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Hyponatraemia inquiry: Children's hospital deaths were avoidable | Hyponatraemia inquiry: Children's hospital deaths were avoidable |
(35 minutes later) | |
An inquiry into the deaths of five children in Northern Ireland's hospitals has found that four of them were avoidable. | An inquiry into the deaths of five children in Northern Ireland's hospitals has found that four of them were avoidable. |
The findings followed a 14-year inquiry into hyponatraemia-related deaths | The findings followed a 14-year inquiry into hyponatraemia-related deaths |
Hyponatraemia is a medical condition that occurs when there is a shortage of sodium in the bloodstream. | Hyponatraemia is a medical condition that occurs when there is a shortage of sodium in the bloodstream. |
The damning report was heavily critical of the "self-regulating and unmonitored" health service. | The damning report was heavily critical of the "self-regulating and unmonitored" health service. |
Mr Justice O'Hara was scathing of how the families were treated in the aftermath of the deaths and also of the evidence given to the inquiry by medical professionals. | Mr Justice O'Hara was scathing of how the families were treated in the aftermath of the deaths and also of the evidence given to the inquiry by medical professionals. |
He said that "doctors and managers cannot be relied on to do the right thing at the right time" and that they had to put the public interest before their own reputation. | He said that "doctors and managers cannot be relied on to do the right thing at the right time" and that they had to put the public interest before their own reputation. |
He also said that some witnesses to the inquiry "had to have the truth dragged out of them". | He also said that some witnesses to the inquiry "had to have the truth dragged out of them". |
The inquiry was set up in 2004 to investigate the deaths of Adam Strain, Claire Roberts, Raychel Ferguson, Lucy Crawford and Conor Mitchell. | The inquiry was set up in 2004 to investigate the deaths of Adam Strain, Claire Roberts, Raychel Ferguson, Lucy Crawford and Conor Mitchell. |
The chairman said that the deaths of Adam Strain, Claire Roberts and Raychel Ferguson were the result of "negligent care". | The chairman said that the deaths of Adam Strain, Claire Roberts and Raychel Ferguson were the result of "negligent care". |
In his report, Mr Justice O'Hara found that: | In his report, Mr Justice O'Hara found that: |
In total, the inquiry made 96 recommendations including the establishment of a duty of candour on medical professionals "that would impose a duty to tell patients and their families about major failures in care and to give a full and honest explanation". | In total, the inquiry made 96 recommendations including the establishment of a duty of candour on medical professionals "that would impose a duty to tell patients and their families about major failures in care and to give a full and honest explanation". |
Mr Justice O'Hara added that the "reticence of some clinicians and healthcare professionals to concede error or identify underperformance or colleagues was frustrating and depressing". | Mr Justice O'Hara added that the "reticence of some clinicians and healthcare professionals to concede error or identify underperformance or colleagues was frustrating and depressing". |
Long-running inquiry | |
The inquiry was set up in 2004, but has been dogged by repeated delays and adjournments. | |
The first witness was not called until April 2012 and it stopped taking evidence in November 2013. | |
Mr Justice O'Hara was a senior barrister when the inquiry began and is now a High Court judge. | |
A total of 106 doctors and other medical professionals gave evidence and 179 witnesses were called. | |
Fifty lawyers were involved, representing the inquiry, the families and the health trusts. | |
Initial reports suggest the inquiry cost £13.5m, but that figure is expected to rise. |