‘Speedy conclusion’ needed in inquiry on Cavan baby deaths

Simon Harris says ‘absolutely essential’ people have confidence in maternity services

It is important for investigations on infant fatalities at Cavan General Hospital to have a "speedy conclusion", Minister for Health Simon Harris has said.

Speaking on Newstalk radio, Mr Harris said: “I think it is really important that we have these reports so we can establish the facts. It’s also very important that we respect patient confidentiality at this very sensitive and difficult time for families.”

He was speaking after it emerged that three babies died in the Cavan hospital in recent days, but one of these is believed to have been a late miscarriage, according to local sources.

Investigations are now under way into two of the deaths.

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In one incident, a baby died early on Sunday morning after problems arose during labour and an emergency Caesarean section was called for.

The investigation is likely to focus on the amount of time that passed before contact was made with the consultant obstetrician on call.

A non-consultant hospital doctor was present but this grade is not allowed to carry out an emergency section without consultant cover being on site.

The baby’s condition deteriorated before the Caesarean section was carried out and the baby died before delivery.

In an earlier incident, a baby died unexpectedly less than a day after being born. The cause of death is also being investigated.

The third case involved the death of a baby at the cusp of viability and would normally be classified as a late miscarriage.

“It’s absolutely essential that people can have confidence in their maternity services. And I see a speedy conclusion of these reports so the facts can be known, as a very important part of that confidence,” said Mr Harris.

The Cavan hospital has one of the smallest maternity units in the State and has been the subject of at least four investigations into deaths in recent years.

The unit is staffed by four consultant obstetricians, one of whom has been on administrative leave for more than 18 months.

This person has been replaced by a locum consultant.

Perinatal deaths

Meanwhile, former master of the Rotunda Hospital Dr Sam Coulter-Smith has said the increase in coroner inquests may be delaying investigations into perinatal deaths.

Dr Coulter-Smith, consultant in obstetrics and gynaecology, told Northern Sound FM that there has been an increase in the number of coroner inquests in recent years.

“Investigating these issues is important and it is important that it is done in a timely manner. There is an issue around that because investigating any situation takes times. The pathology process takes a number of weeks to happen and clearly in that situation time is important,” said Dr Coulter-Smith.

“One of the issues that has arisen over the years is that there are more investigations in coroners’ inquests into deaths. A coroner’s inquest can take a number of years to happen and that can delay the release of results and delay the results of any inquiry for quite some time. And that can be a source of frustration for families,” he said.

Dr Coulter-Smith said the perinatal mortality rate at Cavan General Hospital is relatively low.

“The perinatal mortality rate for any unit should be somewhere around the four per 1,000. And from my knowledge of the perinatal mortality rate in Cavan would be well under that, so the results are extremely good and should be reassuring for people,” he said.

Dr Coulter-Smith said the number of deaths within a short timeframe does not reflect on the quality of staff at the hospital.

“It is important that nobody should jump to any conclusions. These things happen at intervals and often perinatal deaths are unexplained. Sometimes they result from stem, from a problem with the placenta or the umbilical cord; sometimes there’s an inherent issue within the baby that makes it susceptible to become unwell or sometimes die.

“Very occasionally you get a situation where a baby can be damaged or die in labour as a result of a lack of oxygen at birth. The majority of perinatal deaths are due to prematurity, congenital malformation. So there are lots of reasons why babies die and it is very important from a parent’s point of view that the deaths are investigated as fully as possible and in a timely manner to get parents as much information as possible. Because sometimes the system mitigates against that and that is unfortunate,” he said.

Dr Coulter-Smith said it is important staff involved at hospitals where investigations take place are supported and learn from the events.

“When you get a bad outcome on your watch, obviously it takes its toll on everybody. We need to support the staff who have been involved in this . There is a lot of learning to be gained from when something goes wrong,” he said.