Little Aibha (6) turned blue before going into respiratory arrest, inquest told
Doctors have defended their treatment of six-year-old Aibha Conroy, despite protests from her family over their daughter’s medical care.
Kathleen and John Conroy, from Gowla, Connemara, Co. Galway, accompanied by their daughter – Aibha’s younger sister – remained stoic throughout an emotional day at the Coroner’s Court in Dublin.
Mrs. Conroy also continued to assert, through her solicitor Damien Tansey, that she was fully expecting a referral for Aibha to Crumlin hospital for further tests, shortly after 24 August 2011, the results of which could have changed the tragic outcome for her daughter, she argues.
Through Mr. Tansey, the inquest learned that the family questions the dosage of dextrose – which is key is treating hypoglycaemia – given to Aibha upon her admittance to Galway University Hospital in the early morning of 11 December 2011. This discrepancy, and the possibility that Aibha was given the wrong dose, is ‘troubling’ to her family, according to Mr. Tansey.
Aibhe died at Temple Street Children’s hospital in Dublin on December 14, 2011. Four days previously, she had been admitted to Galway University Hospital suffering from hypoglycaemia, or low blood sugar, and weakness.
The cause of Aibhe’s respiratory arrest at 2.10am on 11 December – just an hour and a half after she was admitted to GUH – remains unclear. According to Dr. Aisling Hillock, who was working as the paediatric SHO on call at GUH that night, Aibhe was responding well to treatment and that her blood sugar levels were brought back to appropriate levels.
Dr. Hillock told the inquest that Aibhe arrived at the hospital at approximately 12.45am on 11 December 2011. Aibhe appeared to be sluggish, and needed to be supported by her mother when standing. At the time of admittance, Aibhe’s blood sugar levels were at 1.3, which is quite low.
She was given an infusion with 5pc dextrose, in the hope of raising her blood sugar. Dr. Hillock said that by 1.10am, Aibhe’s blood sugar levels had improved to 2.4, and that she was sitting up in bed and talking to her parents.
At 2.00am, Aibhe’s blood sugar levels were at 4.8 but she vomited and started to complain of headaches. Her oxygen saturation quickly decreased and she turned blue. She then went into respiratory arrest.
Aibhe’s parents, Kathleen and John Conroy, dispute the idea that their daughter was responding well to the dextrose. They argue that she was sluggish throughout the entire time before her arrest.
They also argue that Kathleen had to alert Dr. Hillock to the fact that Aibhe was turning blue right before her arrest. Dr. Hillock emphatically disagreed with this – she said she did not need to be told that Aibhe was turning blue, as she was looking at the young girl and could see for herself.
Unlike many of the witnesses who gave evidence on Monday, Dr. Hillock remembers Aibhe and her parents. She remembers Aibhe in part because Aibhe was the first child whom she had seen arrest. Aibhe was also the first child whom Dr. Hillock had treated for hypoglycaemia, although she had previously treated adults.
Dr. Hillock told the inquiry that, as she had never treated a child with hypoglycaemia before, she consulted her registrar about the appropriate dose for Aibhe, adding that it would be common practice to consult with her senior colleague on such matters.
Dr. Ngi Chiw Teo also gave evidence at the inquiry. As the registrar in paediatrics at GUH on 11 December 2011, he was the most senior doctor on the premises that night (although there was a consultant on call).
Dr. Teo said he did not recall the patient, although he meant no disrespect to the parents by this. He also said he did not provide direct care to Aibhe but provided advice to Dr. Hillock, who told informed him about Aibhe ‘because she’s such a competent SHO’.
Dr. Teo said that when Dr. Hillock consulted him regarding the dosage of dextrose that she was planning to give to Aibhe, he concurred with her.
Dr. Teo said he did not recall seeing Aibhe that night, although ‘I must have’, he said, adding, ‘I had confidence in Dr. Hillock’s assessment’.
Dr. Vladimir Alexieu, who was part of the resuscitation team at GUH the night that Aibhe suffered from a respiratory arrest, said he made it to Aibhe within two minutes of receiving the call about her arrest. At that point he took over ventilation.
Once Aibhe was venitlised, he spoke with his colleagues about her history. He told the inquest that he was informed by his colleagues that Aibhe’s blood sugar right before the arrest was normal.
Dr. Alexieu then accompanied Aibhe to get a CT scan. He said that, while on the way to the scan, Aibhe’s pupils were dilated and were fixed or sluggishly reacting.
On foot of the CT scan, Dr. Alexieu and his colleagues discussed a transfer to Temple Street Children’s Hospital in Dublin, which took place later that day.
As the proceedings today drew to a close, Catherine Corbett Sheridan, a nurse at GUH, gave evidence. She said that she came on duty at the hospital on 24 August 2011, the day that Aibhe was discharged from one of her visits, and spoke with Mrs. Conroy that day.
Mrs. Sheridan knows the Conroy family, as she grew up near Mrs. Conroy. She attended Aibhe’s wake and paid her respects to Mrs. Conroy there.
During his questioning, Mr. Tansey told the inquest that Mrs. Conroy says that she was told on 24 August that Aibhe needed further tests in Crumlin. Mrs. Conroy has said that, at Aibhe’s wake, Mrs. Sheridan asked her whether Aibhe ever got the referral to Dublin.
Although Mrs. Sheridan said she remembered being at the wake and paying her respects to Mrs. Conroy, she told the inquest she could not recall the content of that conversation. ‘I cannot recall the specifics of any conversation from four years ago,’ she said.