Savita Halappanavar's consultant obstetrician has admitted there were a number of system failures in her care at GalwayUniversityHospital, where the 17-week pregnant Indian dentist died last October.
Dr Katherine Astbury told the ongoing inquest into Savita's death at Galway Courthouse in Ireland that she was unaware of blood test abnormalities, adding that the patient's vitals should have been checked more regularly after her foetal membrane ruptured.
According to Irish media reports, coroner Ciaran MacLoughlin then asked her if these aspects of Savita's care could be seen as system failures. "Yes," Dr Astbury replied.
Savita, 31, had delivered a stillborn baby daughter on October 24 and died four days later of a heart attack caused by septicaemia due to E. coli.
Dr Astbury, who is accused of refusing her pleas for a termination because "Ireland is a Catholic country", said she had refused as there was no risk to her life.
"She was well. There was no risk to her life. If you need to give somebody medication to deliver and there's a foetal heartbeat, my understanding is that legally you are considered to be terminating," she said during her cross-examination, when she also denied making the Catholic reference.
"No, I did not mention religion I did say I cannot terminate in this country because the foetus is still alive," she said. The consultant also told the inquest that the couple's baby had six toes on each foot.
Meanwhile, earlier during the ongoing hearing a midwife working on the ward where Savita was treated had claimed that additional entries were made to her medical notes during an internal hospital inquiry.
In her evidence, staff midwife Miriam Dunleavey said entries were put into the medical notes by the hospital's internal investigation set up in the wake of an uproar over Savita's death.
The coroner raised questions as to the appropriateness of this action.
Declan BuckleySC, representing the hospital, stressed that the notes were not tampered or interfered with. He, however, added that it hadn't been possible to identify who made the additional marks on the document, which he described as a "bracket" or "squiggle".
According to Buckley, the marks could not have been made by internal investigation as it started its probe weeks after the document had been photocopied and put in a safe.
The inquest entered its third day today and is charged with registering a cause of death in the case. Savita's husband, Praveen Halappanavar, and a friend have already given their statements in the case highlighting the hospital's failings.
The final draft of an unpublished Health Service Executive report into Savita's death had already concluded an "overemphasis" on the foetus and an "underemphasis" on Savita's deteriorating health.
The case had re-ignited calls to re-define Ireland's confusing anti-abortion laws and the Irish government has since committed to legislate to allow abortion if there is a real and substantial risk to a woman's life by July this year.
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