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Dublin: 2 °C Saturday 25 May, 2013

HIQA considers request to hold statutory investigation into Savita death

The health watchdog has been requested by the HSE to examine the controversial death.

Image: Niall Carson/PA Wire/Press Association Images

THE HEALTH SERVICE Executive (HSE) has formally asked the country’s health watchdog to carry out a statutory inquiry into the death of Savita Halappanavar.

The director general-designate of the HSE, Tony O’Brien, has said he has asked the Health Information and Quality Authority (HIQA) to conduct its own inquiry into the death of the 31-year-old dentist at Galway University Hospital last month.

Savita died after contracting blood poisoning following a miscarriage. Her family claim that was denied an abortion despite numerous requests to doctors at the hospital.

HIQA said this afternoon that its board is meeting to consider the request and it plans to issue a further statement later today.

O’Brien told RTÉ’s News at One that he made the request to HIQA having watched Savita’s husband, Praveen Halappanavar, give an emotional interview to Prime Time last night in which he said he would not cooperate with the HSE inquiry.

His solicitor has also claimed that there is no information in Savita’s hospital file on the requests for termination of the pregnancy that Savita’s husband insists they made before she died.

O’Brien said that no one could have watched the interview with Praveen Halappanavar last night without having “total empathy” for him.

The board of HIQA is currently meeting to consider the request from the HSE.

In a statement the agency said it “has received a request from the Health Service Executive  to undertake a statutory investigation into the tragic death of Savita Halappanavar in University Hospital Galway. The board of the Authority is considering this request and will issue a statement later today”.

In his earlier interview with RTÉ, O’Brien rejected claims from some pro-life activists about the credibility of the independent expert leading the HSE inquiry who has previously called for liberal abortion laws in countries which do not have them.

O’Brien said that Sir Sabaratnam Arulkumaran was seeking to find out why Savita died and “no more and no less” than that.

He also said that despite the lack of any cooperation from Savita’s family with the HSE inquiry it would be “criminally negligent” not to proceed with it.

O’Brien also said that consent was not required to access Savita’s medical records – which her husband wants to withhold from the probe – as they are the property of the HSE.

Read: Opposition calls for Taoiseach to meet with Savita’s husband

Read: Praveen Halappanavar: “I still can’t believe that she’s not with us”

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Comments (51 Comments)

  • Sense beginning to dawn in some quarters. Pity neither the Taoiseach not Health Minister has the stones to call for this themselves.

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  • As far as I know the Coroner carries out a full investigation into any death such as this, assisted by Gardai who for the purposes of the investigation are agents of the coroners office! An inquest is then held in public, once the file is complete, where relevant parties are entitled to legal representation to act on their behalf. Why have another independent inquiry which would duplicate the coroners work at great expense.. Why have a coroner at all if he’s not considered independent?

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  • Why I do terrible for what has happened in our country I’m confused why the guy doesn’t want the records disclosed surely to god if its recorded they wanted an abortion it would be on the record .or is there something missing I’m not seen . Just a thought

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    • @Aisling As I understand it, he is refusing access to them as a kind of protest. He wants a public inquiry. Personally, I agree with him, I think the HSE lead one is tarnished and its findings are going to have a cloud over them no matter what happens.

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    • @irish red I agree the hsc are tarnished but from what I can make out he doesn’t want anyone !! To disclose the records , I find it strange .

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  • Oh boy 22/11/12 #

    Its a pity you have to make it to TV and ball your eyes out before you get justice in this country.

    Good news though.

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    • Oh boy
      How do you call an enquiry into the reasons behind a Death as “justice”. Do you know something about the outcome of an enquiry that has not been held yet?
      While the HSE would normally have an obligation to enquire into all unexpected deaths within the Health Services sometimes it is also of fundamental importance that such enquiries be conducted at arms length. This is one of those occasions when there are two very active lobbies using this case for their own political ends.

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    • There are several enquiries ongoing in relation to this incident, all of them are independent. The Coroners enquiry, the HSE enquiry and HIQA. All independent. All at arms length.

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    • The initial HSE enquiry with staff (who often know each other and work along-side each other) from the very hospital in which they all operate, could not be called “independent” – who are we trying to kid?

      THREE of the staff there alone was being asked to investigate their fellow staff in the same building? Independent my backside!

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    • @Gary It is disingenuous to suggest that this is simply an ‘unexpected death’ – there is a lot more involved than that.

      Also, before you start berating anyone for making this political bear in mind that it was Praveen Halapanavar who went to the Galway Pro-Chouce group for support and that it is he who has said he is doing this partly so that what happened is made public, that there is legislation and it never happens again. It IS necessarily political because politicians have to be involved to change legislation.

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  • If anyone from the HSE had bothered to contact the family in the weeks following Savita’s death or even read a newspaper, they would not have needed to wait for a TV programme before they found some compassion.

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    • I don’t believe that anyone on these pages would even be satisfied with a sworn Public Enquiry. At the end of the day the purpose of any enquiry should be the circumstances leading up to the death of this young lady and if it was preventable. Anything else will simply be a pandering to the nastiness of both lobbies on an entirely separate matter.

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    • These public enquiries are only an opportunity for lawyers to make tons of money, have we not learnt anything.

      Public enquiry means nobody will say anything, in particular the hospital staff.

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  • Maybe we could get Opus Dei to conduct the enquiry.

    Then we’d be guaranteed transparency.

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  • Of course the politicians are using it for their own gains. If one female had any integrity they would have for once shown up the men for their lack of it. They are all the same – addicted to power and money. Hardly human.

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  • While working with the HSE I and several colleagues put complaints in writing to HIQA who were then investigating our department and its management. We never heard back :p

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  • @ James Connolly, concerning Public Tribunals of Inquiry, I hesitate to disagree with you as you clearly have extensive legal expertise but I would make a few points of qualification to what you say. First, Tribunals of Inquiry have all the powers of the High Court to summons witnesses and, subject to a possible privilege against self incrimination, can legally compel witnesses to give evidence. Secondly, the inordinate length of Tribunals of Inquiry, with the exception of the McCracken Tribunal, had excessively broad Terms of Reference. Thirdly, there is more transparency than under processes. I think that we can safely predict the Coroner Court verdict which will take a very long time. Yes, there will be public examination of cause of death but it cannot and will not address the wider legal dimension such as the impact of Article 40.3.3 of the Constitution.

    These qualifications mentioned, they do not detract from your expertise, wisdom and balance on these almost intractable issues. I have learned a lot from your posts and from other posters. This is good because it is a matter of informing ourselves and not, as a small minority are doing, which is advancing a priori positions and not seeking enlightenment. Real debate may trigger solutions. We owe it to Savita, her husband, other women have died in similar or equivalent circumstances and to the lives of women to come to work out the best and safest solution.

    The life of one woman outweighs all the foetuses which have ever or will ever exist, to paraphrase a letter in the Irish Times. That is my personal belief and part of my value system and otherwise I believe an egalitarian society, education, encouragement and the encouragement of positive values will more likely minimise the level of undesirable and sad abortions which are non therapeutic than strict criminal law offences which, for healthy and mobile women can be avoided by going to England. The Netherlands has a low rate of abortions and low rates of teenage pregnancy. I suppose that what I’m trying to say is let us head off, in so far as we can, the causes of or the factors which encourage desperate women to resort to abortions.

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    • Hi Peter, Thank you for your postings – they clarify a more accurate situation of the legal side of things than I can portray! Thank you for the clarification RE the public trial – my view is based upon what I have read in Irish media while living abroad, so my views are somewhat skewed! Please keep the posts a-coming – it is important to portray an accurate viewpoint to everyone! Regards, Jim

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  • Glad that HIQA has been called in though it’s a bit odd that the director general-designate of the HSE is the one requesting it, seeing as he is in charge of the HSE inquiry.

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  • The HSE enquiry could not go ahead anyway without the medical records which her husband quiet rightly refused to release to the initial enquiry. The HSE has dealt with this tragic issue badly from the start .

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  • I should preface my remarks with the reservation that I am not a barrister and certainly far from an expert in Administrative or public law but I have grave doubt that HIQA has the statutory vires to carry out a sufficiently comprehensive and encompassing investigation into Sativa’s death. I have looked in particular at Sections 8 and 9 of the Health Act 2007. I understand HIQA’s role in relation to standards, monitoring of standards and enforcement but does it really have a role in relation to investigation of an individual patient by particular clinicians? Obviously, the first thing that the CEO of the HSE would have done is obtained Counsel’s opinion or advice and established the adequacy of vires.

    Would not independence, credibility, expedition and legal competence by Commission of Investigation established under the Commission of Investigation Act 2004 ? The In re Haughey rights do not fully apply because the investigation would be in private but with a published Report. The investigation could be conducted by an eminent non Irish Obstetrician with expert advice input from a Senior Counsel. There is a procedure for laying down the equivalent of a Terms of Reference and the unpublished Expert Report under retired Judge Ryan could be taken into account if relevant.

    HIQa will need to take legal advice. There is no point in an investigation or Report which would be vulnerable to Judicial Review (certiorari), that is the judicial quashing of the ultimate Report.

    The legal costs of such a method of investigation, as referred to in the Article in today’s Irish times would not be excessive. The Moriarty Tribunal of Inquiry simply spiralled out of control and it was a Public Tribunal of Inquiry.

    Of course, the ultimate cause of this horrible mess and the likely cause of Savita’s death was the pro-life Eight Amendment to the Constitution. This is the infamous Article 40.3.3 of the Constitution. The politicians don’t want a Referendum. This is understandable. Participative democracy is uncomfortable for representative politicians.

    I am now listening to the leaked extract on Prime Time of the Ryan Expert Report.

    Legislation, primary or secondary, will not resolve this legal quagmire unless or until Article 40.3.3 is repealed by a Referendum.

    It seems inherently repugnant to me that pregnant women who were not of voting age in 1983 should be subject to a Constitutional provision they have never voted upon. It may seem a little unkind of me but, to be frank, I would have more trust in a vote of the people than in a vote of politicians. The will of the people should be tested.

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  • It’s still not what he is asking for

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    • It’s the closest to what he is asking for that he will (and should) get. Allowances have been made for some requests, however it is unfeasible to give exactly what he is asking for – time constraints being the primary concern.

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    • @James curious who are you to say what he should and shouldn’t get.The man has clearly expressed he has no confidence in the HSE and is seeking an independant public inquiry.If we can do it for planning surely we can do it for the death of a young woman.

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    • tom 22/11/12 #

      are his motives guided by pro abortion or getting to the truth as quickly as possible. there are so many rumours taken as fact, speculation filling the voids and a campaign war between pro life and pro choice.

      this man has lost my respect with overwhelming eagerness attending interviews with the media and ingnore independent inquiries that does

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    • All of these investigations are independent, including the HSE investigation. It is chaired by a completely independent professional, attended by 6 other professionals, all of whom are internationally recognised and critically acclaimed in their chosen fields. A public enquiry will take months to get the truth, if it does at all get the truth, and this man will not be able to move on with his grieving.

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    • James i do not know what this man is thinking so i won’t answer for him.
      But what i see is various sections of the same system investigating itself who’s results in my eyes would be dubious at best.Thats just my opinion though.

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    • Are you referring to the coroners investigation? Who by definition is required in so far as is possible, to find the truth regarding circumstances of death.
      Or the HSE’s? Which is chaired by a completely independent doctor, who has carried out hundreds of similar investigations all over the world and brought them to a satisfactory ending.
      Or HIQA’s? HIQA being the body responsible for closing several nursing homes, hospital wings, and the fact that no intern now works alone at night and is always covered by a more senior doctor.
      Do you really think, with all these investigations, that there is a hope of cover up? Or perhaps we should accuse the consultants or the government of interfering with the investigation before we begin, and be done with the whole thing?

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    • @tom. Listening to drivetime yesterday praveen halapannavar went public because in the weeks following his wife’s death the hse did nothing- and apart from his own disbelief he had his dead wife’s parents, back in India wanting to know what happened to their daughter. If I were in his position I would have done the same thing. I would not trust the internal hse enquiry either. The majority of people on the investigating panel are on the hse payroll- how the hell can it be independent?

      Tom. The man wants justice for his wife who should not have died. Nothing ‘conspiracy theory’ or sinister about that. Going public was his only option because the hse were doing nothing ( hence the delay in time between her death and him going public). Most people can perfectly understand why he is taking the stand he has and he has the respect of most people in Ireland and beyond.he has my deepest sympathy and I commend his courage.

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    • James Connolly
      You are wrong. There is no enquiry at the present time being conducted by the HIQA and the Coroners Court is only there to ascertain the cause of death rather than the event leading up to it. Please let us contribute in this issue with a little more accuracy.

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    • Garry, apologies. I should have said Cause of death, as you are correct, the coroners office does not deal with circumstances. And yes, while HIQA are not yet involved, it would appear that they may yet be, so the rest still stands. J.

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    • tom 22/11/12 #

      @ Irene
      Justice will and can only come for the coroner’s inquiry.

      I watched the prime time interview and his refusal to take part with independent inquiry, it’s apparent that justice isn’t the issue. By his own admission he is pro-choice and understandably biased.
      No one wants any woman to die if it can be prevented and the quickest way to get to the facts is to have an independent inquiry. His demands for a public inquiry on his terms are going too far and without any proof has cast dispersions on the medical team and hospital.
      But pro choice is so intertwined with this tragic death and pro life so apposed that it needs to be taken out of the arena before any logic informed conclusion can be drawn from the facts.

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    • @tom. Coroners investigation will not establish events leading to the death of savita. A hse investigation is not independent. How can an organisation investigating itself be indpendent? You stated “are his motives guided by pro abortion or getting to the truth as quickly as possible”. Tom, the man’s wife is dead and she should not be dead. He wants an independent inquiry. Perfectly understandable.

      James Reilly, the week this story broke, said there would be an investigation that would stand up to world scrutiny.

      An internal investigation conducted by the hse, is quite simply, not good enough.

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    • @tom. Regarding his sentiments re abortion- he has stated he does not want any woman to go through what his wife went through. She was miscarrying her longed for child and wanted a termination to put an end to her suffering. he believes a termination would have saved her life and wants an independent inquiry.

      Reply
  • @james You are so naive not to recognise how many enquiries that have been carried out with “whitewashed” results. The man is looking for a PUBLIC enquiry for good reason and he should stand his ground against the bullies. It is no business of yours to say how he should grieve.

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    • tom 22/11/12 #

      it is his business if he has to pay for a public inquiry that will take much longer.
      If there is a flaw in the system or law it needs to be corrected quickly rather than point scoring and pushing an agenda.
      The coroners report will be the most important and rightly so.

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    • @tom. The man’s wife died whilst in an Irish public hospital when she should not have died. He is entitled to an inquiry that is indpendent, thorough and funded by the state. A coroner’s investigation, whist important , will establish the cause of death but not the events leading to savita’s death. Additional independent inquiry is required.

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  • This tragic incident is being used for political purposes for Government to introduce Abortion into this country, Whether you agree with it or not, Goverments are manipulation the situation and the people into Problem, Reaction, Solution! Only a referendum without government saying a bloody word can resolve this issue once and for all.

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  • @tom You are missing my point. James advised that a public enquiry would not help him grieve. It’s not his business to say that. Where are you coming from, talking about the cost which is a totally separate point ????
    Of course you are right, cost should come before ethics every time !!!!

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    • How long does a public enquiry take? Not how long should it take, looking at how long public enquiries have taken in Ireland in the past, tell me how long one is going to take? 6 months? A year? 2 years? The result? He may or may not have the answers he’s looking for, depending on how cooperative the relevant bodies are.
      HIQA and the coroners court both have legal powers to compel cooperation from those bodies. A public enquiry, as we have seen in the past, does not, and even when it does, cooperation may still not be forthcoming.
      This really is the best outcome for Mr Praveen and families. It aims to get the truth quickly and efficiently without dragging on and on for years.
      Also, there are serious complications when it comes to the presentation of medical records at a public enquiry.
      I didn’t tell Mr Praveen how to bereave, it is never my job to tell someone how to bereave. However, from experience, delayed bereavement is not the desired option.

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    • tom 22/11/12 #

      Michael it’s not just cost its time, if there is a problem it’s better to address it sooner rather than later especially if other women are at risk. Cooperating with a independent inquiry would not rule out a public inquiry at later date if discovered there was a real need for one.
      But refusing to cooperate is delaying the facts being made known and I can only presume that this is being done because of his desire to make a martyr of his deceased wife so her death will have some meaning. Its a noble cause but it needs the facts rather then hearsay to turn this into reality.

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    • @james.
      Mr Halapannavar. Praveen is his first name.

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    • Apologies. I should correct my own spelling error- mr halappanavar

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  • i would not trust hse to run inquiry, its an inside investigation,, bull ,, it will be covered up,, its ireland, truth dont come out for years,,,

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  • Tom,

    This all comes down to a question of confidence and trust. Because of the scandalous way Sativa was treated by the medical profession in Galway her husband has no confidence in any enquiry set up by the HSE and given their past record, who can blame him. The original enquiry team the HSE suggested had 3 doctors on it from the very hospital that needs to be investigated. Who could have faith in anything an incompetent body like that would suggest ? That is why any enquiry needs to be public and fully transparent.

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