Staff in Savita Halappanavar case ‘disciplined’ after review

A number of staff who were involved in the care of Savita Halappanavar before her death at University Hospital Galway have been disciplined, the hospital has confirmed.

Most of the staff who treated Ms Halappanavar have, however, “no case to answer” over her treatment and death, a review panel set up to consider disciplinary proceedings has decided.

Mild sanctions have been imposed on up to nine staff in accordance with recommendations by the panel established by the local hospital group.

Twenty-one of the 30 staff who treated Ms Halappanavar, prior to her death in the hospital in October 2012, were told some months ago they had no case to answer and were not brought into the disciplinary process, a spokesman for the West/North West Hospitals Group confirmed yesterday.

Of the remaining staff, some were issued with written warnings. Under the HSE’s disciplinary rules, “If the employee fails to make the necessary improvements or if the nature of the unsatisfactory performance/conduct is more serious, she/he will normally be issued with a formal written warning for a period of nine months”.

The written warning gives details of the complaint, the improvements required and the timescale for improvement. The warning is removed after nine months, subject to satisfactory improvement.

A small number of other staff were required to undertake “pre-procedural” informal counselling with training and mentoring. According to the HSE’s disciplinary manual, informal counselling takes place without invoking the disciplinary procedure and involves telling the staff member what aspect of work needs improvement and identifying what supports can be provided to achieve this objective.

Multiple shortcomings

Ms Halappanavar died at University Hospital Galway on October 28th, 2012, having presented a week earlier with back pain. She was 17 weeks pregnant and was miscarrying. Subsequent reports identified multiple shortcomings in her care, especially at the time her condition was deteriorating and she was developing septic shock.

The disciplinary process in respect of “most” of the nine staff is complete, the spokesman said.

The hospital group has been unable to complete the process where staff are out on sick leave, it is understood.

The hospital group declined to say how many staff were issued with warnings and how many were required to undergo counselling. It cited reasons of confidentiality, saying to drill down further could lead to identification of individuals.

The review panel included outside expertise and engaged “independent oversight” so as to restore public confidence in the maternity services at the hospital, the spokesman said. The HSE disciplinary manual says the key objective is “to assist the employee to maintain the required standards, rather than impose penalties”.

While the HSE disciplinary process for staff who treated Ms Halappanavar is virtually complete, the Medical Council and the Nursing and Midwifery Board have yet to say what action, if any, they intend to take.

The findings of the inquest into Ms Halappanavar's death, along with reports by the HSE and the Health Information and Quality Authority, were referred to both regulators by former Minister for Health James Reilly, among others.