Midwife tells of ‘frightening’ deterioration

Galway nurse says records altered by hospital’s internal investigation unit

Miriam Dunleavy, a midwife who was working on the ward where Savita Halappanavar was being treated , leaving after giving evidence at the inquest into the death of Savita Halappanavar in Galway on Tuesday. Photograph: Eric Luke

Miriam Dunleavy, a midwife who was working on the ward where Savita Halappanavar was being treated , leaving after giving evidence at the inquest into the death of Savita Halappanavar in Galway on Tuesday. Photograph: Eric Luke

Tue, Apr 9, 2013, 23:06


Savita Halappanavar was one of the healthiest women in her maternity ward before her condition deteriorated, a midwife at Galway University Hospital has claimed at her inquest.

Miriam Dunleavy, who worked on the ward where Ms Halappanavar was treated last October, said she had never seen a patient deteriorate so fast in her career as a midwife.

Ms Dunleavy said she did not contact a doctor after Ms Halappanavar’s membranes ruptured the day after admission. She said it was not an emergency but a natural progression of her condition.

On the Tuesday night, she was told at handover that Ms Halappanavar’s pulse was raised. She agreed this was something that should be addressed by a doctor.

Asked if she was aware of a misunderstanding between nursing and medical colleagues about the patient’s pulse, Ms Dunleavy said she was not. It was a very busy night and four other patients were sick. Ms Halappanavar was one of the healthiest patients on the ward that night.


Cold
Ms Dunleavy said Ms Halappanavar rang the call bell at 4.15am on Wednesday October 24th because she and her husband were cold in their room and they needed blankets. Ms Halappanavar’s teeth were chattering and she shivered as the blanket was pulled over her shoulder.

However, she made no complaint about pain. She said she didn’t recall checking the heater to see it was working, as Mr Halappanavar has claimed.

Asked if she had taken Ms Halappanavar’s pulse, Ms Dunleavy said she had not. There was no evidence she was sweating at the time. “I decided not to do it,” she told the inquest.


Dramatic change
However, by 6.30am there were “dramatic changes” in her condition, she said. Her pulse was 160 beats per minute and her temperature had gone up to 39.6 degrees and there was a foul-smelling discharge from her vagina, senior house officer Dr Ikechkwu Uzockwu noted.

Ms Dunleavy agreed with Eugene Gleeson SC, for Mr Halappanavar, that this indicated a life-threatening situation. She said it had occurred in the two hours before 6.30am.

“I’ve never seen a woman with an inevitable miscarriage get so sick so quick, and I’ve been seven years on the ward," she said. “The deterioration was frightening.”

Ms Dunleavy also told the inquest her notes were added to afterwards by the hospital’s internal investigation unit.

She said marks on the notes were not written by her and she thought they were put in by internal investigation.

Lawyers for the hospital, responding to queries from coroner Ciaran McLoughlin, said they would check the exact situation.