underlying this inquest at one point in the afternoon. A photo of Aibha was shown to the Dr. O’Connell, as well as to the coroner and the legal teams, in order to show Aibha’s skin colour.
‘She looks like a sweet, happy child,’ Dr. O’Connell said as Mrs. Conroy, for the first time this week, openly fought back tears.