Hiqa could pursue new investigation after Savita case

The Health Information and Quality Authority may establish a further investigation into the care of pregnant women in Irish hospitals following its inquiry into the death of Savita Halappanavar.

The authority, which yesterday published the terms of reference for its investigation into the death of the 31-year-old at Galway University Hospital in October, said if it emerged there could be “serious risks” to anyone in a similar situation, it might recommend “further investigation or . . . a new investigation”.

Ms Halappanavar died on October 28th of septicaemia. She had been 17 weeks pregnant when she presented a week earlier at the hospital’s maternity unit with back pain.

She was found to be miscarrying and, according to her husband Praveen, asked repeatedly for a termination of the pregnancy over a three-day period. He claims this was refused as there was a foetal heartbeat present. He says he and his wife were told by a consultant: “this is a Catholic country”.

Safety

The HSE asked the authority to investigate the death, an action that is in addition to its own inquiry. Hiqa will look into “the safety, quality and standards of services provided by the HSE to patients, including pregnant women at risk of clinical deterioration and as reflected in the care and treatment provided to Savita Halappanavar”.

It will review the safety and quality of care at the Galway hospital to deteriorating patients, including pregnant women and the diagnosis and management of sepsis. Hiqa will also review the arrangements to ensure safe services including promptly identifying, reporting and managing deteriorating patients.

“If in the course of the investigation it becomes apparent there are reasonable grounds to believe that there are further or other serious risks to the health or welfare of any person receiving similar services, the investigation team may recommend . . . these terms be extended to include further investigation or that a new investigation be undertaken.”

Membership of the team will be finalised next week and its work will begin immediately, said a spokesman. The draft terms of reference were sent to Mr Halappanavar’s solicitor this week. Mr Halappanavar, however, does not intend to take part in it or the HSE inquiry. He is pursuing an action to the European Court of Human Rights in his bid to secure a sworn, public inquiry.

Meanwhile, the Galway coroner, Dr Ciarán MacLoughlin, said the inquest would sit in early January.

“We have over 30 witnesses and it will run over a number of days,” he said. “It will be open, there is compellability of witnesses and they can be cross-examined. We expect to have all witness statements taken by December 7th. It will be accountable, transparent and we will get to the bottom of what happened.”