It has been a mixed bag of emotions at the inquest of the
death of a 35-year-old Zimbabwean, Tatenda Mukwata, who died soon after giving
birth at the University Hospital Kerry last year.
She died at 2am on April 21, 2022, after giving birth six
hours earlier to her fourth daughter, Eva, who was delivered by Caesarean
section.
Tatenda had been HIV positive since 2009, and she would
attend an HIV specialist in CUH and always took her medication.
A pathologist told
the opening day of the inquest in August that Tatenda had died of haemorrhage
and shock.
In its apology at the outset of the resumed inquest on
Monday, HSE senior counsel John Lucey read an apology signed by Mary
Fitzgerald, general manager of UHK, “for the failings of care afforded to
Tatenda at this hospital on 20th and 21st April, 2022.
“We fully accept that these failings should not have
happened, and that earlier intervention would probably have prevented Tatenda’s
death.
“An external review of the matter is nearing completion and
as a hospital we will endeavour to ensure lessons are learned.
“We are deeply sorry that you have suffered the tragic loss
of Tatenda. We wish to apologise to you unreservedly and offer our heartfelt
condolences. We acknowledge the grief, stress, trauma, and suffering that you
and your family continue to endure as a result of Tatenda’s death, for which we
are truly sorry.”
A South African obstetrician gynaecologist who had been
working in Ireland for just three months at the time Tatenda died, broke down
at her inquest on Tuesday, asking if he could meet her family.
Dr Fahad Hendricks was assigned to the high-risk ante-natal
clinic and was working his third 24-hour shift in less than a week on April 20.
At 17.30 he went to meet Tatenda, with whom he had “a good
rapport”.
He was excited to see her as both were from Southern
Africa, Dr Hendricks said, breaking down and pausing in reading his deposition.
Tatenda’s Caesarian had been “uncomplicated” and there was
normal blood loss and no haemorrhage.
At 22.55, paged by concerned nurses, he noticed her low
pallor and suspected septic shock.
He had thought there might be a surgical bleed but found no
evidence and nothing to indicate it.
The wound dressing was clean, there was no v*****l bleeding
and the uterus was contracting.
“I trained in South
Africa, 30 percent of women in ante-natal clinics are HIV positive,
immuno-suppressed,” he said.
He was not aware of the drop in haemoglobin.
“In all honesty, I did not check,” Hendricks replied to Dr
John O’Mahony, SC, for the Mukwata family.
But had he been aware of the drop, he probably would have
repeated the blood sample, and his suspicion of intra-abdominal bleeding
strengthened and he would probably have taken steps to have her taken to
theatre for operation, he told the inquest.
There were emotional scenes as Dr Hendricks asked to meet
the family of Tatenda and he was crying and being comforted at the back of the
courtroom as the jury left for their lunch break.
The third day of Tatenda’s inquest heard that staff at UHK
had carried out four C-sections on the night she died, in a “challenging shift”
for nurses and clinicians. – Irish Times/Irish Examiner.
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