Aibha Conroy inquest: Key blood tests not performed

Critical blood tests were never performed on young Aibha Conroy six months before she died, a leading doctor claimed on Wednesday.

Additionally, on the night of her death, six-year-old Aibha did not receive the standard dose of dextrose that is usually given to hypoglycaemic patients, leading paediatric endocrinologist Dr Susan O’Connell told the Coroner’s Court in Dublin.

The expert’s comments came as Aibha’s primary school teacher confirmed the girl’s mother fully expected to receive a referral to Crumlin Children’s Hospital in Dublin for the blood tests, although this referral was not received.

Aibha, from Gowla, Connemara, Co Galway, died at Temple Street Children’s hospital in Dublin on December 14th, 2011. Four days previously, she had been admitted to Galway University Hospital suffering from hypoglycaemia, or low blood sugar, weakness and vomiting.

Respiratory arrest

Shortly after her admittance to Galway University Hospital on December 11th, 2011, Aibha experienced a respiratory arrest and suffered brain damage. Although she died on December 14th, 2011, brain stem death was confirmed shortly after she arrived at Temple Street on the afternoon of December 11th.

Speaking on Wednesday before the inquest, 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 Aibha suffered a prolonged episode of hypoglycaemia on the night of December 10th-11th.

There is a “high probability” that Aibha’s hypoglycaemia was related to the cerebral oedema, or brain damage, that she suffered on December 11th, Dr O’Connell said, although she emphasised 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 Aibha’s admittance to hospital on December 11th, Dr O’Connell said, “This child was profoundly unwell when she presented at University College Hospital Galway.”

Dr O’Connell pointed out that no successful critical samples were ever carried out to determine whether Aibha had an underlying metabolic or endocrinal 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 limited investigations were undertaken during Aibha’s visit to GUH in August 2011, when she suffered from kenotic hypoglycaemia for the second time while in hospital.

No clear reason

Dr O’Connell said there remains no clear reason as to the cause of Aibha’s hypoglycaemia. “Regrettably, we have no clear answers for the cause of the hypoglycaemia in this case,” said Dr O’Connell. “It’s very difficult to come to terms with that.”

Aibha only received an IV infusion of 5 per cent dextrose – used to treat patients with low blood sugar – when she was admitted to GUH on December 11th, 2011, suffering from hypoglycaemia. Dr O’Connell told the inquest the standard dose in such situations would be 10 per cent dextrose.

Caroline Ní Chonghaile, Aibha and her sister Sorcha’s primary school teacher, also appeared at the inquest on Wednesday.

She said that, at the start of the school year in September 2011, Aibha’s mother, Kathleen Conroy, mentioned she was expecting referrals for Aibha to Crumlin hospital very shortly. Because of this, she was expecting that she would have to take both Aibha and her sister out of school for a few days with little or no notice in order to make the visit to Dublin.

Ms Ní Chonghaile said that, on the first day of term that autumn, Ms Conroy also told her about Aibha’s health issues, and requested that the school keep a bottle of Lucozade on the premises for Aibha because it helped her feel better when she felt unwell.

The school follows a healthy food policy and so fizzy drinks are not normally allowed, but Ms Ní Chonghaile and her principal decided that in this case they could make an exception.

Later that day, and on three other occasions, Aibha became unwell. On all these occasions, she complained of a headache, became flushed and her “eyes were very glazed, very watery”, said Ms Ní Chonghaile.

On all these occasions, Aibha was given some Lucozade and recovered within about 30 minutes.

Very upsetting

Aibha’s death was very upsetting to herself, the school and community, said Ms Ní Chonghaile. She said members of the community are very close and most of them would use Irish as their primary language – Aibha was fluent, as is her sister.

Kathleen and John Conroy, accompanied by their daughter – Aibha’s younger sister – were again present for the entire proceedings on Wednesday. Their solicitor, Damien Tansey, said the family is “expecting answers” from the inquest.

Those present in the court were reminded of the personal tragedy underlying this inquest at one point in the afternoon.

A photo of Aibha was shown to Dr O’Connell, as well as to the coroner and the legal teams, in order to show Aibha’s skin colour.

“She looks like a sweet, happy child,” Dr O’Connell said as Ms Conroy, for the first time this week, openly fought back tears.