An inquest into the death of a baby boy who suffered a lack of oxygen to the brain during his delivery nine years ago has reopened after fresh evidence emerged.

Aaron Cullen was born on May 4, 2016, by emergency C-section at the Midlands Regional Hospital in Portlaoise but died five days later at the Coombe Hospital in Dublin, where he was transferred after suffering complications at delivery.

The original inquest, which concluded in 2019, recorded a narrative verdict.

The fresh inquest had been sought by Aaron’s mother, Claire Cullen, a co-founder of the Safer Births Ireland organisation, after she obtained additional material from the hospital through a Freedom of Information request in 2023, which raised concerns about an oxygen machine used to resuscitate her son.

Yesterday, senior midwife Michelle Mahon told the inquest that the Resuscitaire was working as ‘the dials were moving’, which she believed indicated that oxygen was flowing. A paediatric senior house officer, Conal McCarthy, said he witnessed the normal checks being conducted by a paediatric registrar.

Dr McCarthy said he measured the baby’s heart rate at less than 60 beats per minute compared to the normal neonatal rate of more than 100 beats per minute. Chest compressions and mechanical ventilation were continued after two unsuccessful attempts to intubate the baby.

In reply to questions from the coroner, Myra Cullinane, Dr McCarthy confirmed that there were no specialist neonatal doctors attending the delivery.

Ms Cullen’s solicitor, Caoimhe Haughey, said it was a concern that there were no medical notes about the baby’s first 10 minutes of life.

Ms Cullen told the inquest that she expressed her concern to hospital staff during a 34-week check on Friday, April 29, 2016, about the lack of movement in her baby and discomfort all over her abdomen. A subsequent scan revealed increased amniotic fluid, while both of Aaron’s kidneys were found to be dilated.

Ms Cullen recalled that a doctor said she would discuss the findings with her consultant gynaecologist and obstetrician, Hosam El-Kininy, as well as recommending an urgent, more detailed foetal anomaly scan in the Coombe Hospital. The inquest heard her abdominal pain and irregular contractions worsened over the weekend, but tests showed everything was fine.

She was admitted to hospital on May 2, 2016, and a midwife appeared concerned after Ms Cullen’s waters broke at 10.45 pm that evening. Ms Cullen said her stomach deflated so rapidly that she could see the outline of her baby and she was informed shortly after being brought to the labour ward at 11.05 pm that the foetal heart rate had dropped.

Ms Cullen said she remembered a red button being pressed at 12.50 am to signal she needed an emergency caesarean section, but was told at 1 am that they were waiting for Dr El-Kininy’s go-ahead. She said her son was floppy, blue in colour and did not appear to be breathing when he was born at 1.30 am.

She claimed a consultant paediatrician did not arrive in theatre until 15 minutes after Aaron’s birth. Ms Cullen recalled that she could not see her baby at the time, but did notice that her husband was extremely upset.

‘All I could manage to do was pray to God that I would hear a cry,’ she added. ‘I recall feeling useless, and I just continued to pray over and over for God not to let anything happen to my son.’

Doctors in the Coombe Hospital, where Aaron was transferred, told her that they did not know what happened in a four-hour period in the Midlands Regional Hospital Portlaoise, where he had suffered a lack of oxygen to the brain.

Ms Cullen said it was ‘absolutely devastating’ to learn his chances of survival by staying in the Coombe were low. ‘The loss of Aaron has shattered the hearts of all his family, and we grieve his loss to this day,’ she said.

Dr El-Kininy gave evidence that he decided to refer Ms Cullen to the Coombe for an urgent scan after finding ‘massive’ polyhydramnios and expected she would have been seen in the days after the bank holiday weekend. The inquest resumes today.