A DRAFT review into the death of Savita Halappanavar in a Galway hospital was told how staff attributed her symptoms of shivering and teeth chattering to the cold rather than a life-threatening infection, because the radiator in her room wasn't working.
The report notes that, at one stage, "the radiator in the bedroom was not working" and a nurse went to fetch a blanket for her. Her shivering turned out to be symptoms of a serious infection taking hold in her system, which ultimately led to her death.
The incident is among a catalogue of concerns identified by her husband, Praveen, around the care given to Savita at University College Hospital Galway. The quality of care is expected to be among the issues examined at an inquest into Savita's death, which opens in Galway Courthouse tomorrow.
Sixteen hospital staff, including the consultants, doctors and nurses who treated her in her final days, are expected to testify at what will be the first public examination of her death. More may be called as the inquest unfolds. Expert witnesses will also be asked to testify.
The 31-year-old dentist died of sepsis and E-coli in October last year, after she miscarried in the hospital. Her husband, Praveen, has said that their repeated requests for an abortion were refused and they were told Ireland is a Catholic country.
According to sources close to the hospital, the use of the phrase will be "clarified" if it is raised at the inquest, in terms of who said it and the context in which it was uttered.
The inquest is ultimately tasked with establishing the cause of Savita's death and the circumstances leading to it. The draft report says that a termination should have been considered, to remove the source of infection and reduce the risk to Savita's life.
It says: "Different management options needed to be considered, including termination of pregnancy, as the removal of the source of infection reduces the potential risk of sepsis, thereby potentially avoiding rapid deterioration in the patient's clinical condition."
It noted there was inadequate assessment and monitoring of her condition, and concluded that too much emphasis was placed on the foetus rather than the mother.
The HSE has apologised to Savita's family for the events while in hospital care that contributed to her death.