Thursday 23 May 2019

Savita Halappanavar: How the events of October 24 unfolded

The inquest today heard how the events of Wednesday October 24 unfolded:

- At 4am midwife Miriam Dunleavy gives Mrs Halappanavar paracetamol for a high temperature and an extra blanket as she shivers in bed. She checks her 45 minutes later and her temperature has dropped.

- By 6.30am the nurse took Mrs Halappanavar's vitals and said that in her seven years at the hospital she had never seen any woman with an inevitable miscarriage get so sick so quickly.

- Dr Inkechukwu Uzockwu was called to examine the patient and believed she is suffering from sepsis due to chorioamnionitis - an infection of the foetal membrane - and informed a more senior medic but he said he believes he never reviewed Mrs Halappanavar.

- Around the time her pulse was 160 beats per minute - almost double what it was on admission - her temperature was 39.6, and blood pressure and respiratory rates up while there was a foul smelling discharge from her vagina.

- By 8.25am Dr Astbury saw the patient during her normal round and noted her temperature and pulse rates had dropped slightly. She complained of feeling cold and of having a headache and back ache but the baby was still alive. She discussed her concerns about chorioamnionitis with the couple and ordered tests to rule out that a urinary tract infection was causing the fever.

- At 1pm the senior doctor is called again by ward staff and told the pregnant woman's condition had deteriorated again. She discussed the case with colleagues, who agreed on a termination. Mrs Halappanavar was sweaty and having difficulty breathing and believed to be suffering from septic shock. A scan also revealed the baby had died.

- At 2pm Dr Astbury called a microbiologist for advice on what medication to give the patient.

- By 3.15pm Mrs Halappanavar delivered her daughter, who had six toes on each foot, and samples from the placenta taken for chromosomal analysis.

- At 4.45pm Mrs Halappanavar is transferred to the high dependency unit and later to intensive care, where she died on the Sunday.

Mr Halappanavar glared at Dr Astbury as she read her four page statement in the packed courtroom, where she will be cross examined tomorrow.

He claims his wife asked for a termination three times on the Monday and Tuesday, when he alleged Dr Astbury made the controversial "Catholic" remark which she denies.

The doctor admits Mrs Halappanavar did ask about getting medication to cause a miscarriage on the Tuesday, but informed her that the legal position in Ireland did not permit her to terminate the pregnancy in her case "at that time".

Ireland's strict abortion laws mean a termination can only be carried out if a heartbeat is present when there is a substantial risk to a mother's life.

Elsewhere, the medic also revealed that on the Friday night she told her husband blood tests had showed Mrs Halappanavar had septicaemia due to E coli and extended spectrum beta lactasmase which was resistant to many antibiotics so she was being given more appropriate medication which they hoped would improve her condition.

"Ms Halappanavar suffered cardiac arrest at 12.45am on Sunday October 28 2012 and resuscitation was unsuccessful," she added.

"I would like to offer my condolences to Mr Halappanavar and to his family at this difficult time."

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