A FOUR-DAY-OLD baby boy sustained an irreversible brain injury after his mother had an epileptic seizure, collapsed out of her hospital bed and pinned the child underneath her, an inquest in Cork has heard.

Marie and Darragh Downey of Knockanevin, near Kildorrery, Co Cork passed away within 33 hours of each other after tragedy unfolded in March 2019 at Cork University Maternity Hospital (CUMH).

Marie, who had an uncomplicated pregnancy, suffered from epilepsy and had a seizure, possibly whilst breastfeeding her infant in her hospital bed in her private room.

The 36-year-old was found dead on the floor of her hospital room shortly after 8am on 25 March, 2019.

Dr Keelin O’Donoghue Consutant Obstetrician/Gynaecologist at CUMH treated the deceased mother for all three of her pregnancies.

During her first pregnancy, she suffered a seizure at thirty weeks and decided to go back on medication for her epilepsy prescribed for her by her neurologist, Dr Peter Kinirons.

She had gone off her medication for a period amid her concerns about taking it during pregnancy.

O’Donoghue told the inquest that she had discussed the risks of the mother not being on anticonvulsant medication, that they were both happy with her returning to her medication and that she was diligent about taking her tablets.

She had previously taken the medication through her subsequent two pregnancies.

O’Donoghue also said she had experience in dealing with women who suffer from epilepsy and their care during pregnancy.

The doctor stated that during Downey’s third pregnancy in 2018, she had told her at her 12-week appointment that she had an appointment with Kinirons in January of 2019.

Downey did not make the appointment due to family events.

O’Donoghue said that she regretted not asking Downey if she had attended the appointment, and conceded that it was an “oversight” for her not to have written to the neurologist about the care of her patient.

She also said that she had “made the assumption” that Downey had attended the appointment, and told the inquest that she was shocked when it subsequently emerged that the neurologist had not even been aware of the third pregnancy.

Fatigue and stress

O’Donoghue said she was conscious that fatigue and stress were “precipitators for seizures” in Downey, and that breastfeeding could also have been stressful for her.

She described what occurred to the mother and her baby as “shocking and unexpected”, and again extended her condolences to the husband of the deceased woman Kieran Downey.

She also told the Coroner’s Court that prior to the tragedy unfolding, Downey was breastfeeding, doing well and “keen to get back home”.

O’Donoghue recalled starting her rounds in the hospital on the morning of 25 March, 2019.

The doctor told the inquest that when she went in to the room of the deceased shortly after 8am, she was shocked to find that the deceased was “half out of the bed”.

“Her legs remained on the bed, with her upper body on the floor. She was in an unnatural position,” O’Donoghue said.

She explained that she quickly checked Downey’s neck for a pulse, before ringing an emergency bell in the room and calling out into the corridor.

Another staff member who arrived shortly afterwards also re-checked for a pulse, but confirmed that none could be found was no pulse.

After Downey was moved, the ward manager noticed that her baby Darragh was lying underneath her, having been concealed initially from the view of staff.

“He was cold, mottled and with discoloured skin. The midwife brought him to the nursery and the neonatal emergency team was called,” O’Donoghue said.

She added that she was not involved in the treatment of the baby boy, and that she asked for the midwifery manager to contact Mr Downey and tell him that his wife had been very unwell and to come to the hospital.

Mother collapsed

Also at the inquest today, Dr Brendan Murphy, a consultant neonatalogist at CUMH, said that baby Darragh suffered a hypoxic ischamemic encephalopathy after his mother collapsed on top of him.

The doctor told the inquest that when the baby was found under his mother by paediatric staff, every effort was made to resuscitate him.

The boy received comprehensive medical interventions including intubation, the administration of adrenaline and fluid and chest compressions. When his oxygen saturation improved, he was transferred to the hospital’s neo-natal intensive care unit.

However, doctors there determined that Darragh was “clinically comatose”, and had sustained an “irreversible brain injury”.

Murphy offered his condolences to the baby’s father Kieran and said the infant was comatose from the moment he was found.

“He (Darragh) never regained consciousness. He was unaware of (medical intervention). There was no suffering,” the doctor told the inquest.

Intensive care support was withdrawn following consultation with the family, and Darragh passed away at 5pm on the 26 March, 2019.

Kieran Downey and his two young sons were given the opportunity to spend time with Darragh in a family room before his death.

Murphy said that he knew from the outset that Darragh’s prognosis was bleak, but that hospital staff gave him “every opportunity’ for signs of recovery.

The inquest heard that the baby lived for 33 hours after his mother was found dead.

“I was under no doubt, from his admission to the unit that his prognosis was bleak and that he was unlikely to survive, but I wanted to satisfy myself and the family that we had given him every chance of recovery,” the doctor said.

Dr John O Mahony, Senior Counsel for the Downey family, said that they were aware that every effort was made by doctors to assist the baby.

A statement from Dr Hannah Glynn, a junior obstetrics registrar was also read in to evidence.

She said that it was her belief that the baby’s mother may have been breastfeeding before the tragedy, because her right breast was exposed when she was found.

Glynn also said that CPR was not administered to Downey, because she was already dead when doctors discovered her.

The inquest continues this week, and is expected to last at least an additional day before it is adjourned.

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