Tuesday 23 May 2017

Six-day-old baby due to go into care died a day after being discharged

The Dublin Coroner's Court
The Dublin Coroner's Court

Louise Roseingrave

A six-day-old baby whom social workers planned to take into care died a day after he was discharged from hospital.

The baby boy was born at the Rotunda Hospital in 2015 where he was closely monitored for withdrawal symptoms for five days following his birth.

Dublin Coroner's Court heard his mother had been through a detox programme and was being prescribed methadone.

Her urine samples throughout pregnancy were clean apart from one sample that tested positive for opiates a week before the birth.

The baby displayed no symptoms of withdrawal and neonatal ward staff reported to social workers that both were doing well.

Two social workers involved in the case met the mother in hospital the day before mother and baby were discharged to inform her of the intention to seek an interim care order.

There was no immediate concern for the baby's well-being but there were long-term concerns regarding "environments the mother might find herself in".

At a meeting with social workers, the mother "went quiet and began to cry", the court heard.

Advised that if the interim care order was refused, Tusla would seek a supervisory care order, the mother became "angry" and said she was not being given "a chance".

After five days in hospital, mother and baby were discharged and returned to the woman's home, where preparations for the arrival of the baby had been made and checked by social workers.

Daily visits from the social care team formed part of the immediate care plan.

The mother, who was taking 80ml of methadone daily along with an anti-depressive sleeping tablet, took a taxi home with the baby at around 4pm.

That evening she fed and changed her baby as normal. At about 3am she fed the infant for the last time.

When she woke up the next day the child's colour was blue and she phoned for an ambulance. Dublin Fire Brigade logged the call at 2.15pm.

Resuscitation attempts by paramedics failed and the baby was pronounced dead at the scene.

Risk

The time and cause of death was undetermined, according to a post-mortem carried out by Deputy State Pathologist Dr Michael Curtis.

The post-mortem revealed subtle changes in the brain that can be associated with a predisposition to Sudden Infant Death Syndrome (SIDS), the court heard.

Consultant Neonatologist Dr David Corcoran said the preferred feeding time for a newborn baby should not exceed six hours.

"That would put the baby at risk of a fall in blood sugar," Dr Corcoran said.

Pathological findings of brain changes associated with SIDS were not inconsistent with hypoglycemia, the court heard.

Asked if a trace of methadone found in the baby's system had any clinical significance, Dr Corcoran said "no".

The jury returned a narrative verdict setting out the facts of the case.

Irish Independent

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