Thursday 22 August 2019

Premature baby died after E. coli overwhelmed her

Rotunda Hospital.
Rotunda Hospital.

Louise Roseingrave

A "vigorous" baby girl born prematurely died a day later due to E. coli.

Baby Karly Farrell was born at 31 weeks' gestation but died the next day due to an overwhelming infection.

An inquest into her death heard she was not strong enough to fight the infection due to her prematurity.

Swab test results revealed E. coli was present four days before birth but this result was not made known to ward staff until the baby was born.

An inquest heard the Rotunda Hospital has implemented changes relating to the treatment of swab test results following the baby's death.

However, Master of the Rotunda Professor Fergal Malone said the baby's treatment would not have changed despite the delay.

Prof Malone said E. coli in the vagina during pregnancy is common and is not treated to avoid fostering an infection that becomes resistant to antibiotics.

The baby's mother Louise McGuirk, from Swords in Co Dublin, presented to the Rotunda on July 23 and a swab test was taken.

She was discharged and returned to hospital on July 26.

Baby Karly was born by Caesarean section at 8.37am on July 27.

The infant was described by the midwife as "vigorous" at birth.

However, her condition deteriorated and a diagnosis of septic shock was made.

Baby Karly was treated with penicillin and gentamicin, both broad spectrum antibiotics covering E. coli and septicemia.

"E. coli septicemia is a terrifying entity with a 10 to 30pc mortality rate.

"She was the sickest baby we'd looked after for quite some time," said Dr Michael Boyle, consultant in the neonatal unit.

Baby Karly developed multi-organ failure and died at 11am on July 28. The cause of death was E. coli septicemia due to ascending vaginal infection.

"A premature infant who has E. coli would find it very difficult to fight that infection," Pathologist Dr Emma Doyle told Dublin Coroner's Court.

Prof Malone said prenatal swabs showing E. coli were common.

"If found, it is not treated as you cannot eradicate it. The downside of treating it is you foster resistance... We are now finding cases of Group B streptococcus that don't respond to penicillin," Prof Malone said.

New electronic systems introduced at the hospital return laboratory test results directly to the doctors who order them.

"We are confident that error [of not following up on a result] will not happen again," Prof Malone said.

The coroner endorsed the system changes and returned a narrative verdict.

"It is so sad, unexpected and tragic for you, really there's nothing can be said to parents who have lost a baby in this way," Coroner Dr Myra Cullinane said to the family.

Irish Independent

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