AN INDEPENDENT expert is to be retained by the coroner for south Mayo to review all records held at Mayo General Hospital on the postmortem carried out on a 38-year-old woman who died at the hospital last year within hours of giving birth.
John O'Dwyer said yesterday he would contact the Royal College of Pathologists in London about providing a specialist with expertise in the area of maternal death and amniotic fluid embolism to review the case.
Dr Fadel Bennani, the pathologist at Mayo general who conducted the postmortem on Evelyn Flanagan from Hollyhill, Castlebar, on October 19th last, concluded amniotic fluid embolism was the cause of death but he had never personally come across a case before as it is very rare.
He said the amniotic fluid, which had been around the baby in the womb, had entered Mrs Flanagan's bloodstream contributing to her death.
It emerged while he was giving evidence that he still had slides and photographs from the post-mortem which could be reviewed by a third party. He said he was happy for them to be reviewed as he was 100 per cent sure of his diagnosis.
John Jordan, counsel for Pádraig Flanagan, who has argued the cause of death of the young mother was massive haemorrhage rather than amniotic fluid embolism, said he had not been made aware of the slides in advance of the inquest.
He sought an adjournment to allow them to be independently looked at by somebody he could engage himself or somebody who could be engaged by the coroner.
Mr O'Dwyer said he would retain the expert and circulate that expert's report to all parties. He said his decision was being made in the interests of "fairness and justice" to all as it appeared from the evidence no doctor at Mayo general had an expertise in amniotic fluid embolism.
Tony O'Connor, counsel for the HSE, did not object and the inquest was adjourned to December 1st. Mr O'Dwyer made his decision after three days of evidence at the inquest into the death of the mother of two.
Earlier yesterday a number of midwives who cared for Mrs Flanagan at the hospital gave evidence. Neither Kathy Hegarty nor Mary Devers could say at what time blood was ordered for her when she lost blood after giving birth or who ordered it. Mr Flanagan had claimed in his evidence to the inquest on Monday that his wife only got her first emergency blood transfusion an hour and 10 minutes after it was first ordered.
Mr Flanagan had also claimed he had to go and get a nurse when his wife's blood pressure monitor was constantly bleeping after giving birth, indicating her blood pressure was low and she was bleeding. Ms Hegarty denied this. She said she never left the room.
Mr Jordan suggested to Ms Hegarty she had breached An Bord Altranais guidelines by making retrospective entries in Mrs Flanagan's medical records without marking them as late entries. Asked why she didn't mark them as late entries she replied: "I suppose it didn't occur to me at the time."
Meanwhile Mr Flanagan had claimed in his evidence that Ms Devers didn't notice his wife was haemorrhaging until he pointed out to her that there was blood dripping from under her bed on to the floor. Ms Devers said she didn't see any blood on the floor.
However, she said she knew Mrs Flanagan was haemorrhaging when she pulled back the sheets shortly after 2pm on the day she gave birth and called for help. Mrs Flanagan was taken to theatre for a hysterectomy but never regained consciousness after the operation.