herald

Monday 18 December 2017

Tragic mum Dhara had 60-hour wait to see kidney specialist

A NEW mother was not seen by a kidney specialist for 60 hours after being diagnosed with acute kidney failure, an inquest heard.

Dhara Kivlehan (29) died of multi-organ failure after being transferred to the Royal Victoria Hospital, Belfast on September 28, 2010.

It was eight days after giving birth to her son, Dior, at Sligo General Hospital. Dior was four last Sunday.

During evidence, it emerged that despite identification of acute kidney failure on the morning of September 22, the renal specialist was not contacted until the next day and did not attend until September 24.

At her inquest in Carrick-on-Shannon, consultant anaesthetist Dr Ronan O'Hare agreed the 60-hour delay was not an "appropriate response".

But later under cross examination by Adrienne Egan SC for the HSE, the consultant said that this issue did not affect Dhara's overall care. Dhara was suffering from a variant of pre-eclampsia known as HELLP Syndrome which can cause fatal organ failure.

Dr O'Hare told the coroner Eamon MacGowan that he discussed Dhara's condition on the phone with renal physician Dr Austin Stack on September 23, 2010. He told Dr Stack - who worked at both Letterkenny and Sligo hospitals - he had a patient who was "very, very ill" with significant renal failure. "He said he would see her the next day," Dr O'Hare recalled.

Dr O'Hare said he did not know if Dr Stack came to Sligo the next day specifically to see Dhara or if he was due that day.

alarming

The consultant said there was no treatment for HELLP syndrome, apart from immediate delivery of the baby, and Ms Kivlehan had already undergone the C-section. He believed the mortality rate from HELLP was one in 40,000.

He told Ms Egan that Dhara had been "clinically quite well" on September 23. Referring to her deterioration the next day, he said "it was quite alarming and something you rarely see".

Dr O'Hare confirmed that he told Michael Kivlehan on the afternoon of September 24 that it was likely his wife would die.

He recalled that throughout that Friday he had discussions with ICU colleagues in several hospitals about transferring the young mother. He told the jury that there was no obstetrics ICU in Ireland because there were not enough cases to warrant it.

He contacted a number of other hospitals and was told either that they had no beds or could offer no additional treatment.

Paul Glover, a Belfast ICU consultant who first saw Ms Kivlehan on the day she died, said he did not believe his colleagues would have accepted the patient if there was no chance of survival.

The inquest continues today.

hnews@herald.ie

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