A NURSE who cared for Savita Halappanavar has revealed how she was certain the young woman was suffering a "septic abortion" hours before the consultant made the same diagnosis.
Patricia Gilligan, a ward nurse in St Monica's ward at University Hospital Galway, gave evidence that she was seriously concerned for Ms Halappanavar's health from as early at 8.10am on the Wednesday morning.
Dr Katherine Astbury did not make the decision to go ahead with a termination until lunchtime that day.
Ms Gilligan told the inquest she had moved Ms Halappanavar to a room closer to the nurse's station where she could be watched more closely.
"I was very concerned for her, yes, I felt she was in septic abortion," she said, agreeing with Eugene Gleeson, counsel for Praveen Halappanavar, that "alarm bells were ringing" at that stage.
When asked by Mr Gleeson had she communicated her concerns to Dr Astbury, Ms Gilligan replied that she had not had the opportunity to do so until later but insisted it was clear from the chart.
"She had the same observation chart I was seeing and she saw the same patient in the bed that I was seeing," she said.
Speaking of her early concerns for Ms Halappanavar, Ms Gilligan added: "It wouldn't be my normal miscarriage on a ward – they wouldn't normally have a temperature of 39.6."
When asked by the coroner, Dr Ciaran McLoughlin, what she meant by septic abortion, Ms Gilligan replied: "She was so septic, the foetus wasn't going to continue, really. It's hard to survive sepsis without having a septic abortion."
She also agreed with the coroner that it was her view at this stage on Wednesday morning that the child would not survive.
Earlier Dr Paul Naughton, a consultant anaesthetist in the ICU, told the inquest that the 31-year-old woman had been suffering from "profound sepsis" from lunchtime on Friday.
Dr Naughton took over care of Ms Halappanavar from Friday, October 26 until her death on the morning of Sunday, October 28, 2012.
Dr Naughton said that even though medics had by that stage been treating Ms Halappanavar with the correct antibiotics, the sepsis had "set off a cascade of events that led to an inflammatory action that just didn't stop because you are getting at the right bacteria".
The anaesthetist said septic shock was "very difficult" to reverse and agreed with coroner Dr Ciaran McLaughlin that in this case it proved impossible.