This week an inquest ruled that five-year old Elaine Barrett’s brain damage was caused by an ‘accidental’ overdose of magnesium. Now her distraught parents tell the unbearably moving story of caring for their beloved daughter—and of their anger that still no one will accept the blame.
When they brought their daughter Lorna to her first day at school this September, Frank and Eileen Barrett couldn’t help but regret what might have been. As they escorted Lorna through the schoolyard at Briarhill in Castlegar, Co. Galway, they both imagined their other daughter, Elaine, being there with them to guide her little sister through the terrors of those first days at school.
Instead, the family are preparing themselves for the second anniversary of Elaine’s death.
‘Lainey’ was just five years old when, in October 2008, she passed away from pneumonia, just one of the many illnesses the courageous little girl battled in her too-short lifetime.
Born prematurely, she was given a contaminated food supplement that was supposed to boost her nutrition. Instead, the mix, which contained toxic levels of the mineral magnesium, left her severely brain damaged and fighting for her life.
This week the Galway Coroner’s Court ruled that Elaine had died because of a medical accident, the result of a systems failure at B Braun Medical, a Dublin-based company who manufactured the toxic supplement.
Frank and Eileen accepted an apology from B Braun’s managing director Paul Mulally, but say that after being kept in the dark about what went wrong by the company for seven years, it’s ‘too little, too late’.
A honeymoon baby, Elaine was delivered by emergency section 26 weeks into the pregnancy on April 16, 2003, at the National Maternity Hospital in Dublin’s Holles Street.
Eileen had pre-eclampsia and the doctors warned her and Frank that their first child could have severe learning difficulties, even if they were able to deliver her alive. What happened next defied the odds so much that doctors in Holles Street nicknamed Elaine ‘the Galway Miracle’. ‘When they opened the birth sac she screamed straight away. She was healthy,’ says Eileen, at the family home in Cloonacaueen, Claregalway.
‘She only weighed 1lb 4ozs so she was still in danger, but they told us that once she weighed 3lbs we could take her back to Galway.’ Frank, a member of the Defence Forces, continues: ‘After two weeks, when she was 1lb and 7 ounces, they decided to move her to Galway because she wasn’t regarded as critical. She was in Galway for two weeks and was gaining weight, making progress, but in the third week she got an infection.’ While she was fighting the infection, Elaine was fed via an intravenous feed, and given a product called Total Parental Nutrition. This was manufactured by B Braun Medical.
Each bag was manufactured to the individual specifications of each patient following instructions from the patient’s hospital each day. Two bags of TPN were ordered for Elaine. However on May 23rd 2003, there was a devastating systems failure in B.
Braun’s plant on the Naas Road. A computer froze as the system was manufacturing a bag of food intended for an adult. That bag of food was subsequently discarded.
However, due to a combination of human error and a changeover in staff that morning, a standard safety practice was not followed. The pipe still contained some of the adult feed and an adult dose of magnesium, and should have been ‘primed’ or flushed out with water before the next bag of food intended for Elaine was manufactured—but it wasn’t.
When Elaine was fed her first TPN bag on Friday May 23, 2003, she became extremely agitated and her condition deteriorated.
‘We were informed that she had a bad night, her stats were down, they didn’t know why. It looked like she was going septic from the infection,’ says Frank.
‘One of the doctors decided to take a full blood test and found huge amounts of magnesium, 124 times the safe amount, and up to 80 times the amount of zinc. The only place she got those was from the bag.
‘The hospital treated her as a poisoning case, and said the only way to get rid of the magnesium poisoning was to flush out her system but when you are 1lb 7 ounces, the veins are tiny and she would have had to transfuse twice the mount of blood already in her body. They were worried about all her organs failing.’ On Sunday May 25, it was decided to transfer Elaine to Holles Street in Dublin. Because of the stress, Eileen’s blood pressure rose so high, she had to be admitted to a unit downstairs in University College Hospital Galway, while Elaine was upstairs in the neo-natal unit.
‘While we were waiting for the ambulance to come from Dublin, they put the three of us in a room together.
Me and Frank took it in ten to fifteen minute turns to tell Elaine about ourselves in case she passed away.
‘We wanted her to at least know who we were. I remember she had this constant tear streaming out of her left eye.
‘Frank drove after the ambulance but I was kept in because they said my life was in danger too.’ Frank arrived behind the ambulance at Holles Street and accompanied Elaine to Unit 8, where tests revealed the toxic magnesium levels were falling, and his daughter’s fragile kidneys were fighting to clear the poison from her body. For a few hours on Monday May 26rd, there was hope.
But the following morning a brain scan revealed colossal damage. The magnesium in the contaminated food bag had destroyed 90% of Elaine’s brain.
This was the first case of its kind in Ireland, and only the third in the world.
Eileen discharged herself from Galway and a friend drove her to Dublin. ‘Frank rang me at one point to see where we were and I knew straight away from his voice that something was wrong,’ she says.
Frank continues: ‘The doctors had told me that her brain was destroyed. On a level of one to three, hers was on the high end of three for brain damage. After all the fighting she had done first in the womb, and outside, from being on oxygen to being transferred from Dublin ahead of time, to suffering the setback of the infection; for her to be caught by this, by contaminated food, something that was supposed to be saving her life, it was so hard to accept.’
Eileen arrived on Monday evening and was told by Frank that their first born was severely brain-damaged.
After a doctor explained the impact of the magnesium, she was convinced Elaine had only hours to live.
‘She was in an open incubator with a heater above it and she looked so tiny, lying there in this frog-like position on her back,’ she says.
‘There was bruising on her body from where they were trying to get veins to inject her. When the doctor told me the extent of the brain damage, I just can’t describe how I felt. I thought she was dying there and then. It was only later that they told me her magnesium levels had dropped and despite everything she was still fighting. It was like this ordeal began in March that year when I discovered the pre-eclampsia, and then we were just hit with one thing after another. After six days we brought her home to die.’ Frank was 36 and his wife 29, when they brought Elaine home. Frank had to continue his work in the army, while Eileen gave up her job with Irish language group, Áras na Gael, because looking after Elaine would be a 24-hour operation.
‘They told us there was nothing more they could do for her. We brought her home thinking she was going to die and that it could be a matter of days, but we wanted her to see her home before she passed,’ says Eileen.
Elaine defied everyone’s expectations by surviving for five-and-a-half years. But from the first night at home, she cried incessantly.
‘It was a 24-hour operation,’ says Frank. ‘Elaine couldn’t move, she was in a semi-vegetative state, she had to be fed and cleaned. She had continuous seizures and she would get a lot of chest infections, so you had to suck the fluid out and use a nebuliser and medication.’ For two years, which Frank says were ‘damn hard’, Elaine lived with pain and daily seizures because doctors thought there was nothing they could do for her.
‘She screamed non-stop,’ he explains.
‘We thought it was just the way she was going to be because 90% of her brain was taken and replaced by liquid. The doctors thought she couldn’t get seizures because of the fluid, but she could. ‘The hardest part for the first while was the lack of sleep. For two years, I would stay up until 3.30am and 4am and then Eileen would take over while I got a couple of hours sleep before work. She was our daughter, our first child, so we didn’t know any better.’ ‘She was in a continuous rigid state, where she was arching her whole body,’ says Eileen. ‘It was like a severe migraine all the time. She wouldn’t sleep for three days, sometimes she could be awake for as long as four days at a time, then sleep for 24 straight.’ But there was some consolation for Frank and Eileen when, in 2004, they took Elaine to Lourdes along with a group from the Jack and Jill Foundation.
‘She smiled for the first time in Lourdes. We were told that she would have no comprehension because of the level of brain damage caused, but she did comprehend and she found ways to speak to you with her eyes,’ says Eileen.
‘She was a fighter. Her personality started to shine through. She had a sense of people around her, she loved music and commotion around her.
‘We played her everything from traditional Irish music to pop songs from the Eighties and she loved it. We would bring her to GAA matches in Pearse Stadium and she loved the roar of the crowd.
‘She loved getting her hair brushed, and you could see the reaction in her eyes and her smile.’ Family members and neighbours helped out—along with a nurse from the Jack and Jill Foundation, who visited once or twice a week—but with the seizures and the lack of sleep taking a toll on all of them, the Galway couple sought medical help.
In 2005, Elaine underwent a series of brain scans which showed that her seizures were being caused by her brain stem—a treatable condition. Tragically, the anti-seizure medication had horrific side effects for the frail little girl.
She began to suffer bouts of hypothermia, and her body temperature would often drop to 30 degrees—seven degrees below normal levels. Her parents had to admit her to hospital on 18 separate occasions.
‘When you are not moving around your lungs get full of fluid. It was basically just a case of wrapping her up in a silver blanket and just keeping an eye on her, knowing she could die at any time,’ says Frank.
‘That used to happen maybe once a week, then it might not happen for a month. You never knew.’ Eileen brought Elaine to Lourdes again in 2006, and it was on the night of her third birthday, in April 2006, that she and Frank decided to try for another child.
‘We decided that night but neither of us realised I was already pregnant with Lorna. It was a nervous time after everything that had happened with Elaine, but I came from a family of 11 and I wanted Elaine to have a brother or a sister,’ says Eileen.
Frank explains: ‘She was a little miracle. She defied all the odds. She made all her own rules. We wanted her to have a brother or sister before she passed away. It was a big decision to make.
‘If Elaine lasted two or three years and she never had a sister or brother then we felt she would be missing out, plus maybe our point of view, our whole outlook about whether we wanted children would be different when Elaine died, so we decided we would try for another child.’ Lorna was born in December 2005, and a third child, Cormac, was born in 2008. It was Lorna who gave Elaine her family nickname, Lainey Lou.
‘Lorna has started school now and she’ll be five at Christmas,’ says Frank. ‘She is such an advanced fiveyear-old. She could operate the machine that we used to feed Elaine through a peg in her stomach.
‘Lorna knew everything about her medications. She thinks medicine can solve everything. She said to me: “Why can’t we just dig Elaine up and give her pinkie [Calpol] to make her better.” It was good that they got to spend those three years together.’ After another bout of pneumonia, Elaine passed away on October 16, 2008.
‘When she died, it sounds strange, but it was such a shock,’ says Frank. ‘She was so used to going into hospital and so were we. She had started to get seizures again. She was going to a special needs school, Burren View, and they brought her to hospital to get treatment for the seizures. ‘She was in there for three or four days and she got a massive seizure that went on for four hours. She went comatose.
‘Once she came out of that, there was no recognition there at all in her eyes. They did a brain scan and there was very little brain activity. We decided to take her home to die. We organised to have hospice care at home. She lasted a couple of weeks.
‘She was just the most amazing little child. When you think of all the people who just don’t seem to care and here she was, she was such an inspiration.
‘You’d come home to Lainey, and she’d give you such a lift. She’s still an inspiration to me now and I miss her. You always think about your first child and what if.
‘When I brought Lorna to school for her first day, I was thinking her only sister should be here. It will be like that for communions and confirmations and weddings and all the major events, you think Lainey should be here.’ Before Elaine’s death, the Barretts had sued B. Braun Medical for the damage caused to their daughter by the contaminated medication.
A settlement was reached but it has not yet been ratified by the High Court. At the inquest into Elaine’s death in Galway this week, the family learned how B. Braun and the Irish Medicines Board were aware within a week that it was a contaminated food package that had caused their daughter’s brain damage.
However, it took seven years for them to inform the Barrett family of this. The coroner recommended that, were a similar situation to arise in future, the IMB should contact those involved immediately, rather than making them face an agonising wait like the one the Barrett family had.
Eileen and Frank say that they are angry about being needlessly left in the dark for so long—and they feel that they will never get justice for their daughter.
‘Since this whole ordeal began all we have ever wanted to know is how and why it happened,’ says Eileen.
‘It took Elaine’s death and a coroner’s inquest for us to be told what happened. We ask the question why the IMB weren’t required to furnish us with the findings of their investigation.
‘Instead we were forced to embark on expensive litigation in an attempt to get the truth of the matter.’ It’s been a long and expensive process, but now that the inquest is over, the Barretts say they can finally let go of some of that anger and focus on remembering their little smiling girl.
‘On Elaine’s seventh birthday, Lorna and I went and bought a helium balloon to put on her grave, and Lorna was shouting in the shop about how she was buying a balloon for her sister who’s dead,’ says Eileen.
‘The people in the shop were crying.
But Elaine was worth it.
‘We had tough times but one smile from her, and it was worth it, every second, every minute, every day was worth it.’