No action against obstetrician who led Savita Halappanavar care

Medical Council decides no further steps should be taken against Dr Katherine Astbury

No action will be taken by the Medical Council against Dr Katherine Astbury, the consultant obstetrician who led the care of Savita Halappanavar before she died at Galway University Hospital in October 2012.

The regulatory body for the medical profession has written to the Lord Mayor of Galway Pádraig Conneely informing him of its decision.

Mr Conneely, who is also a Fine Gael councillor in the city, lodged a complaint about Dr Astbury with the Medical Council in 2013.

Dr Astbury led the care of Ms Halappanavar from Monday, October 22nd 2012, the day after she had presented at the Galway hospital complaining of back pain, until her death at 1.09am on Sunday, October 28th.

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The 32-year-old dentist had been 17 weeks pregnant and was told she was miscarrying.

Termination requested

She requested a termination, but this was refused as a foetal heartbeat was present.

The inquest into her death heard that senior midwife Anne Marie Burke told her on Tuesday, October 23rd a termination was not possible because "it's a Catholic thing".

The foetal heartbeat stopped on Wednesday 24th and Ms Halappanavar spontaneously delivered a girl.

Ms Halappanavar was transferred to the High Dependency Unit that day and later to intensive care.

She had contracted Ecoli ESBL, a virulent strain of the bacterium, and developed chorioamnionitis, an infection of the foetal membranes. She developed sepsis, septic shock and died of multi-organ failure.

Her widower Praveen, as well as her family in Karnataka in India, has since maintained that, had her request for a termination been acceded to, she would not have died.

Abortion debate

Her death reignited the abortion debate in Ireland.

Three investigations into her death found failings in her care and significant lapses by a number of the clinicians caring for her.

Cllr Conneely said he had complained about Dr Astbury’s conduct on the grounds that there had been “failings” in the care given to Ms Halappanavar and because Dr Astbury had been in charge of that care.

Responding, the council wrote to him on March 9th saying his complaint had been examined by its preliminary proceedings committee (PPC) on February 25th this year.

During these proceedings the committee considered an independent expert report from Dr Jane Norman, professor of maternal and foetal health at the University of Edinburgh, dated December 2014.

Dr Norman concluded: “Katherine Astbury’s management of Savita Halappanavar was appropriate; in terms of clinical decision-making and treatment options...

“She involved colleagues from other specialities appropriately... I do not think the actions of Dr Katherine Astbury fulfil the criteria for poor professional performance or professional misconduct.”

The committee said this view would be conveyed to the council.

In further correspondence dated March 23rd, Cllr Conneely was told: “At its meeting on March 20th, 2015, the Medical Council considered the PPC’s opinion and decided that no further action should be taken.”

Sepsis guidelines

Responding to the development, the Pro-Life Campaign called for the full implementation in Irish hospitals of guidelines for the treatment of sepsis in pregnancy.

Cora Sherlock, deputy chairwoman of the campaign, said recommendations issued by the Health Information and Quality Authority in 2013 on the introduction of sepsis early warning systems had not been followed satisfactorily.

She said there was a need to ensure the 2014 Department of Health guidelines on sepsis management were "properly and promptly" implemented.

“Every time the Savita case is mentioned, it is presented in a way that gives the impression that her death was due to the lack of abortion in Ireland at the time.

“We know from the several official reports that were issued following Savita’s death that this was not the case,” said Ms Sherlock.

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times