The family of Dhara Kivlehan say they are "anxious beyond words" as they await direction from the Attorney General as to whether an inquest into her death should now be held in Sligo.
The HSE yesterday agreed a settlement of €790,000 with Ms Kivlehan's family and apologised "unreservedly" before the High Court over "shortcomings" in relation to her treatment at Sligo General Hospital in September 2010.
Ms Kivlehan died at the Royal Victoria Hospital in Belfast of multi-organ failure, a week after the birth of her first child, Dior, in Sligo General.
Dhara Kivlehan, nee Shandhu (28), originally from Gujarat in northwestern India, was admitted to the Sligo hospital on September 20th, 2010, having developed complications earlier in the pregnancy.
Her son was delivered by emergency section at 5.25am on September 22nd. She was returned to the maternity ward at about 10.15am, and was, according to medical notes, “confused and hypotensive” with an elevated pulse. A diagnosis of pregnancy-related renal failure and Hellp syndrome was made. Hellp syndrome is a life-threatening obstetric complication, usually a severe complication of pre-eclampsia.
She was transferred to intensive care on September 24th, 2010, and airlifted to the Royal Victoria Hospital in Belfast later that day at the request of her husband, Michael Kivlehan. She died there on September 28th.
In the civil case settled yesterday, her family had alleged signs of Hellp syndrome were missed at the Sligo hospital.
'Bitter end'
When approving the settlement yesterday, Ms Justice Mary Irvine said this was the third case before her within days where a defendant had "held out almost to the bitter end" before admitting liability. This was "very regrettable" and caused enormous distress to a family, she said.
She expressed sympathy to Mr Kivlehan and his parents, who are helping him rear the couple's child, Dior (3), at their home in Dromahair, Co Leitrim. It is understood a separate case by Mr Kivlehan for nervous shock was settled for an undisclosed sum.
Mr Kivlehan, through his solicitor Roger Murray of Damian Tansey solicitors, has made repeated requests to the coroner for Sligo/Leitrim, Dr Desmond Moran, to hold an inquest into his wife's death.
Seven written requests, made on November 15th, 2012; January 29th, 2013; February 7th, 2013; March 15th, 2013; April 3th, 2013; April 18th, 2013 and April 30th, 2013, were not responded to by Dr Moran. He told The Irish Times in May Ms Kivlehan had not died in his area. Dr Moran later told Mr Kivlehan his decision was that he would not hold an inquest into her death.
The 1962 Coroners Act is silent on whether an inquest may or may not be held in cases where a death takes place outside the coroner's area. There have, however, been precedents for such inquests. In March 2009 Dublin Coroner's Court heard an inquest into the death of Andrew Hanlon (20), who had been shot dead in Oregon, US, the previous year.
Although he initially said he was not going to conduct an inquest, Northern Ireland coroner John Lecky said in September he would hold an inquest and put aside a week in October for the hearing, to be held in Enniskillen, Co Fermanagh. However, this was postponed pending the outcome of yesterday's hearing.
No complaints
Mr Murray said it was now unclear whether the Northern Irish inquest would go ahead at all. The family has no complaints about Ms Kivlehan's treatment in Belfast.
“Mr Lecky has written to us to say that really the most appropriate jurisdiction for the inquest is the Republic. There are limits to his power to compel witnesses to give evidence in the North and some of the crucial witnesses in Sligo have not been very helpful. The situation is very unsatisfactory for the Kivlehans. It is three years since they lost Dhara and a lot of unanswered questions remain.”
“We have asked the Attorney General in this jurisdiction to direct the coroner to hold an inquest and that has not happened up to now. The family have now decided that they are so concerned that questions must be answered that, if the Attorney General refuses to direct the coroner in Sligo to hold an inquest, then we will judicially review that decision into the High Court.”
He said yesterday's settlement would enable Mr Kivlehan to begin to rebuild his life and the future for himself and his son. Speaking to The Irish Times in May, Mr Kivlehan said although his son was "beautiful and well", he felt his life had been "destroyed" by the loss of his wife. He has had to give up work to look after his son. The house he and his wife were renovating in Dromohair, lies unfinished and he and Dior live behind it in a mobile home.
In a statement yesterday the HSE said lessons had “been learned from the tragic outcome in Dhara Kivlehan’s case”.
