The death of an Indian dentist who died after a miscarriage in an Irish hospital was the result of medical misadventure, an inquest jury ruled Friday.
Savita Halappanavar, 31, was 17 weeks pregnant when she died in October at University Hospital Galway.
The inquest jury heard seven days of evidence from staff and expert witnesses, as well as her widower, Praveen Halappanavar.
A pathologist, Professor Grace Callagy, told the inquest the cause of death was septic shock, E. Coli in Savita Halappanavar's bloodstream and a miscarriage.
In his evidence, a leading obstetrician said Halappanavar's life could have been saved had a termination been carried out a day or two before her miscarriage.
However, Dr. Peter Boylan admitted it would not have been practical under Irish law, which states there has to be a real and substantial risk to the mother's life.
The coroner, Dr. Ciaran MacLoughlin, on Friday directed jurors at Galway Coroner's Court to consider carefully the verdict and his recommendations, including that Ireland's Medical Council should lay out exactly when doctors can intervene to save the life of a mother.
The jury unanimously returned the misadventure verdict and "strongly endorsed" his recommendations.
MacLoughlin told the dentist's husband: "The whole of Ireland has followed your story and I want, on their behalf, to offer our deepest sympathy."
Outside the court, Praveen Halappanavar said he still had not got all the answers but would "get to the bottom of the truth."
Somebody has to take responsibility for his wife's death, he said.
He told reporters that the way Savita had been treated in the hospital was "horrendous, barbaric and inhuman."
Friday was particularly poignant as it would have been the couple's fifth wedding anniversary, he added.
In his evidence last week, Praveen Halappananvar said that he had been told an abortion could not be done while the fetus was still alive because Ireland is a Catholic country.
The couple were married in India before moving to Ireland, where they had lived for four years before Savita's death.
Giving evidence last week, consultant Dr. Katherine Astbury, who treated Halappanavar, denied saying an abortion could not be carried out "because Ireland is a Catholic country."
But she acknowledged that she felt constrained by Irish law, which does not permit a termination even if there is no prospect of the fetus surviving.
Astbury also admitted that there were "system failures" in Halappanavar's care. For example, Astbury had not been made aware of blood test abnormalities and an infection, she said.
A midwife at Galway hospital, Ann Maria Burke, apologized in her evidence for telling Halappanavar a termination would not be possible "because Ireland is a Catholic country." She said the comment was not meant to be hurtful.
Halappanavar went into the hospital on October 21, complaining of back pain. Three days after the request for a termination was made, the fetus died and was removed. Four days later, Savita died of a blood infection.
An inquest by a coroner is standard procedure in cases of sudden, unexplained or unnatural deaths in Ireland.