Published Wednesday, 09 October 2013
The 31-year-old, who was 17 weeks pregnant, had asked for a termination after being told she was having a miscarriage.
Staff refused and she died days later, having developed an infection.
A report published on Wednesday by the Health Information and Quality Authority said there was a failure to recognise that Mrs Halappanavar was developing an infection.
There was also said to be a failure to act on signs of deterioration in her condition.
A number of "missed opportunities" were also identified in the report. If acted upon, the health authority said there may have been a different outcome for the young woman.
A total of 34 recommendations have been made in the report regarding improvements to be made in the care of clinically deteriorating pregnant women.
The authority has also called for a national maternity services strategy to ensure that women receive safe and reliable care.
In April, an inquest into Mrs Halappanavar's death ruled that she died due to medical misadventure.
© UTV News