Family of woman who died 25 years ago after giving birth appeal for inquest

The family of a Dublin woman who died from septicaemia after giving birth in the National Maternity Hospital 25 years ago has appealed for an inquest into her death.

Antoinette Pepper (26) died on St Patrick's Day, 1988, in St Vincent's hospital after being transferred from Holles Street hospital following the death of her baby the previous day.

The cause of her death, septicaemia, developed after her membranes were ruptured in pregnancy, resembles that of Savita Halappanavar and Tania McCabe.

Her death attracted widespread attention at the time but the family’s requests for an inquest to shed light on the cause of her death were rejected. The view of the Dublin city coroner at the time that he had no function in the case was supported by the attorney general.

Following the death of Ms Halappanavar and renewed publicity over the death of Ms McCabe, the Pepper family appealed unsuccessfully to Minister for Health James Reilly and current Dublin city coroner Dr Brian Farrell to hold an inquest into Ms Pepper's case.

"It's 25 years since my sister died of septicaemia but this has been going on ever since. Maybe if they had looked at things back then, women's lives wouldn't have been lost in the meantime," her brother, Greg Pepper, said yesterday.

Overdue
A confectioner, Ms Pepper was in good physical health with no medical problems when she became pregnant for the first time. She was admitted to Holles Street when several weeks overdue.

Her family say they first noticed something wrong the day after she was admitted when they visited her in the evening and found her agitated. Earlier that day, her waters had been artificially ruptured after eight attempts, she told them.

The baby died in the second stage of labour and was delivered stillborn. The family were told in the early hours of Tuesday, March 16th, that the child was dead and Ms Pepper was very weak. She was then transferred to St Vincent’s as her condition deteriorated, and died there. The postmortem found evidence of infection from several virulent organisms in her system.

"It appears reasonable to suppose that infection, followed by septicaemia, initiated the disseminated intravascular coagulation which resulted in uncontrollable haemorrhage and death of the patient," the pathologist stated in her postmortem.

Not satisfied
The Pepper family was never satisfied with the explanations provided for her death and wanted an inquest to be held, but they ran into a series of difficulties. It took three months for their solicitor to get the postmortem report and six months for medical records to be released. The Dublin city coroner, Dr PJ Bofin, said he had no function in the case. The Department of Health took the unusual step of seeking reports on the case but refused to release them.

Michael McDowell, then a local TD, raised the case in the Dáil, where he challenged the failure of the coroner to hold an inquest. However, minister for health Rory O’Hanlon said he had no power to direct a coroner to hold an inquest.

Three months after her death, a former master of the hospital, Dr Dermot MacDonald, was asked about the case during a radio interview. He described Ms Pepper’s death as a sad and “absolutely extraordinary” occurrence.

At the time labour was being induced, doctors found some infection which was sent off to the lab for tests which confirmed their clinical suspicions, he said. As for the baby, Dr MacDonald said: "A forceps delivery was carried by an experienced man and the baby was stillborn".

Challenge
The Pepper family, who lived just a stone's throw from Holles Street, held raffles and cake sales to raise money for the legal case, but a High Court challenge to the coroner's stance was rejected.

The controversy over Ms Halappanavar’s death has revived memories for the Pepper family of their daughter’s death, but Dr Reilly had told them he has no powers to call for an inquest.