Coroner calls for guidelines on labour drug after baby's death
A CORONER has recommended the introduction of national guidelines on the use of a drug which brings on labour, following the death of a newborn boy.
It was one of two recommendations arising from an inquest into the death of Joshua Keyes in Co Laois in 2009.
Joshua's parents, Joseph Cornally and Shauna Keyes, hope the recommendations can prevent further fatalities.
Their baby died an hour after his birth by emergency Caesarean section at the Midland Regional Hospital Portlaoise on October 28, 2009.
Coroner Eugene O'Connor found Joshua had died as a result of intrapartal anoxia, or oxygen deprivation at birth.
Ms Keyes was admitted to hospital on October 27 and was placed in the maternity ward at 3pm. She was given the drug Syntocinon to progress the birth but it was stopped due to concern over the baby's heartbeat at 5.15pm.
A short time later the drug was again administered and this resumed until concerns were raised about the baby's CTG trace – which monitors the foetal heartbeat – which ultimately led to the decision to carry out an emergency Caesarean section.
Evidence was heard during the two-day inquest that Syntocinon, a drug which brings on contractions, continued to be used during labour despite a concerning CTG trace.
Solicitor Roger Murray described the CTG trace as "a guide to foetal well-being" and he questioned why the drug had been administered in a lesser dose while the CTG trace was abnormal.
Pathologist Dr Peter Keleghan said the manner of death due to deprivation of oxygen at the time of birth was clear but the cause remained unknown. "We don't see any reason why the baby just stopped breathing and died," he said.
At the request of the family, the coroner recommended a categorisation of emergency sections depending on the level of risk to mother and child.
Mr O'Connor also agreed to the families' recommendation that the HSE put in place a national guideline for the use of synthetic forms of oxytocin used to progress on deliveries.
A third requested recommendation that all emergency sections be carried out in half an hour was rejected by the coroner.
The inquest was told Ms Keyes had not undergone the procedure within the recommended 30-minute timeframe from the decision being made and it took around 15 minutes longer.
Speaking for the couple afterwards, Mr Murray said: "They feel thoroughly vindicated by the verdict because it proves what they were alleging all along, which is that Joshua died because of the circumstances of his birth.
"They hope that lessons will be learned and that the HSE can absorb the information that they heard here with a view to fatalities being avoided in future," he said.
There was no explanation as to why Ms Keyes and Mr Cornally – both from Tullamore in Co Offaly – had to wait four years for an inquest into their son's death.