'Four years of hell': Cork couple on the inquest and legal battle since death of baby Alfie

They visit him often in the graveyard near their home in Midleton, East Cork. They and his siblings Emilia, Sophie, and Brody will be there on Christmas morning as they have been every Christmas.

“Since Alfie, I don’t think we’ve managed to put up Christmas decorations without crying, all the happy moments are sad,” Amanda said.

“I know that’s very hard for a lot of people to understand, but true joy — I don’t think we’ve felt that since Alfie passed.”

The grieving parents settled a High Court action against the HSE over the death of their son in July this year, following a legal battle Amanda described as “four years of hell”.

They now wish to highlight the trauma this process and the inquest caused — in the hopes of bringing about change.

Amanda is a midwife who previously worked at Cork University Maternity Hospital (CUMH).

She described how at 39 weeks pregnant with Alfie, her second child, in July 2020, she went to CUMH very worried by not feeling kicks that Sunday night.

She was sent home again after a scan during which Alfie kicked once.

“Then, I woke up during the night with pains. I thought I was labouring and went downstairs on the birthing ball. I last felt a movement from him at 6am on the Tuesday,” she said.

They returned to the hospital, where Amanda had to go in alone due to the covid restrictions.

Aidan said: “I was pretty much just doing laps of Wilton [shopping centre], across the way, waiting.”

Over three hours, Amanda and her baby were monitored and scanned — but she was becoming steadily more and more anxious. At one point, she used the toilet.

“I passed a clot,” she said starkly. "And then I went onto the bed and he started kicking frantically.

They believe that is when he passed away

She was then rushed down to give birth, Aidan arriving in to see her being wheeled away. Alfie was immediately taken to the neonatal intensive care unit.

While staff tried to reassure her, Amanda could see tragedy looming because, as a midwife, she understood clearly what was happening.

“I knew then in that moment. I knew he was going to die or at the very best be severely disabled. I just lost it,” she said.

Initially Aidan was more hopeful. However, by Friday, an MRI on their baby’s brain sadly showed no activity.

Turning off the life-support on Saturday was “the most difficult day of our lives”, she said.

They were told an autopsy would be done as legally required. However, they found thinking about Alfie having this procedure quite disturbing.

“There’s no choice, which isn’t right,” Aidan said. “It should be up to the parents.”

By October 2020, they had begun to suspect birth negligence and then contacted a solicitor.

To their further frustration, the inquest in Cork was not held until April 2022.

The couple want to raise queries about the inquest itself, including why a jury was used instead of a coroner deliberating.

They want to know why the jury asked them to remove a “gorgeous” framed photograph of Alfie they had in court.

“We were told to face the picture down because one person in the jury was offended,” Aidan said. He has since seen photographs displayed during the Stardust inquest and others.

Describing other issues, he added: “At every step we took, it felt like people were disrespecting Alfie. The only voice he has is us.”

However, it was the verdict of death by natural causes which really shocked them.

“That was despite the coroner, the HSE, and our own legal team all requesting a narrative verdict at the end.

The jury just decided it was natural causes

In contrast, at the High Court, the HSE admitted liability in the action — where it was claimed delay in delivering the baby by caesarean section had caused or contributed to Alfie’s death.

Coming to that point in court almost exactly four years after Alfie died was simply traumatic, Amanda said. “It’s wrong, we’ve suffered the greatest loss that you can,” she said.

“Liability lies with the HSE and, in an attempt to get justice and answers for Alfie, we’ve been put through four years of hell. We faced tactics and manipulation and insults from the HSE and the State Claims Agency and their legal team. The system shouldn’t be like that — not when admission of liability is given.”

During preparation for the court, for example, Amanda was assessed by an occupational therapist for the HSE’s side.

“She was making recommendations that I take a year out of work, that I be funded to re-train,” she said.

“Impartial and fair. She was working for the HSE but, when it came to the court case, they withdrew her as a witness so we couldn’t get access to her report.”

An apology was discussed during mediation in late June this year between their legal team and the one representing the HSE and State Claims Agency.

“Money has absolutely nothing to do with it. What was important to us was we got acknowledgement it was their fault, which we never thought we would get,” Amanda said.

“So we got that and then we wanted an apology.”

To their shock, the apology was written by the HSE’s legal team and the grieving parents had to argue over every phrase.

Amanda said: “They wrote the apology and sent us down a copy while we were in the mediation room.

“When you think you can’t possibly be insulted any further they managed it. It was the most roundabout language.”

Aidan described it as “copy and paste spiel”.

“So we re-wrote it,” she said. This included replacing the phrase “on the loss of your baby” with “on the death of your son”.

The legal team then checked this with CUMH, who made further changes. The couple were still unhappy, but were told this was final.

That was why it was important we called it out in the court and to the papers that we didn’t accept the apology

“It was one we had to ask for and we had to write," Amanda said.

Sitting in their kitchen, Amanda gestured around and said: “He is missed every day. He should be four now, running around the place.”

Their solicitor is Ciara McPhillips, a partner with Michael Boylan Litigation.

She said it was April 2022 before they received a copy of the hospital’s internal review. Her copy is undated.

The apology, she said, “was written after a lot of toing and froing about the wording”.

“I know the family felt this took away from the sincerity... which is very understandable,” she said.

She said both CUMH and the O’Reillys had sought a narrative verdict at the inquest.

“In my respectful view, I do not think inquests of this nature are suited to a jury.

“Further, the family had a picture of Alfie in court and the jury asked that it be removed,” she said.

“I say all of this with absolute respect to the coroner and the jury of lay persons, but the legislature ought to review the Coroner’s Act to remove the possibility of juries hearing inquests of this nature.”

She also said that, while open disclosure legislation is now in place in the HSE, it came after Alfie’s passing and is not applied retrospectively.

Keelin O’ Donoghue, the head of the Pregnancy Loss Research Group based in University College Cork and CUMH, has studied this area.

“[We] have published lots of work over many years now to show that the current process of reviewing why babies die during pregnancy, at or after birth, isn’t working well for anyone — and isn’t leading to meaningful change either,” she said.

Parents don’t get answers and the individual healthcare professionals also get damaged within the system

An apology on behalf of CUMH and its staff was read to the High Court by HSE counsel. This expressed “heartfelt sympathies and condolences on the death of baby Alfie”.

The hospital apologised “unreservedly and sincerely for the failings in care” during the course of the fetal-maternal haemorrhage “that caused the death of your son Alfie”.

The hospital said it did not underestimate how traumatic it has been for the O’Reillys, and wished to acknowledge its enduring impact on them.