HSE probe into more baby deaths
A clinical review of 28 baby deaths and traumas has recommended that up to eight cases should be investigated, the Sunday Independent has learned.
A team of obstetricians recommended the further action to the Health Service Executive (HSE) after reviewing the clinical charts in 28 cases in which babies died or suffered injury during birth over more than two decades.
Most of the cases that will be investigated relate to the maternity unit at the Midlands Regional Hospital Portlaoise, but maternity units at other hospitals are also involved.
Letters will be sent to families in the coming weeks. The 28 cases were prioritised for clinical review from 176 complaints made about Portlaoise and other maternity services in the wake of an RTE documentary on baby deaths at the hospital last year.
Since then, concerns over maternity services have escalated to include Portiuncula, where 12 births are being independently investigated, and Cavan General Hospital, where the deaths of four babies are being reviewed, and where an infant died during a Caesarean delivery last week.
The clinical review team, led by Dr Peter Boylan - the former master of the National Maternity Hospital on Holles Street - is now moving on to review around 68 birth charts.
Sources said more cases could be referred to the review team as the fall-out continues from a damning report by the health watchdog, Hiqa, on Portloaise.
The report found that senior health management failed to act on serious concerns over patient safety at the maternity unit, and there was a lack of compassion and dignity afforded to traumatised parents.
Rhona Mahony, master of Holles Street Page 24
However, Hiqa also raised concerns about shortcomings in other regional maternity hospitals. Last week, the health watchdog announced that it had begun a "focussed programme" of monitoring all of the 19 maternity units to ensure they were compliant with national standards, including staffing and clinical governance.
The Sunday Independent revealed earlier this year that the HSE has conducted serious incident reviews into 59 cases involving the care of babies or their mothers since 2012, including deaths. Ten of those reviews have been completed and 49 are ongoing. But the HSE said it would not disclose which maternity units were involved for reasons of confidentiality.
Figures released by Health Minister Leo Varadkar last week suggested that regional maternity units were more likely to be sued than the voluntary maternity hospitals in the capital. In response to a parliamentary question, the minister said claims against HSE-run maternity units as a percentage of overall national births amounted to 0.20pc for 2014. Claims against voluntary maternity hospital units amount to 0.13pc for 2014.
The figures were supplied by the State Claims Agency, which has been monitoring negligence claims against maternity units.
In a study earlier this year on oxytocin, a labour-inducing drug frequently cited in malpractice claims as it can be harmful to the foetus if not administered properly, the State Claims Agency found disparities in how the drug was administered in 19 maternity units around the country. The study also found that none of the hospitals asked mothers for their written consent before they were administered the drug.
The State Claims Agency called for national clinical guidelines, which are now being drafted by the HSE. It has also said a national information leaflet on oxytocin should be circulated to women.
Sam Coulter-Smith, the Master of the Rotunda Hospital, told the Sunday Independent that the key factors affecting maternity units are a lack of clinical governance and staffing levels.
"Clinical governance is a process of overseeing the activity within the hospital," he said. "If you don't have good perinatal audit, you are not going to have an understanding of why your outcomes are what they are."
"There are vacant posts all over the country at NCHD and consultant level and that is all over the country."
A spokesman for Minister Varadkar said he wanted a patient advocacy service "up and running in the shortest possible time frame, possible within months".
The minister said last week he was ashamed of his profession after an emotional meeting last week with families who recounted their disturbing experiences at the maternity unit in Portlaoise.