independent

Thursday 17 April 2014

Head of inquiry is perfect choice to uncover truth of this tragedy

A GRIEVING husband, an international outcry and a hospital under siege. Since the explosive mix of emotions, which has remained unabated following the news of the death of Savita Halappanavar after a miscarriage in Galway University Hospital, the nearest anyone has come to the voice of calm has been Professor Sabaratnam Arulkumaran.

Prof Arulkumaran, who agreed to chair the inquiry team into the death of Savita, is head of obstetrics and gynaecology at St George's Hospital in London. He has a distinguished career, including over 250 academic publications, and is the editor and author of 28 books. It emerged last night that these include a report calling on countries to make termination of pregnancy a legal right to reduce maternal death and illness.

Before the tumult which erupted after news of Savita's death, the hospital had promised an inquiry – but it was still unsure if any outside expert would be included in the investigation team and the possibility of securing anyone from abroad also seemed remote.

When Prof Arulkumaran appeared before the media on Monday to outline how the inquiry would proceed, he answered the limited number of questions which could be asked in a straightforward and forthright manner.

The impression was that this is the man who will ultimately come to the conclusions about the treatment and death of Savita, supported by the other members of the team.

Nevertheless, the presence of three senior consultants from Galway University Hospital, who would be sitting in judgment of their colleagues, did cause surprise in light of the clear wish by Savita's family for independence.

The presence of an obstetrician might be warranted, given the legal questions which hang over when doctors can intervene if a pregnant woman is at potential or probable risk of death.

Prof Arulkumaran could not be expected to be acquainted with the X case and the fallout for doctors from a lack of legislation.

Although Prof Arulkumaran referred to the need for other specialists from Galway to be on the team, to throw light on the kind of antibiotics they use to treat septicemia, he also saw the value in getting insight into the obstetric response.

The decision to ask the three Galway consultants to step down yesterday, following objections from Savita's husband, Praveen, will go a long way towards easing his fears about the inquiry's lack of independence.

The information which the inquiry will need to put the tragic events in Galway in context can be obtained from interviewing senior staff, without the need to have them on the panel.

In fairness, the record of these kind of inquiries in recent years in finding the truth has been admirable.

The case of the late Tania McCabe, who was pregnant with twins and died of sepsis with haemorrhage in 2007 at Our Lady of Lourdes Hospital in Drogheda is one that mirrors that of Savita.

The inquiry team found that Ms McCabe had been the victim of misdiagnosis. The report highlighted problems such as short staffing and high workload as contributing to the tragedy.

IT IS significant that the review team which carried out the inquiry was led by Dr Seosamh O Coigligh,an obstetrician in the hospital, with other members coming from Cavan hospital and the Coombe. The report was clear and coherent in its conclusions.

Central to the inquiry into Savita's death will be the care she received for septicemia, the blood poisoning which it is believed caused her death. A whole range of factors will have to be examined here including the kind of symptoms she had and how well they were recognised by staff.

Prof Arulkumaran has already previous experience of examining maternal deaths under the national spotlight. He was involved in a major investigation into 10 maternal deaths at Northwick Park hospital in Harrow in England.

He will have learned a lot from the conduct of that inquiry which he will be able to bring to the benefit of the Galway probe.

Irish Independent

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