As soon as a senior midwife took charge of Savita Halappanavar’s care at 8am on Wednesday, October 24th, she formed the view she was “a septic abortion”.
Patricia Gilligan, senior midwife on St Monica’s maternity ward, told the coroner Dr Ciaran MacLoughlin there was “no way the foetus could continue” at that point, as Ms Halappanavar was “so septic”.
Ms Gilligan said Ms Halappanavar was the first patient in the 15-bed ward she attended to on her handover from the night shift.
“I was very concerned about her. She was the first patient I went down to see,” she said.
She had Ms Halappanavar moved from room two, which was near the exit to room nine, next to the nurses’ station, where she said she could keep a closer eye on her. She also had the room cleared of any superfluous furniture in case equipment was needed later.
“When I heard what her temperature was at 6.30am [39.6 degrees] and her pulse rate was 160 bpm, I felt I really don’t hear that too often. It wouldn’t be the normal miscarriage in the ward.”
Asked what she meant by the term “septic abortion”, she said when a pregnant woman was in severe sepsis, foetal survival was highly unlikely.
“Sepsis is very difficult. It can be overwhelming. It’s very serious. She was so septic the foetus was not going to continue. With the pulse rate and everything the child was not going to survive.”
“Alarm bells were ringing?” John O’Donnell, JC for Praveen Halappanavar asked. “Yes they were.”
She said consultant Dr Katherine Astbury was coming at 8.20am for her ward round and she felt the medical team would respond to Ms Halappanavar’s condition.
She did not have an opportunity to talk to Dr Astbury at that point.
“I saw her on the ward [at 8.20am] but I didn’t talk to her. The doctor would have had her chart. The doctor would be seeing what I was seeing.”
The inquest had already heard evidence earlier that Dr Astbury did not see Ms Halappanavar's chart on that ward round as her colleague, Dr Anne Helps had it.
Key indicators
The inquest had heard Dr Astbury was not told about some key indicators already apparent in Ms Halappanavar, indicating that she was in septic shock.
Dr Astbury had told the inquest that, had she been aware of these, she would have moved sooner to consider a termination of pregnancy.
Yesterday ’s midwife witness Patricia Gilligan said she contacted Dr Astbury at about 1.10pm to express her increasing concern about Ms Halappanavar’s condition and Dr Astbury arrived on the ward at 1.20pm.
