The HSE has agreed to pay almost €800,000 and has unreservedly apologised before the High Court to the family of a 29-year-old woman who became seriously ill when in Sligo General Hospital for delivery of her first child and died eight days later.
“The HSE confirms that lessons have been learned from the tragic outcome in Dhara Kivlehan’s case,” it also said.
The payment and apology are part of the settlement of an action brought by the family of Ms Kivhelan, nee Sandhu, a native of India, who died on September 28th 2010. The HSE admitted liability in the matter last week.
The settlement was ruled today by Ms Justice Mary Irvine who said this was the third case before her within the last two weeks where a defendant had "held out almost to the bitter end" before admitting liability. This was "very regrettable" and caused enormous distress to a family, she said.
She expressed sympathy to Ms Kivlehan’s husband, Michael, and his parents, who are helping him rear the couple’s child, who were all in court.
Earlier, Adrienne Egan SC, for the HSE, said it unreservedly apologised for the shortcomings in relation to the management and care of Ms Kivlehan at Sligo General Hospital and wished to express its sincere condolences to Mr Kivlehan, his family and his wife's family in India.
Ms Kivlehan is survived by her husband and son Dior, now aged three, and her parents and three siblings in India. The couple met in London, where Ms Kivlehan had come to in 2002 to study fashion design and textiles. They married in 2005 and came to live in Ireland.
Outside court, Mr Kivlehan thanked his lawyers Callan Tansey for their work in achieving the settlement but added: "Our battle for justice must continue: three years on from Dhara's death, we still await an inquest.
The family were heartbroken their calls for an inquest here have, to date, been declined as “many unanswered questions need to be addressed”, he said.
“Dhar’s memory deserves an inquest and it is an ongoing breach of our family’s human rights for our calls for justice to remain unheeded.”
Ms Kivlehan was admitted to Sligo General Hospital on September 20th, 2010 for the delivery of her first child, Dior. She was two weeks past her due date, her counsel Des O’Neill SC said, and when admitted was showing signs consistent with pre-eclampsia.
It was claimed, when admitted, she presented with a history of painless contractions for two days and, on examination, had evidence of oedema of the lower limbs and slightly elevated blood pressure.
It was also claimed that blood tests performed on the afternoon of that same day established Ms Kivlehan had grossly abnormal liver and kidney function but that the results of those tests were not communicated to her doctors until some 12 hours later.
In the interim, she was transferred to the delivery ward and her son Dior was born healthy at 5.56am. Ms Kivlehan was then transferred to a side room off the maternity ward where she remained until 4.45pm the next day when she was transferred to the Intensive Care Unit.
It was claimed, while she was receiving treatment in that side room, it was not adequate or suitable and she should have been moved to the ICU and appropriately treated much earlier. It was clear to her husband and family her condition was deteriorating and they had sought earlier transfer to the ICU, it was claimed.
She remained in the ICU until about 11pm that night when she was airlifted to the Royal Victoria Hospital in Belfast where, despite intensive intervention, she died four days later of multi-organ failure consequent on HELLP syndrome, a severe variation of pre-eclampsia.
Lawyers for Ms Kivlehan’s family alleged, had the action proceeded to hearing, they would have called doctors to give evidence suggesting, while HELLP Syndrome is a severe and life threatening condition, it has a mortality rate of less than 1 per cent in the developed world if appropriately treated.
In their claim, the family alleged the delivery of Ms Kivlehan’s child was negligently delayed and inadequate urgency and speciality was applied to her case.
The decision to transfer her to the Royal Victoria Hospital in Belfast was “too little, too late”, it was alleged. The family accepted everything possible was done for her in the Belfast hospital but alleged her treatment at Sligo General Hospital was “in marked contrast”, the lawyers added.
There was a failure at the Sligo Hospital to appreciate the significance and severity of her worsening condition and either treat her appropriately there or transfer her to a more appropriate tertiary centre fort the necessary intensive care, it was alleged.
It is understood a separate case by Mr Kivlehan for nervous shock was settled for an undisclosed sum.