The parents of an apparently healthy young girl, who complained of stomach pains and went on to suffer cardiac arrests before dying in December 2004, told Dublin Coroner's Court yesterday they would never know exactly how she died.
Aoife Myler (5), Ballykelly, Drinagh, Co Wexford, had been in good spirits before she went to bed on December 18th, 2004, her mother, Helen Myler, said.
At about 11.50pm Aoife came into her parents' bedroom to use the en suite toilet and cried out before falling on to the bed. Ms Myler put her to bed and stayed with her until 2.10am when she brought her to A&E at Wexford General Hospital. She was admitted with "abdominal pains with vomiting".
Seven hours later she was extremely pale with an increased heart rate. A blood transfusion was carried out and she was transferred to intensive care. After an ultrasound and cat scan a "large complex mass" was detected on the left side of her groin.
On the morning of December 20th Aoife, now unconscious, was transferred by helicopter to Our Lady's Hospital for Sick Children in Crumlin, Dublin.
Fergal Quinn, consultant surgeon, told the court Aoife was taken straight to theatre. He found massive haemorrhaging at the lower end of the aorta near the kidney, a result of a ruptured aneurysm - a bulge in the blood vessel, he said. The bleeding was cleaned up.
The following day Aoife was brought back to theatre to repair the aorta. "She tolerated the surgery well," said Mr Quinn. However, through the night Aoife suffered multiple cardiac arrests and died at 3.15pm on December 22nd.
Mr Quinn said there was "no inherent disease" in the blood vessels and they were healthy. The damage to the aorta must have been caused by a "secondary trauma", some days or weeks before Aoife's death.
She had been diagnosed with "focal" or localised epilepsy in September 2004, and had two seizures before she died.
Pathologist Michael McDermott said he would not "outrule" the possibility that a seizure damaged the aorta. However, given that the epilepsy was focal, "it would be very hard to draw that conclusion".
Aoife's father, Kieran Myler, said: "We accept we will never know exactly what happened to Aoife."
Coroner Brian Farrell said it was difficult to deliver a legal cause of death in the case. He could return a verdict of death by natural causes, "but I don't think it would do justice" to the circumstances. "I think death by misadventure would be more fitting in the circumstances."
To Aoife's family he said he couldn't imagine the trauma and sorrow they were experiencing. "I wish sincerely to empathise with you in your grief. I just hope and pray you will be able to find the strength to bear this."
