A SENIOR midwife has apologised after admitting she told an Indian woman suffering a miscarriage that she could not have a termination in Ireland because it was a "Catholic country".
Ann Maria Burke, a clinical midwife manager at University Hospital Galway, said the comments had preyed on her mind since she made them five days before the death of Savita Halappanavar, and insisted she had never meant them in a "hurtful context".
Her apology came as details of Ms Halappanavar's care revealed a litany of failures during her treatment and subsequent death in the hospital.
The 31-year-old died on October 28, 2012, at Galway University Hospital, a week after being admitted.
She was 17 weeks' pregnant when she suffered a miscarriage in the hospital.
The inquest has heard that her requests for a termination were refused.
Yesterday, coroner Dr Ciaran McLoughlin raised concerns about a number of aspects of the care given to the dentist -- including staff failing to convey medical information to colleagues, delays in observing the patient's vital signs and failure to correctly read medical notes.
He also questioned the "confusion" of the medical notes relating to Ms Halappanavar, which contained a high number of retrospective entries.
Visibly shaken, Ms Burke admitted telling Ms Halappanavar that she could not have a termination because of the Catholic ethos of the country, but insisted she now regretted it.
When asked by Dr McLoughlin if she had made the comment about Ireland being a Catholic country, Ms Burke replied: "Yes, to be honest. I've been upset about this and I'm very upset.
"I did mention a Catholic country, I didn't mention it in a hurtful context."
Ms Burke, who has decades of experience in nursing, made the comments to Savita and her friend Mrudula Vasealli on Tuesday, October 23, while she was talking to them about the situation. However, she rejected ever having referred to Ms Halappanavar as "dear" when telling her the termination could not take place.
Ms Burke said she was speaking with Savita in a conversational manner which was not related to her medical care. She told the inquest they had talked about what would occur in India and the Hindu faith had been mentioned in the conversation. Ms Burke was explaining why things were different in Ireland, she told the inquest.
"So it was not in a context to offend her. I'm sorry if I came across . . . I don't think I came across as insensitive at the time. It does sound very bad now, but at the time I didn't mean it that way," she said.
Ms Burke said she was trying to put in context the law of the land adding: "There were two referendums and the Catholic Church were pressing it."
"It was more to give information and to kind of throw light on our culture than to be hurtful or insensitive," she added.
Ms Burke said she had thought of the conversation more as a chat and was nothing to do with medical care.
"She had mentioned the Hindu faith that this would happen and there would be no problem, and I really had to say something and I was trying to be as kind as I could. And it came out the wrong way and I'm sorry I said it," she added.
The consultant in charge of Savita's treatment, Dr Katherine Astbury, conceded at the inquest yesterday that there head been a number of system failures before her death.
Dr Astbury earlier admitted that she should have been aware of "significant" medical notes on the chart which she admitted would have resulted in her performing an earlier termination.
The notes warned of a serious deterioration in Savita's condition and the suspected onset of sepsis at an earlier stage.
Colleagues had also noted a change in heart rate and blood count but Dr Astbury was not aware of this.
The consultant obstetrician finally planned to carry out a termination on the afternoon of Wednesday, October 24, just one day after informing Ms Halappanavar that a termination was not possible because of the legal position in the country.
She told the inquest that had she been aware of a number of changes to Ms Halappanavar's condition she would have began the termination process hours earlier on Wednesday morning.
Coroner Dr Ciaran McLoughlin pointed out that the comments had gone around the world. He stressed that no hospital in Ireland followed a religious persuasion or dogma, which Ms Burke accepted.
Earlier, the inquest heard from Eugene Gleeson, counsel for the Halappanavar family who put it to Dr Astbury that Savita had suffered as a result of "geographical mischance".