HSE chief Tony O' Brien sent a text message to the head of the country's independent patient safety watchdog seeking an "informal off-line chat" about the damning investigation report on Portloaise Hospital before it was published.
The text was sent by Mr O'Brien to Hiqa chief Phelim Quinn, who did not reply, according to the minutes of a crunch meeting last March seen by the Irish Independent.
The meeting, convened by chief medical officer Dr Tony Holohan, followed three angry letters from Mr O' Brien to Hiqa about a draft report on its investigation into Portlaoise Hospital where five babies died.
Mr O'Brien had earlier claimed in the letters that the HSE, which is heavily criticised at all levels, was not allowed due process to respond to draft findings, some of which amounted to "reckless endangerment".
The minutes of the March meeting reveal that Mr Quinn confronted Mr O'Brien about the text message. He said he was confused by the HSE chief's approaches, which included the formal letters and the informal text message.
Mr Quinn pointed out Mr O'Brien had outlined in his letters "implicitly and increasingly explicitly" a threat that the HSE would go to the High Court to seek to a judicial review to stop the report being published until, in his view, there was a right of full response.
Mr Quinn said he was "confused" by the HSE's chief's approaches. The text message was "outside of the formal process" and at odds with the content of the letter.
Mr O'Brien acknowledged his text message "to which you didn't answer".
Dr Holohan emphasised to the meeting the importance of the report in progressing patient safety at the hospital.
He said a court action by the HSE to stop its publication would "inconsumable".
Dr Holohan said that "we all knew the issues in Portlaoise Hospital" and that the purpose of the meeting was not to "open the report" in terms of content.
He agreed with Hiqa that a request by the HSE for another several more weeks to provide responses to the draft was too long and it should be published in the "near future".
The HSE took particular issue at the meeting at the inclusion of patient experiences in the report. These included accounts of how mothers who lost babies had first sight of the dead infants squeezed into a metal box on a wheelchair.
Mr Quinn said the report made it clear the information was based on relatively small number of patients.
The external members of the Hiqa investigation have emphasised the need to record the patient experience. The HSE said the accounts by patients in the draft report left some staff in tears.
Hiqa maintained that due process was followed and the final report remained largely unchanged
It was eventually published on May 8. It highlighted failures at national, local and regional level in ensuring there was proper patient safety standards at the hospital.
It also revealed how the HSE failed to response to several alarm bells over the years which may have prevented the baby deaths from 2006 and 2013.
A promised external review of accountability in the HSE has yet to be set up.