By Niall McCracken
A DOCTOR who cared for 17-month-old Lucy Crawford says he cannot remember a conversation with another consultant, indicating an early awareness about what could have caused the toddler’s condition to deteriorate – and maintained that he had no idea what killed her.
Dr Jarlath O’Donohoe was a consultant paediatrician at the Erne hospital in Enniskillen who travelled with Lucy when she was being transferred to the children’s hospital in Belfast. He contradicted the account of another doctor who gave evidence last week about a conversation they both had before her transfer that concluded fluid mismanagement could have caused her condition at the time.
He was also questioned by inquiry chairman Mr Justice John O’Hara about why he did not pursue a coroner’s inquest. The chairman also raised issue with the fact that Dr O’Donohoe did not meet the parents following Lucy’s post mortem report despite previously assuring them that he would.
Dr O’Donohoe, who has now retired, said he could not explain now why he did not meet Lucy’s parents.
For more information on why the Hyponatraemia Inquiry was established please click here.
In his witness statement to the inquiry Dr O’Donohoe said that he would now consider Lucy’s care at the Erne hospital as inadequate. He acknowledged as Lucy’s consultant he should have written out the prescription for Lucy’s fluid management and ensured that his senior medical staff and nursing staff understood it.
Dr O’Donohoe was asked about the level of awareness he had about what had happened to Lucy before he left the Erne. Specifically he was asked about conversations he had in the Erne Hospital as outlined by another doctor to the inquiry last week.
Dr Thomas Auterson was a consultant anaesthetist at the Erne Hospital and was on duty on April 13 2000 when Lucy suffered a fit.
During his evidence last week Dr Auterson said that while resuscitation attempts were taking place on Lucy he had discussed the possible reasons for what had caused Lucy’s condition with Dr O’Donohoe.
Today Dr O’Donohoe told the inquiry that he had no recollection of this conversation happening. Questioning Dr O’Donohoe on this point, inquiry chairman Mr Justice O’Hara said:
Q) “What is seriously curious to me to say the least is that Dr Auterson says he is aware of the fluids that Lucy received and you did not know.”
A) “I don’t recall him speaking to me about the fluids particularly.”
During his evidence last week, Dr Auterson said: “It wasn’t so much a discussion, it was more here are the U&E results [urine and electrolytes], it shows hyponatraemia, maybe she’s got too much fluid.”
In response to this Dr O’Donohoe said he did not recall that being said. The chairman asked Dr O’Donohoe what he thought had gone wrong:
Q) “If you couldn’t reach a conclusion at that time, what suspicions did you have?”
A) “I didn’t have any suspicions, I had never seen a child deteriorate in that fashion before. I literally could not understand what had happened.”“I SHOULD HAVE MET WITH THEM”
The chairman also asked why Dr O’Donohoe failed to meet with Lucy’s parents despite saying he would do so after her post mortem report was complete:
Dr O’Donohoe: “I honestly can’t remember making a decision either way I don’t know what my thought processes were.”
Q) “It seems to me thought processes can’t be that complicated. These parents have just lost a child who was previously healthy in circumstances which were rather difficult. You arrange to meet in May but this meeting is entirely unsatisfactory because you don’t have hospital notes with you. You said you will meet with them after the post mortem report, but you don’t. What is complicated about this scenario?”
A) “There’s nothing complicated about it, I should have met with them and I can’t explain why I didn’t.”
As previously reported by The Detail, the coroner is due to give evidence at the inquiry on June 25 2013. At today’s hearing junior counsel Mr Martin Wolf outlined the coroner’s previously-held position was that he was disappointed that Lucy’s death did not make it to his attention.
Mr Wolfe said that it was the coroner’s opinion that the responsibility not only lay with clinicians in the children’s hospital, but also with clinicians from the Erne hospital who were aware of Lucy’s condition when she was being transferred.
Mr Wolfe questioned Dr O’Donohoe on this issue.
Q) “You said you were surprised it wasn’t going the coroner’s route.”
Q) “But it appears you didn’t check to ascertain why it wasn’t going to be an inquest.”
A) “I’ve no recollection of asking why.”
Dr O’Donohoe went onto say that during his time at the Erne he did not receive training in the procedures of reporting to the coroner. The chairman asked him to explain this in more detail.
Q) So from 1997-2000 you had received no training in the erne hospital during your time there, about your obligation to report a death to the coroner.”
A) “Not that I can recall. Again I’m not sure that I can actually recall when I last had specific training on these issues.”
Mr Wolfe) “But clearly it was significant that it wasn’t going to be a coroner’s led post mortem.”
The hearing continues tomorrow.