Hiqa publishes details of inquiry prompted by maternity hospital death

The terms of reference for the planned investigation that arose following the death of Malak Thawley at Dublin's National Maternity Hospital, Holles Street, in 2016 have been published.

The Health Information and Quality Authority (Hiqa) investigation will centre on the measures in place to ensure the safe conduct of obstetric or gynaecological surgery outside of core working hours.

The terms of reference for the inquiry do not mention Ms Thawley or her husband, Alan.

Ms Thawley (34), a teacher originally from Dallas, Texas, was expecting her first baby with her husband when she died at Holles Street on May 8th, 2016.

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Minister for Health Simon Harris directed the authority to carry out the investigation under section 9 of the Health Act 2007.

In his direction, Mr Harris said he had reasonable grounds to believe there was a particular patient safety risk in relation to the provision of surgical services outside of core working hours and the readiness of the hospital to effectively respond to major emergencies regarding obstetric or gynaecological surgical intervention.

Judicial review

However, on foot of a case brought by the hospital, the High Court recently granted leave for a judicial review of the decision by Mr Harris to order an investigation. The case is expected to be heard towards the end of March.

The hospital said it would welcome a further inquiry into the events surrounding the death of Ms Thawley. It said it had already proposed an international expert inquiry in order to maximise the local and national learning from this case, but that it was open to other proposals.

The hospital said its concern about the inquiry proposed by the Minister was solely with the very particular type of review he had directed. It said he had proposed a review under section 9.2 of the 2007 Health Act, which was only to be used when the Minister believed there was a serious risk to patients.

Terms of reference

Hiqa said on Monday the terms of reference for the planned investigation were:

a) To investigate, determine and evaluate the appropriateness of measures employed at the National Maternity Hospital to manage risk and ensure safety in the conduct of obstetric or gynaecological surgery outside of core working hours

b) In doing so, to take particular account of the presence of required senior medical clinical decisionmakers during the conduct of surgical procedures outside of core working hours

c) To investigate and assess the wider overarching governance arrangements at the hospital to ensure safe surgical services outside of core working hours

d) To investigate and assess the readiness of the hospital to respond to major emergencies related to obstetric or gynaecological surgical intervention outside of core working hours.

Separately, the hospital said it would not be using funding it received from the State to pay for its legal battle against the investigation.