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Call for Coombe inquiry

Husband’s forty-year quest for truth about wife’s death following anaesthetic  – Frank Connolly 

 

Micheál Grealy has waited almost 40 years to find out what caused the death of his wife, Kathy, just weeks after she gave birth to their first child in Dublin’s Coombe Hospital. Admitted in full health to the hospital after 39 and a half weeks of a normal pregnancy on Christmas Day 1972, Kathy Grealy died seven and a half weeks later in the intensive care unit of St Vincent’s Hospital where she was taken soon after her baby, Casey Anne, was born.

The child died from congenital haemolytic disease on the day of her delivery after the Coombe hospital medical team failed to identify the incompatibility between Kathy’s Rhesus negative and her husband’s Rhesus positive blood groups. In this case, the hospital had not established the incompatibility through a routine test for anti-bodies, or taken adequate steps to ascertain that Kathy had a pregnancy terminated some years earlier.

Kathy Grealy was an Australian-born citizen who met her Mayo-born husband when she first came to Ireland to trace her roots in the mid-1960s. She died after food entered her lungs – a complication known in medical terms as Mendelson’s Syndrome – during the administration of the general anaesthetic before the Caesarean birth. She had requested, and was promised, that an epidural rather than a general anaesthetic would be administered. The Coombe hospital report of her case describes a “regurgitation of small amount of gastric contents on induction of anaesthesia after failure to pass Ryles tube”.

The St Vincent’s in-patient summary on her admission to the intensive care unit on St Stephen’s Day 1972 records that “this woman was admitted from the Coombe Lying-in Hospital for intensive care following accidental inhalation of vomitus (Mendelson’s Syndrome)”.

The confirmation that her death on 16th February, 1973 from complications including ‘haemorrhage from tracheostomy site’ and irreversible lung and kidney damage was precipitated during the anaesthetic procedure in the Coombe led her distraught husband on an increasingly-desperate journey to establish the full circumstances surrounding her medical care in one of the country’s largest maternity hospitals. Kathy Grealy had chosen the Coombe over other, private, facilities, not least because she was impressed by the reputation of its leading gynaecologist, the late Professor J K Feeney.

The Journal of the Irish Medical Association published in November 1973 provided an apparently unambiguous explanation of where responsibility lay for Kathy’s death, although it also contained seriously inaccurate information about her mental state. In its Annual Maternal Mortality report for 1972 it described her death as “avoidable” while the “hospital” was the only item listed under the heading “Factors of Responsibility”.

After almost 40 years of personal investigation and legal inquiries, not one individual or institution has been made answerable for Kathy’s “avoidable” demise.  Nor has there been any explanation why the 1973 report in the IMA journal described her as a “psychotic patient” although she had never displayed any psychotic tendencies according to subsequent reports from experts in the field.

In a letter sent to Grealy in August 2005, the Master of the Coombe, Dr Seán Daly, stated that there was no reference in the clinical notes “to any type of psychosis or details that would suggest that the description of psychotic patient should have been applied to your wife”.

Dr Daly stated that he did not know “who made the diagnosis, when it was made or upon what is was based as there is no evidence from the clinical notes that such a diagnosis was made”. Yet the ‘diagnosis’ is written in black and white in the IMA Maternal Mortality Committee report on her case.

Efforts to get all of the notes, documents and reports relevant to the issues have been unsuccessful despite the involvement of lawyers, politicians, a private investigator and the Information Commissioner who was informed back in 2002 that no relevant files exist in the Department of Health or in the hospital.

Grealy met former Labour TD, and later Fianna Fáil health minister, Dr John O’Connell, in the early years of his search for truth and was told by the politician that an inquiry was urgently needed into certain circumstances in the Coombe, a view echoed by two senior civil servants in the Department of Health at the time.

Over the years he has met with a wall of resistance, not least from within the medical and legal professions.

It took an extraordinary ten years before Micheál Grealy was informed of the identity of the anaesthetist who administered to Kathy. He claims that he was told, wrongly, by Professor Feeney that the procedure had been carried out by someone of another name.

When contacted since, the now-retired consultant anaesthetist declined to answer any questions until they were first put to his lawyers. Attempts to contact other members of staff, including nurses and mid-wives have proved fruitless to date.

Recently Village has been informed by senior medical sources that there are issues of serious public importance surrounding medical practice at the hospital during the years around Kathy Grealy’s death.

Her husband is now seeking the assistance of the Ombudsman’s office to help uncover any illuminating official information – and hoping someone who may know what really happened makes contact with him.

It may require an independent inquiry assisted by an expert obstetrician and anaesthetist to help explain why Kathy Grealy and her daughter did not survive childbirth and why other patients may have suffered negligent care by personnel of that hospital, in the Coombe and elsewhere.