Background to the Hyponatraemia Inquiry

Hyponatraemia is a condition which results in a low level of sodium in the blood stream causing the brain cells to swell with too much water and in some cases resulting in death.

Fluid overload happens when excessive amounts of intravenous (i.v.) drip fluid are delivered into a patient’s veins. This, in turn, exceeds the body’s ability to cope with this large volume.

The inquiry was announced in 2004 by the then Health Minister Angela Smith following an investigation by UTV into the death of baby Lucy Crawford and two other children who had died as a result of suspected fluid overload.

The ‘Impartial Reporter’ newspaper had also raised serious questions about the death of 17-month-old Lucy, from Letterbreen, who died in April 2000 following fatal errors in administering fluid in a drip. She had initially been admitted to the Erne hospital for treatment of a stomach bug.

The inquiry was delayed after the PSNI decided to conduct investigations into the deaths. The Public Prosecution Service later ruled that no one at the Sperrin Lakeland Trust should be prosecuted.

Chairman of the inquiry, Mr Justice O’Hara, and his team are investigating the deaths of five children who died in hospitals in Northern Ireland between 1995 and 2003. Each of the children’s intravenous fluid regime is implicated in the deaths; it is said to have caused low sodium – hyponatraemia – in four of the children, which in turn caused lethal severe brain swelling.

The children are:

Adam Strain who died in November 1995, aged four years, in the course of a kidney transplant at the Royal Belfast Hospital for Sick Children.

Claire Roberts who died in October 1996, aged nine years, at the Royal Belfast Hospital for Sick Children. At the time her death was wrongly linked to epilepsy.

Lucy Crawford who died in April 2000, aged 17 months, following treatment at the Erne Hospital, Enniskillen, for a stomach bug. Like Claire, Lucy’s death was not reported to the coroner at the time of her death. Instead it was attributed to dehydration, rather than the fluid overload caused by the hospital. The inquiry is not investigating the circumstances of Lucy’s death at the request of her family. However, it is looking into what extent there was a failure to learn lessons from her death and what impact this may have had on the death of another child 14 months later.

Raychel Ferguson who died in June 2001, aged nine, following an appendectomy at Altnagelvin Hospital, Derry.

Conor Mitchell who died in April 2003, aged 15, following treatment at Craigavon Area Hospital. Like the other children, Conor suffered brain swelling, although his fluid regime appears to have caused hypernatraemia – excess sodium – rather than the low sodium noted in the four other cases.