A consultant microbiologist at Ireland’s National Maternity Hospital has criticized the care given to tragic Indian mum-to-be Savita Halappanavar at Galway University Hospital.

Dr Susan Knowles has told the inquest into Savita’s death that she should have been given stronger antibiotics. She also said medical staff should have been called in earlier when her blood pressure began to fall.

Dr Knowles was also critical of poor documentation at a critical time in Halappanavar’s care on Wednesday, October 24th last.

She told the inquest it was possible Halappanavar had a sub-clinical infection when she was admitted to Galway University Hospital on October 21st last because tests showed her white blood count was raised.

The Irish Times reports on Dr Knowles’ concerns that it wasn’t clear that her medical team were made aware of this test result.

She told the inquest that after the membranes ruptured earlier the following day, the risk of infection grew.

The report adds that there was no clinical indication for intravenous antibiotics prior to the Wednesday. It says that the witness told the inquest that when Halappanavar complained at 4.15am that morning of being cold and shivery, all her vital signs should have been checked.

Dr Knowles also said she was investigated later that morning, but an antibiotic with a broader range of cover, including E. coli, should have been administered at the time. The drug that was used is recommended for use in maternal cases in leading reports.

The specialist said there was no mention in the notes of a plan to deliver Halappanavar’s baby at this point, and this was a critical aspect of her care. A second opinion on the need to deliver was needed.

Dr Knowles added there was a delay in recognising that Halappanavar was deteriorating further, and medical staff should have been called when the patient’s blood pressure was falling.

She concluded that from 1pm on the Wednesday, Halappanavar received a high standard of care.