Husband of woman who died after birth gives evidence

The husband of a woman who died after giving birth at Sligo Regional Hospital said he told an obstetrician at least three times after the birth that something was wrong, but was told to go home and that she would be up having breakfast when he returned .

A short time later the same doctor told him that his wife had had a stroke and that he should contact family members.

Sally Rowlette (36) from Dromore West, Co Sligo died in the hospital on February 5th 2013 the day after her fourth baby was born.

At the opening of the inquest into her death at Sligo courthouse, her husband Sean (39) recalled that when their baby girl was born in the early hours of February 4th , his wife had held her and said: “At last, I have my red head”.

Mr Rowlette recalled “a heated discussion” between two doctors about what dosage of pethidine Sally should receive, shortly after they arrived in the hospital. Sally had asked for an epidural but was told as she was already five centimeters dilated, this was not possible, he said.

One medic wanted to administer a 20ml dose of the pain relief but was confronted by Dr Sinéad McDermott who said it should be 4ml, he said. Mr Rowlette said he did not want to get involved in the argument as it was making his wife anxious “and I didn’t want to panic her further”.

The medic “aggressively grabbed the syringe, pushed Dr Sinéad McDermott out of the way, and administered the 20ml dosage of pethidine to Sally,” he said.

He said that 15 minutes later “chaos erupted and staff rushed around in a panic”. He asked what was wrong and was told that the baby’s heartbeat had dropped to 40 and Sally needed to go to theatre for an emergency C-section.

Mr Rowlette said he was told Sally was being brought to ICU after the birth because her blood pressure was high.

He said when he noticed that his wife was getting weaker and seemed confused, he expressed concern to obstetrician Dr Heather Langan but she replied: "What do you expect? She's just had a baby".

Mr Rowlette said he told Dr Langan that he had been there through three other pregnancies and knew something was wrong. “I told her that something was wrong at least three times”.

Dr Langan told him to go home and to come back in the morning when Sally would be “ up having breakfast” but he stayed , Mr Rowlette said.

After waiting in the day room for about 45 minutes he crept quietly back into ICU as he didn’t want to wake any other patients.

He said he saw Dr Langan and her team standing at the end of Sally’s bed, speaking amongst themselves. “When Dr Langan saw me, she nodded towards me and put her finger to her lips to silence her colleagues,” he told the jury.

Mr Rowlette asked Dr Langan what was wrong and was told that they were working on Sally’s blood pressure. He was asked to wait outside. “Some time later, Dr Langan came out and told me that Sally had had a stroke,” he said.

When she asked him to contact family members, he knew it was serious “but no one mentioned a risk of death”.

At about 9.30am Sally was brought for a scan and he was told that she had “suffered a bleed on her brain” .

A doctor mentioned the possibility of transfer to Dublin. Some time later he expressed concern to Dr Seamus Crowley who was sitting at the desk in ICU . “He was dismissive and rude,” Mr Rowlette said. “He told me to go away and let him do his job”.

At about 11am, Sally was put on a ventilator and a doctor told him that she could no longer breathe on her own, he said. He asked different members of staff questions “but no one was able to tell me anything” .

Mr Rowlette recalled helping a nurse to push Sally’s bed to theatre. Both he and his wife had to sign some paperwork in the lift which seemed to stop at every level on the way up to the eighth floor .

“Sally was very drowsy at this point but knew what was going on around her and seemed upset”.

After approximately 15 minutes he was asked to come into theatre as the baby had been delivered normally before the C-section could be done.

The baby who had red hair “just like her mother” was lying on Sally’s chest. The panic and chaos had ended “and everyone seemed relaxed, now that the baby had been delivered”,Mr Rowlette said.

But he noticed that his wife seemed drowsy and struggled to answer his questions.

Mr Rowlette said he was aware that Dr Langan was saying that that Sally asked at this point if she could have been affected by HELLP syndrome, a severe form of pre-eclampsia, but this was untrue. She could not have a simple conversation with him , “let alone a detailed discussion with a doctor about medical matters”. Neither he nor Sally had ever been told what HELLP syndrome was, he said.

Mr Rowlette said that after checking on the baby he returned to ICU at about 4am and expressed concern to Dr Langan after trying to wake Sally who was now confused and muttering. At about 11am, Sally was put on a ventilator and a doctor told him that she could no longer breathe on her own. He asked different members of staff questions “but no one was able to tell me anything” .

Soon after 11am, Dr Crowley took himself and Sally’s sister and mother into a room. “He told us that Sally’s pupils were unreactive and that she was seriously ill but that transfer was still on the cards”.

“I stayed in the hospital all day hoping that Sally would be transferred,” Mr Rowlett said.

The following morning Dr Crowley told them that Sally was now brain dead and that there was no hope of recovery and no point sending her to Dublin.

Dr Crowley told him that Sally had HELLP Syndrome and that she had had this during her second pregnancy, Mr Rowlette said.

But Sally’s obstetrician Dr Murshid Ismail later told the family that the other doctors had diagnosed HELLP Syndrome but that he did not agree. Mr Rowlette said that at a meeting with Dr Langan months later, she said Sally’s blood pressure was very high and that it had “set alarm bells ringing”.

She stated that this was a warning sign that things were not right. Mr Rowlette told the jury that the previous night when he was sitting on his own with Sally he had decided that if she did not survive, he would donate her organs. “Sally was a very kind person and always looked out for others. I know that she would have wanted her organs to be donated”.

Mr Rowlette told Conor Halpin SC for the hospital that he was not aware that his wife had previously had HELLP sydrome during her second pregnancy in 2007.

He was aware that she had high blood pressure. Mr Rowlette said he did not know that when his third child was born in 2010 that there was reference in the medical notes to Sally previously having HELLP.

Pathologist Dr Clive Kilgallen agreed with Damien Tansey solicitor for the Rowlette family that Ms Rowlette’s blood pressure reading had been “off the wall”. He agreed with Mr Tansey that essentially she had died from a massive brain haemorrhage . Dr Kilgallen told the jury that Ms Rowlette had HELLP syndrome.

Earlier Mr Halpin put it to Mr Rowlete that doctors would dispute parts of his testimony.

Dr Ahemd Koura would say that he had been administering labetalol a medication for lowering blood pressure , and not pethidine. He did not push the other doctor out of the way.

Counsel added that Dr Seamus Crowley did not recall the exchange detailed by Mr Rowlette who said he was dismisisve and rude.

Mr Rowlette told the jury that he had asked Dr Langan if there was anything she would have done differently, if she had been Sally’s treating doctor, instead of Dr Ismail. “She informed me that yes, she would have brought Sally in at 38 weeks and induced her, because of the history.”

Dr Langan also told him that Dr Ismail resigned from his post at Sligo General Hospital three weeks after Sally’s death and she did not know his whereabouts .

Three people had received transplants as a result of her death.

The case continues.