A coroner has claimed the death of a baby girl 10 days after she was born at Cork University Maternity Hospital (CUMH) was the most “clinically complex” case she had ever experienced in her career.
The coroner, Aisling Gannon, made her remarks at the conclusion of a two-day inquest at Dublin City Coroner’s Court into the death of Faye Neiland on October 11th, 2019 at Children’s Health Ireland at Crumlin where she had been transferred for special treatment after her birth.
A postmortem showed baby Faye died as a result of multiple organ failure consistent with brain injuries due to lack of oxygen and blood.
Ms Gannon observed a range of medical experts with different areas of specialities were unable to agree on a definitive time for the onset of the baby’s injuries.
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Faye’s parents, Christina and Kevin Neiland from Pearse Road in Ballyphehane in Cork, claimed their baby’s death could have been avoided if the hospital had stricter protocols and policies on how to respond to abnormal heartbeats detected in a baby before delivery.
They believed there were failures by CUMH staff to recognise and react to abnormal readings from a CTG monitor which measures foetal heartbeat and maternal contractions.
Ms Neiland told the hearing that she had an uneventful pregnancy with her first child before she was induced at CUMH on September 29th, 2019 when she was 10 days over her due date.
Evidence was heard that Ms Neiland, who subsequently gave birth to two daughters, was given increasing amounts of oxytocin – a drug used to make contractions more regular – at regular intervals from around 11.30pm on September 30th, 2019 as there was no sign of labour starting.
Her husband said they believed gels used to induce labour and oxytocin should not have been administered to his wife and the induction process should have been abandoned given the abnormal CTG tracings.
Instead, Mr Neiland said Faye should have been delivered by emergency Caesarean section at an earlier stage.
Although one registrar had directed that oxytocin should be discontinued because it could distress the baby, the decision was reversed a short time later by a consultant obstetrician.
The inquest heard one midwife had discreetly expressed dissatisfaction with oxytocin being reintroduced in the care of Ms Neiland.
A senior consultant obstetrician at CUMH, Prof Richard Greene, also acknowledged there had been a “missed opportunity” to deliver the baby by Caesarean section instead of putting Ms Neiland back on oxytocin.
The coroner returned a narrative verdict to reflect the complexity of the case, although counsel for Faye’s parents, Alan Keating BL, had called for a verdict of medical misadventure.
Ms Gannon said she welcomed the fact that CUMH had informed the inquest that the hospital was reviewing its policy on induction of labour in light of the case as well as looking at other areas of care including handover procedures.
Offering her sincere condolences to Faye’s parents, the coroner said she would also contact CUMH to notify it of the concerns raised by the Neiland family at the hearing.
Ms Gannon noted that no specific source of infection had been determined.
She also observed that no genetic condition that could explain the death had been found.
The coroner remarked that the case was “particularly sad” and the most clinically complex death she had ever come across.
Speaking after the conclusion of the inquest, the Neiland family’s lawyer, Aisling Maher of Cantillons Solicitors, acknowledged CUMH’s commitments to make improvements, particularly in relation to reviewing guidelines on induction of labour.
“We would hope that this would better educate those working in maternity units on the appropriateness of continuing the induction of labour process and how to deal with complications arising from the process on a timely basis to avoid similar unnecessary deaths into the future,” said Ms Maher.
She added: “We hope that lessons are learned from the inquest and our investigations on behalf of the Neiland family into the tragic passing of their daughter Faye.”