Mother agrees she was told of risk to babies from drugs

THE MOTHER who claims her daughter was born with disabilities because she was not advised to stop taking certain drugs for psychiatric illness when pregnant has agreed in cross examination before the High Court that consultant psychiatrist Prof Patricia Casey had advised her the drugs represented certain risks to babies.

Lisa McGillin, whose daughter Rebecca has a deformed hand, motor difficulties and other features of Sodium Valproate Syndrome (SPS), said she understood from both Prof Casey and her gynaecologist, Dr Mary Holohan, her child was not at risk if she took high doses of folic acid.

She had trusted advice from Prof Casey to the effect she should come off Lithium (a mood stabiliser) for the first three months of pregnancy but could continue taking Epilim (an anti-convulsant primarily used to treat epilepsy but also used as a mood stabiliser). She denied she knew all along there was a residual risk from Epilim.

She later decided herself, having read a book, to come off all drugs about four months into pregnancy but did not tell Prof Casey she had done so because Prof Casey was “quite formidable” and might become “angry”.

Prof Casey had described her as “a blubbering mess” when she attended her in April 2001 shortly after Rebecca’s birth and had also said SPS was not even proven to exist, she said. “Her treatment of me was appalling.”

Her daughter had been diagnosed with SPS shortly after birth and she ceased attending Prof Casey in August 2001.

Ms McGillin was being cross-examined by Murray McGrath, counsel for Prof Casey, in the continuing action by Rebecca, suing through her father Barry McGillin, of Gainsborough Avenue, Malahide, Co Dublin, against Prof Casey, practising from the Mater Misericordiae Hospital, Dublin, and Dr Holohan, practising from the Rotunda Hospital, Dublin.

It is alleged Rebecca was exposed to a risk of injury as a result of alleged failure of the defendants properly to assess the nature and type of prescription drugs taken by her mother before and into pregnancy and to give any or any proper advice as to certain effects of those drugs, including Epilim. Both defendants deny the allegations.

Yesterday, Ms McGillin agreed Prof Casey, who treated her for psychiatric illness including depression from 1997, told her in September 1998 Lithium and Epilim represented risks to the foetus in pregnancy and had posted her various articles that same month relating to drugs and pregnancy, plus further articles in August 2000, shortly after she became pregnant.

She said Prof Casey told her in September 1998 Lithium could cause cleft palate and heart defects in a baby while the risk from Epilim was a neural tube defect.

If she had received information about the risks of sodium valproate (the active ingredient in Epilim) before she was pregnant, she might have come off it herself even though she was not directed to do so by Prof Casey, she said.

She agreed she was being told Epilim represented a heightened risk of neural tube defects but said both Prof Casey and Dr Mary Holohan, told her taking folic acid would “negate” the risk from Epilim. She trusted them and was not a doctor or pharmacist herself.

Mr McGrath said Prof Casey’s evidence would be she never told Ms McGillin folic acid would negate the risk. Dr Holohan has also denied she ever told Ms McGillin that. Ms McGillin disagreed she was not so advised.

When counsel put to her Prof Casey had in September 1998 sent her an article about anti-epileptic agents and birth defects, she said the first time she saw that article was in documents sent by Prof Casey to Ms McGillin’s solicitors.

Mr McGrath said Prof Casey would give evidence she advised Ms McGillin, prior to her becoming pregnant about July 2000, there were risks to Ms McGillin herself if she came off her medication and risks to a baby should she become pregnant.

When counsel put to Ms McGillin the final decision as to staying on or off her medication had to be made by herself, she disagreed. She was in court because “someone has to take responsibility for what happened to my daughter”.

She had been extremely worried throughout her pregnancy and constantly sought reassurance about the effects of the drugs, she said. Prof Casey had told her at one point there was nothing more she could say to reassure her, she said.

The case continues.