Critical blood tests were never performed on young Aibhe Conroy six months before she died, a leading doctor has said.
Additionally, on the night of her death, six-year-old Aibhe did not receive the standard dose of dextrose that is usually given to hypoglycaemia patients, paediatric endocrinologist Dr Susan O'Connell told the Coroner's Court in Dublin yesterday.
Aibhe, from Gowla, Connemara, Co Galway, died at Temple Street Children's hospital in Dublin on December 14, 2011. Four days earlier, she had been admitted to Galway University Hospital (GUH) suffering from hypoglycaemia, or low blood sugar, weakness and vomiting.
Shortly after her admittance to GUH on December 11, 2011, Aibhe experienced a respiratory arrest, and suffered brain damage. Although she died on December 14, 2011, brain stem death was confirmed shortly after she arrived at Temple Street on the afternoon of December 11.
Dr O'Connell, who is based in Cork University Hospital and is one of an elite number of paediatric endocrinologists in the country, conveyed her condolences to the Conroy family.
She emphasised the significance of the fact that Aibhe suffered a prolonged episode of hypoglycaemia on the night of December 10-11.
There is a "high probability" that Aibhe's hypoglycaemia was related to the cerebral oedema, or brain damage, that she suffered on December 11, Dr O'Connell said, although she emphasised that the relationship between hypoglycaemia and cerebral oedema is not totally understood.
Dr O'Connell emphasised that prolonged hypoglycaemia "is not good for the brain".
Referring to Aibhe's admittance to hospital on December 11, Dr O'Connell said, "This child was profoundly unwell when she presented at University College Hospital Galway."
Dr O'Connell also pointed out that no successful critical samples were ever carried out to determine whether Aibhe had an underlying metabolic or endocrine issue.
These critical samples are a series of blood tests that must be carried out while a patient is suffering from hypoglycaemia. They are critical in the investigation of hypoglycaemia, said Dr O'Connell.
Dr O'Connell said it appeared that limited investigations were undertaken during Aibhe's visit to GUH in August 2011, when she suffered from kenotic hypoglycaemia for the second time while in hospital. Dr O'Connell said that there remains no clear reason as to the cause of Aibhe's hypoglycaemia.
Aibhe only received an IV infusion of 5pc dextrose - used to treat patients with low blood sugar - when she was admitted to GUH on December 11 2011 suffering from hypoglycaemia.
Dr O'Connell told the inquest that the standard dose in such situations would be 10pc dextrose.
Parents Kathleen and John Conroy, accompanied by their daughter - Aibhe's younger sister - were again present for the entire proceedings. Their solicitor, Damien Tansey, said the family is "expecting answers" from this inquest.