[Article] - 5 hour trip for autopsy

Cookie_Monster

Firstly I'm not sure if this is the right forum for this so Mods please move if you feel it should be somewhere else.

I just read the below story

Link

THE distraught parents of a baby boy who died suddenly had to take his remains on a five-hour bus journey to Dublin for an autopsy because there is no paediatric pathologist in Co Donegal.

The incident which occurred last week has prompted Coroner Dr John Madden to renew his call for a more sensitive protocol to be put in place in the northwest.

"Neither of the pathologists who are based in Co Donegal feel qualified to carry out post mortems on infants. Thankfully, the problem does not arise very often but when it does we need to have a protocol in place where someone is designated to do infant post-mortems for Donegal.

"That may mean going across the Border rather than accessing a pathologist in Dublin or Galway," he told the Irish Independent last night.

The two-week-old infant died in his sleep on November 24, 2009.

The young mother and father -- who have one other child -- were then forced, later that day, to endure a five-hour mini-bus journey with their child's coffin from their home in Buncrana to a Dublin hospital for a post-mortem.

Infant pathologists are only available in Dublin and Galway -- and in this case, the parents' journey time was shorter from Donegal to Dublin.

In accordance with procedure, the couple were accompanied on their journey by a local garda sergeant.

One parent is required to be present during the post-mortem.

It is understood the authorities covered the cost of the private transport.

Trauma

Dr Madden said there was no other choice available to him because a post-mortem was required where a GP cannot certify the cause of death.

"The trauma of losing a child is bad enough but then to have to go through the added trauma of a five-hour journey to Dublin. It must have been awful.

"This should not be happening in this day and age. We should be a lot more sensitive to the needs of parents at a time like this," he said.

Dr Madden has written to the county secretary of Donegal Co Council demanding a resolution to what he described as the "extremely unfair" system currently in place. Dr Madden pointed out that he had written a letter two years ago following a similar situation, but nothing had happened since.

He said he had been told by the pathologist in Our Lady's Hospital in Crumlin that they would "entertain no more such requests for autopsies" from him or any of the four Donegal coroners in the future.

"If Temple Street decides the same, there will be no one who can do them," he said.

Disgrace

Buncrana councillor Rena Donaghey, who knows the family in question, last night described the current system as "a disgrace".

"As if it wasn't enough that this young couple was trying to cope with their grief, they then had to endure a five-hour journey with their child's body to Dublin.

"They had to stay overnight in Dublin and didn't get home to arrange their child's funeral until late the following night," said Cllr Donaghey.

"This is the second time in as many years this has happened in the Inishowen area and something has to be done about it.

"No other parents should have to go through what this young couple had to go through," said Cllr Donaghey.

A HSE spokesperson last night said that, in the event of an unexpected infant death, it is the responsibility of the coroner to source a paediatric pathologist.

"In the Republic, the nearest paediatric pathologist to Donegal is based in Dublin.

"The HSE's role is to provide the use of facilities to the Department of Justice at its hospitals to allow post-mortems to be carried out," said the spokesperson.

I'd like to express my sympathy with the family for their loss and the situation they had to endure.

What I want to ask is, is it really necessary to hold an autopsy. I mean if they had to go through all that when their baby has already died?

Can they not have it "made official" by a local doctor / hospital and lay their child to rest without all that hassle and upset? Is their a legal reason why an autopsy must specifically be carried out?

Ickle Magoo

Autopsies are carried out when an otherwise healthy person dies; the pathologist has to confirm that the child had died of natural causes.

kelle

Oh, my God that is so, so awful - my eyes are welling up!

When my mother died suddenly, we refused a PM because she had already been through enough (she had cancer but was doing well on chemo - my Dad had died 4 weeks previously, we believe she died from a broken heart) and it wasn't going to bring her back. However, circunstances were different because she died in hospital while this poor baby died at home.

What these parents had to go through is just horrific, and that's putting it mildly.

TheNog

Oh jesus this is the lowest of the low. Those poor parents.

Mr Magnolia

I can't express how saddened I am at reading that.

My thoughts are with the family.

RIP

seamus

It's not nice, but extenuating circumstances in reality. The autopsy has to be done (you can't just ignore the dead of a healthy child) and it would be grossly negligent for a local doctor to "sign off" on it just for the sake of it.

I do find it bizarre though that the parents would have to bring the child themselves - I would have thought that the state would take care of transporting the body in an ambulance. An alternative is to have the pathologist travel to the county, but his may not feasible depending on the demands on the pathologist's time.

It wouldn't be feasible to have a pathologist just for Donegal, the population doesn't justify it.

Donegal has these problems - it's very isolated in a geopgraphical context and it has a low population density, meaning that it's isolated from services too because it often can't justify having services available in the county itself.

Aside from asking the pathologist travel to the county - which may not be feasible; think of equipment and so forth - or transporting the body in an ambulance, I don't see what else could have been done.

January

seamus wrote: »

It's not nice, but extenuating circumstances in reality. The autopsy has to be done (you can't just ignore the dead of a healthy child) and it would be grossly negligent for a local doctor to "sign off" on it just for the sake of it.

I do find it bizarre though that the parents would have to bring the child themselves - I would have thought that the state would take care of transporting the body in an ambulance. An alternative is to have the pathologist travel to the county, but his may not feasible depending on the demands on the pathologist's time.

It wouldn't be feasible to have a pathologist just for Donegal, the population doesn't justify it.

Donegal has these problems - it's very isolated in a geopgraphical context and it has a low population density, meaning that it's isolated from services too because it often can't justify having services available in the county itself.

Aside from asking the pathologist travel to the county - which may not be feasible; think of equipment and so forth - or transporting the body in an ambulance, I don't see what else could have been done.

I see your point but as per the article there are TWO pathologists based in Co. Donegal and neither of them "feel qualified" to carry out infant autopsies! It's a disgrace really, one or both of them needs to update their skills so that they are qualified to carry out infant autopsies.

A pathologist should have traveled to Donegal to carry out the procedure. A parent needs to be present in the room while the autopsy is carried out.

"Neither of the pathologists who are based in Co Donegal feel qualified to carry out post mortems on infants. Thankfully, the problem does not arise very often but when it does we need to have a protocol in place where someone is designated to do infant post-mortems for Donegal.

metrovelvet

They had to carry a dead infants body on bus eireann?

Is this real?

January

metrovelvet wrote: »

They had to carry a dead infants body on bus eireann?

Is this real?

Wasn't public transport, it was a mini bus provided by the state.

seamus

adrieanne__x wrote: »

I see your point but as per the article there are TWO pathologists based in Co. Donegal and neither of them "feel qualified" to carry out infant autopsies! It's a disgrace really, one or both of them needs to update their skills so that they are qualified to carry out infant autopsies.

Agreed, but the nature of medicine is to specialise and a pathologist and a paediatric pathologist are two entirely different things. It's quite rare for a doctor to specialise in two areas, so "upskilling" may not be feasible for either of these two pathologists (specialising is quite a lot of work), which would necessitate replacing one pathologist with another who specialises in both adults and paediatrics. Who would cost more, naturally.

Then every county will want their own personal double-jobbing pathologist.

So while it's the "right" thing to do, it's not really feasible.

A pathologist should have traveled to Donegal to carry out the procedure. A parent needs to be present in the room while the autopsy is carried out.

Absolutely. And I'm surprised that the HSE or whatever didn't comment on why this wasn't done.

metrovelvet wrote: »

They had to carry a dead infants body on bus eireann?

Is this real?

In a coffin. Wouldn't be unheard of.

bogtotty

seamus wrote: »

An alternative is to have the pathologist travel to the county, but his may not feasible depending on the demands on the pathologist's time.

Demands on the pathologist's time? What about the demands on the time of the parents when they are trying to deal with grief and funeral arrangements, the demands on the garda sergeant's time, the demands on the bus driver's time? This is a disgraceful example of the subservient attitude this country has towards its consultants. Why shouldn't part of a peadiatric pathologist's duties include having to travel to perform such autopsies? The equipment will be in place in the local hospitals (other autopsies are carried out on site), it is only the expertise that is lacking. Surely it makes much more sense to have one person travel to a hospital in Donegal than causing this much upset to a family and carting parents, garda, bus driver and poor little baby's remains halfway across the country? Centralising medical services and maintaining consultant-centred care is undemocratic and unjust, whether the issue is cancer treatment or infant autopsies. Make consultants mobile and clinics local - they get paid enough to justify them taking a few day trips out the country a couple of times a month.

seamus

bogtotty wrote: »

Demands on the pathologist's time? What about the demands on the time of the parents when they are trying to deal with grief and funeral arrangements, the demands on the garda sergeant's time, the demands on the bus driver's time?

What I mean is that one particular pathologist may have 5 (for example) similar autopsies to complete that day. If the pathologist has to travel to Donegal and back, then every one of his other autopsies for that day have to be put off until the next day, meaning that instead of one set of parents being put through the trauma, you now have four sets of parents for whom the waiting has been prolonged and the grieving process has been postponed.

I don't give a crap about the pathologist's personal time, but you need to consider the needs of all of his patients, not just one particular case.

pickarooney

They could have at least flown them from Carrickfinn if they really had to bring the child's body to Dublin but it's unbelievable that a pathologist would not be qualified to do an autopsy on a baby.

metrovelvet

pickarooney wrote: »

They could have at least flown them from Carrickfinn if they really had to bring the child's body to Dublin but it's unbelievable that a pathologist would not be qualified to do an autopsy on a baby.

From what I understand, at least from pediatric surgery, is that because everything is so teeny tiny you need very specially trained hands to poke around in there.

THey need more pediatric care in the west to start with.

bogtotty

Does anyone know how many paediatric pathologists there are in the country? Looking at the CSO figures for 2006 (last available) there were 335 deaths among the under-15s that year. Surely it's unlikely that any paeds pathologist would have more than one autopsy to perform in any one day? And that it should be possible for them to travel to perform their duties rather than causing this sort of upheavel to a family?
Sorry, I'm ranting a bit - it's such a sad, sad story I can't help but get a bit worked up...

Ickle Magoo

Paediatric pathologists also cover perinatal cases so the figures you have do not reflect all the cases that would have been dealt with. There is also specialist equipment and laboratory techniques used specifically for infants that may not be mobile or available out-with paediatric medical facilities.

It's a desperately sad journey to have a parent make but I'm sure they wanted answers too and in lieu of qualified personnel and/or relevant equipment, the child being taken to an appropriate facility is the only other option. Having said that, having parents accompany their dead child in a mini-bus sounds so irreverent, surely there is a more sensitive way of handling such a situation?!

betterlife

I'm sad at the news. The autopsy is not necessary since the baby is not killed by any person.

seamus

betterlife wrote: »

The autopsy is not necessary since the baby is not killed by any person.

Only an autopsy can determine that unfortunately.

Ickle Magoo

betterlife wrote: »

I'm sad at the news. The autopsy is not necessary since the baby is not killed by any person.

Every death could be declared as natural, unfortunately only an autopsy can determine if that is actually the case.

littlebug

this is so sad In that position I would really want to know why my baby died though having to travel to Dublin is horrendous.

Demonique

metrovelvet wrote: »

They had to carry a dead infants body on bus eireann?

Is this real?

Not Bus Eireann, it was a mini-bus provided by the state.

I have seen items I wouldn't have thought would have been on the bus in the first place on buses in other countries in the past. When I was in Canada waiting for the Greyhound bus to arrive there was someone waiting with a medical cooler which was labelled as being donated blood.

Demonique

betterlife wrote: »

I'm sad at the news. The autopsy is not necessary since the baby is not killed by any person.

Well, the baby could have died of an infectious disease. What if they didn't perform an autopsy and didn't find out about a disease and then there was an serious outbreak the effects of which could have been lessened if they'd detected it earlier?

eviltwin

My heart is breaking for that poor couple. I cannot believe that this happens in this day and age. RIP the little one and my thoughts are with the family.

enniscorthy

absolute disgrace in the 21st century