Review of Savita obstetrician finds no safety or quality issues

Consultant obstetrician continues to work as normal at University Hospital Galway

Consultant obstetrician Dr Katherine Astbury: the review concluded that her management of patients was in keeping with the standard of care expected. Photograph: Eric Luke/The Irish Times

No safety or quality issues arose after a review of some of the work of the obstetrician who treated Savita Halappanavar at University Hospital Galway. Dr Katherine Astbury continues to work as normal at the hospital, a spokesman for the West/North West Hospitals Group – which includes UHG – has confirmed.

The review concluded that Dr Astbury’s management of patients was in keeping with the standard of care expected.

Up to nine staff at the hospital have been disciplined over the care provided to Ms Halappanavar, who died in UHG in October 2012, The Irish Times reported last week. None has been identified by hospital authorities.

Last October, a report by the Health Information and Quality Authority (Hiqa) said there were 13 “missed opportunities” in the care of Ms Halappanavar which, had they been identified, could have saved her life.

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It added: “Ultimate clinical accountability rested with the consultant obstetrician who was leading Savita Halappanavar’s care.”

Ms Halappanavar’s husband Praveen is taking a civil case against the HSE and Dr Astbury alleging negligence in her death.

Asked this week if Dr Astbury had been the subject of any internal review, the hospital group said its clinical director, Dr Pat Nash, commissioned Prof Deirdre Murphy of the department of obstetrics and gynaecology at Trinity College to review and audit the quality of obstetric care provided by Dr Astbury.

The review focused on the “care plans, decision-making and adherence to recognised clinical practice guidelines, based on an independent review of case notes from patients under the care of Dr Astbury.

“The purpose was to seek independent, professional assurance with regard to the clinical care provided by the consultant in order to ensure that there were no ongoing patient safety issues to be addressed.”

Prof Murphy reviewed the case records of 29 consecutive “unselected” patients booked under the care of Dr Astbury, who delivered in September and October 2012. All care was completed before October 20th, 2012. This was the day before Ms Halappanavar presented at the hospital.

Prof Murphy concluded in her review: “It is my opinion that Dr Astbury’s management of obstetric patients is in keeping with the standard of care expected of any consultant obstetrician of equal skill and experience.”

Dr Astbury, who studied medicine in UCD, has been on the register of the Medical Council since 1995 and its specialist register for obstetrics since 2009.

The original investigation into Ms Halappanavar’s death, conducted by the HSE’s national incident management team in November 2012, reviewed the roles of all staff, including Dr Astbury, from a patient safety view, the hospital group spokesman said.

This group made a number of interim safety recommendations for immediate action by the gynaecology ward within the hospital, including the introduction of an obstetric early warning score chart for patients, training on sepsis, the provision of counselling for women who miscarried and the introduction of new methods of managing healthcare records.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.