AN INDEPENDENT review into the death of an infant delivered by Caesarean section at Mayo General Hospital has been ordered by the Health Service Executive.
It comes after a jury yesterday returned a verdict of misadventure at an inquest in Castlebar, Co Mayo, into the death of the infant boy who was stillborn when delivered by emergency Caesarean section following a car crash in 2009.
The jury delivered its decision on the third day of an inquest into the death of Andrew James Niland, whose parents live at Agloragh, Ballyhaunis, Co Mayo.
The infant’s mother, Lorna Niland (37), was almost 32 weeks pregnant in October 2009 when the car she was driving was involved in a head-on collision with another car near her home. She was not wearing a seat belt and was struck by an airbag.
Ms Niland was taken by ambulance to Mayo General Hospital in Castlebar complaining of abdominal pain. She had not felt foetal movements since the collision.
The mother of seven was admitted to the hospital at 12.45pm on October 25th, 2009. A decision was made at 4.50pm on the same day to carry out an emergency Caesarean section.
Prof Michael Turner, professor of obstetrics and gynaecology at UCD and clinical lead of the HSE’s obstetrics programme, told the inquest the standard of Ms Niland’s care in the maternity department on the afternoon in question was below what he would expect. He said he believed if the Caesarean section had been carried out earlier the stillbirth would have been prevented. Prof Turner pointed out, however, that earlier surgery would not have guaranteed a perfect outcome. There was a possibility, Prof Turner stated, that the infant would have survived normally and gone on to lead a normal life.
Cross-examined by Declan Buckley, counsel for the HSE and Mayo General Hospital, Prof Turner agreed that placental separation was an extremely difficult diagnosis to make. The witness agreed a decision had been made in good faith not to intervene by carrying out a section earlier.
Prof Turner’s conclusions differed from those of the retired consultant pathologist who carried out a postmortem examination of the infant. Dr Malcolm Little said he believed the cause of death was related in some way to the crash.
He gave the cause of death as: “Fresh stillbirth with evidence of intrauterine asphyxia. Umbilical cord around the neck with minor placental tear. Mother involved in a road traffic accident.”
Before the jury retired, south Mayo coroner John O’Dwyer said they should consider returning one of four verdicts: misadventure, medical misadventure, natural causes or an open verdict.
After the verdict of misadventure was returned, the HSE issued a short statement saying the management and staff of Mayo General Hospital extended their sympathies to the Niland family on their tragic loss.
“In accordance with usual HSE procedure, an independent review will take place and preparations are now being made to facilitate this process,” it said.