'We went to have a baby, and he came home without his mammy' - Mum-of-three died from 'extremely rare disease'
A mum-of-three who died shortly after giving birth to her son had “pleaded” for a C-section, a jury inquest heard today.
Tracey Campbell Fitzpatrick (36) died on Easter Monday in 2016 shortly after giving birth to her son Max at St Luke’s Hospital, Kilkenny.
The jury at Kilkenny Coroner's Court today agreed with the coroner's verdict that the primary cause of the mum-of-three's death was an extremely rare disease called Amniotic Fluid Infusion Syndrome that presents itself in women either during or after childbirth.
Tracey, originally from Shanvaghera in Mayo, lived with her husband Bernard and two children, Jamie and Adam, in Nurney, Co Carlow.
Tracey, who married her husband Bernard in 2014, gave birth to her healthy baby boy in the early hours of March 28, 2016, but shortly after the delivery her condition began to suddenly deteriorate and she began to haemorrhage, the inquest heard.
Medical staff became very concerned about her status and she was rushed to an operating theatre for treatment.
Sadly, she died before emergency surgery could begin.
The inquest, attended by Tracey’s widowed husband Bernard, her parents James and Pauline and other family members, heard how Tracey had “pleaded” for a C-section.
In his statement today, Bernard Fitzpatrick described the moment he and his parents-in-law were told of Tracey’s death; “We asked, ‘why didn’t you give her a C-section?’, Dr McMurray replied, ‘she did not ask for one’.
"I stood up and said, ‘she pleaded with you for one, you replied you were not going to break eggs on Easter Sunday.'"
Speaking outside the court, Mr Fitzpatrick said: "It's pretty horrendous. We went to have a baby, and he came home without his mammy. There are two kids at home with no mammy."
Gynaecologist Dr David McMurray told the inquest today that Mrs Fitzpatrick had not requested a C-section, but had asked previously would a C-section be “necessary”. He added there had been “no clinical indication to do an elective or an emergency C-section.”
He said he had meant the 'breaking eggs on Easter Sunday' comment “in a nice way in a good situation.”
Bernard Fitzpatrick described his late wife as being in “severe agony” during labour. He also told the inquest how after the childbirth, he went to see Baby Max and took a photo on his iPhone to bring back to Tracey “because she wanted to see her baby.”
“I proceeded to show Tracey the photo of Max on my iPhone,” he continued.
“I was asked to move away, I saw that her music the Saw Doctors was on the radio and I told her to get a smile from her.”
Tracey was then brought to the operating theatre where she died.
Consultant perinatal pathologist Dr Peter Kelehan told the inquest today that he concluded Mrs Fitzpatrick died from an extremely rare condition called Amniotic Fluid Infusion Syndrome.
Dr Kelehan said there are between 6 and 15 deaths per every 100,000 women, according to U.S. data.
The disease involves amniotic fluid from the uterus entering the blood stream and going directly to the lungs. Here it produces hypertension in the heart and also immediately reduces the ability for the blood to clot, meaning haemorrhage can quickly become fatal.
“It is a very, very rare disease that only occurs in pregnancy,” Dr Kelehan told the inquest.
“It is a fundamental cause of death in the developed world.
“Detection depends on being able to recognise it from a clinical scenario. It is not identifiable in any way, except at post-mortem.
“It is unpredictable and unpreventable because there is no particular situation in the course of pregnancy where you could predict it,” the doctor continued,
“One condition of the disease that does not produce a sign is the silent loss of clotting factors in the blood. This is very silent, it does not produce any signs or symptoms.”
Dr Kelehan said there are no tests for the condition, although there have been many attempts to find a test.
“It’s a healthy woman that loses her life this way,” Dr Kelehan continued.
“A normal pregnancy and a normal delivery, but a post-partum haemorrhage, which is common, can soon become fatal.”
He shared his condolences with the family of Tracey.
St Luke’s Hospital carried out a thorough investigation into Mrs Fitzpatrick’s death and prepared a 160-page report which included several recommendations for the hospital, including the recommendation of the use of a larger cannula in all women who now present themselves at the hospital in labour, so fluids can be administered in large amounts and quickly if necessary.
The inquest had heard that the medics’ attempts to gain IV access for Tracey proved difficult, and had a larger cannula been inserted initially, more fluid may have been administered quicker.
Ireland records an average of two maternal deaths each year.
They are defined as the death of a mother during pregnancy or within 42 days of her pregnancy, ending with the exception of fatalities due to accidents or causes totally unrelated to the pregnancy.