A PREGNANT diabetic woman who went into septic shock and ended up in a coma had a condition so rare that some experts dispute its existence, Dublin Coroner's Court has heard.
Mother-of-two Jennifer Crean (35), of Ashford, Co Wicklow, had a heart attack during an emergency caesarean at the National Maternity Hospital (NMH) in Dublin on July 2, 2008, after developing septic shock from an infection in the central line used to deliver her insulin.
She died on February 10, 2009, of brain damage caused when she had a subsequent cardiac arrest while in a coma.
Mrs Crean was an insulin-resistant Type 1 diabetic and needed the line to administer the drug into her bloodstream.
The court heard yesterday from Prof Richard Firth, consultant endocrinologist at the Mater Hospital, that Mrs Crean's resistance to insulin was extremely unusual.
"There are many who believe it does not exist," he said.
The court had previously heard that the line was prone to infection and needed to be changed on a regular basis.
However, when she presented at the NMH on June 29, 2008, complaining of pain in her abdomen and sweating profusely, staff failed to change it despite repeated pleas from Mrs Crean and her husband, Francis.
She was so concerned about her condition that she insisted on naming her unborn child in case something happened.
Rather than replace the line, staff left it in place while they tried to secure an alternative access point to administer Mrs Crean's insulin.
Consultant endocrinologist Dr Brendan Kinsley said yesterday that he was contacted by the specialist registrar looking after Mrs Crean for advice on how to administer her insulin after her infection was diagnosed.
He said Mrs Crean could be given insulin through a peripheral intravenous line. He added that at no point did he say the central line should not be removed, and he had told the specialist registrar that treatment of the infection was the "prime clinical issue".
Last year, the High Court approved a settlement of €690,000 against the NMH for Francis Crean and the couple's two sons, Adam (11) and Daniel (4), who was delivered in the emergency caesarean. Adam also settled his action for damages for nervous shock for €40,000.
The inquest continues today.