Woman died as a result of ‘huge’ cyst in brain, says consultant

A consultant neurologist has told an inquest at Mullingar courthouse that the woman at the centre of the case died as a result of a “huge” cyst in her brain of unknown origin which caused a build-up of pressure on her brain stem and cut off her blood supply.

Dr Stephen McNally of Beaumont Hospital told an inquest into the woman's death that a multi-disciplinary team there decided on December 2nd last year not to carry out the "gold standard" test for brain death at that stage because the woman was 15 weeks pregnant and the test might potentially harm the foetus.

They felt they had a duty of care to the foetus and looked for legal clarification but got no “strong” legal advice.

A CT brain scan performed about 11.37pm on November 29th at the Mullingar hospital noted a cyst causing compression and associated hydrocephalus, he said. Beaumont advised on treatment during her transfer to the Dublin hospital. She arrived on November 30th at 1.40am, intubated and ventilated with pupils fixed and dilated.

He could say clinically or medically that she had died before she left Mullingar as she was receiving drugs which prevented that being said. Due to the state of the woman’s brain when a postmortem was carried out on December 27th, it was not of assistance.

He did not know if this was a simple cyst and it was also very difficult to say if the cyst was around for some time.

It would be "absolutely natural" for doctors to link headaches to excessive vomiting and dehydration in pregnancy. The woman's partner, and father of her unborn child, supported the family's High Court application for the somatic treatment to be stopped so the woman could be buried "with dignity", the jury heard.

In a statement , the woman’s father said she attended her doctor three times from October 2014 and each time she was referred to the Mullingar hospital. He said at no time did it examine her for her severe headaches. He was not aware of the details of her examinations.

She told him on November 29th she was expecting a CT scan to be carried out on her the next day but it had been deferred to December 1st, he said.

Dr Hilary Cronin, medical consultant at the Midland Regional Hospital, Mullingar, said she saw the woman on the morning of November 29th and she appeared in no obvious distress. It was considered her symptoms were associated with excessive vomiting and dehydration in pregnancy and a CT scan was not indicated at that time, she said.

She agreed that hospital notes that night stated the woman was “incoherent with pain” and she later fell deeply unconscious. Her pupils were fixed but not dilated on leaving Mullingar and potentially something could have been done to reverse the situation, she added.