Family of baby who died days after birth question hospital's decision not to carry out emergency C-section, inquest hears
Baby Alex Farrell, born at Dublin's Coombe Maternity Hospital, died two days later in her mother's arm
The family of a baby who was born with a life-threatening condition questioned why she was not delivered by emergency Caesarean-section on the day the illness was discovered, at Dublin Coroner’s Court.
Baby Alex Farrell, of Daingean, Tullamore, Co Offaly, was born at the Coombe Hospital, Dublin, on February 22, last year, but died two days later from complications of hydrops fetalis, a condition where fluid accumulates in the body while the baby is in the womb as a result of a poorly functioning heart.
The condition was first noticed when her mother Gillian Farrell attended the Midland Regional Hospital’s (MRH) outpatient clinic in Tullamore on Wednesday, February 20, complaining that she could not feel the baby moving.
She had been due to have a C-section the following Monday.
Consultant obstetrician Dr David Mortell said that he was using an “old scanner” and could see some fluid.
He asked Mrs Farrell to go to the MRH Mullingar the next day for a more detailed scan and this confirmed the presence of hydrops fetalis.
There was no evidence of the condition in her previous scans, he said.
Speaking from the body of the court, the Farrell family including Alex’s father David questioned why Mrs Farrell was not transferred to the Coombe for an emergency C-Section immediately after the condition was discovered.
Dr Mortell said that he had concerns on the initial scan in Tullamore but the baby was moving and "seemed to be doing quite well".
After the Mullingar scan, they had a verbal report that hydrops was present but the fluid around the baby was fine and she was moving, he said.
“It was not apparent that the baby was as ill as it transpired to be,” he said.
Dr Mortell said they had been looking for a hospital in Dublin to deliver the baby to ensure better care following birth.
The extent of the illness was confirmed the next day in a written report, however, Mrs Farrell had already been taken to the Coombe for an emergency C-section having gone into labour that morning.
Dr Mortell told the court that carrying out an emergency C-section in Mullingar on the Wednesday would have “put the baby in more jeopardy”.
Dr Pamela O’Connor, consultant neonatologist at the Coombe, said that Baby Alex was in poor condition at birth with a “guarded” prognosis.
Her condition fluctuated over the following days. Staff suspected that she suffered an air embolism – an air bubble – when a nurse was working on an arterial line.
Dr O’Connor said that a micro-embolism was later confirmed but the baby’s condition had improved in the time after the incident. Baby Alex subsequently deteriorated and died in her mother’s arms on February 24.
Pathologist Professor John O’Leary said that the air embolism was a co-morbidity in a baby that was very ill. The post-mortem was unable to establish the cause of the hydrops fetalis.
Returning a narrative verdict outlining the facts, coroner Dr Brian Farrell said that he is satisfied that the cause of death is severe foetal hydrops with an air embolism as a significant co-morbidity.