Earlier transfer of Dhara 'may have lead to different outcome', says doctor
The country's leading expert in maternity care says if Dhara Kivlehan was transferred earlier to a centre of excellence the outcome in her case "may have been different".
The Clinical Director of the National Maternity Hospital Dr Peter Boylan has described the delay in obtaining a specialist renal and liver consult, as a material contributor in the 29-year-old's death in September 2010.
Dhara Kivlehan died at Belfast’s Victoria Hospital of multi organ failure due to HELLP syndrome just over a week after an emergency C-Section at Sligo General Hospital.
Citing the series of delays involved in the care of Dhara Kivlehan at Sligo General Hospital, Dr Peter Boylan has told Sligo Leitrim Coroner’s Court that it is clear that there were unacceptable deficiencies in both her clinical care and at a systemic level.
However, chief amongst those concerns is a failure by staff in Sligo to consider the possibility of intra abdominal bleeding following her emergency c-section.
In his statement to the court, he says had this been recognised and dealt with, and an earlier transfer organised, it remains possible that the outcome in this case may have been different – however, he has stipulated that this remains conjecture.
He has described her case as very complicated because on presentation, she did not show classical symptoms of either PE or HELLP.
He agreed that the emergency c-Section was a reasonable course of action but said that afterwards, the fact that all of her problems were attributed to HELLP syndrome was a deficit in her care.
He said it is unacceptable that a liver consult was never sought during Ms Kivlehan’s treatment in Sligo and that ideally staff should have sought a transfer to a centre of excellence straight after delivery.
Dr Boylan has also pointed directly to the lack of intensive care beds at centres of excellence in Dublin and Galway as a key failure, as well as the lack of continuity of care at consultant level which he says is due to insufficient numbers of obstetric consultants on staff at Sligo General Hospital.
