Annie O’Brien: Inquest into young lawyer’s death hears bombshell evidence
An inquest into a pregnant young lawyer’s sudden death has heard from the emergency doctor who first treated her.
The doctor who first examined a pregnant woman at a Melbourne hospital has told an inquest she “didn’t think she was sick” in the hours before her misdiagnosed sepsis death, and conceded she made an error in not running a crucial sepsis test.
In a bombshell day of evidence, a coronial inquest into the 2017 death of Annie O’Brien also heard that a sepsis protocol sheet was available at the hospital, but may have been unused on the night of the young lawyer’s death.
Ms O’Brien, 37, died in August 2017 of sepsis after originally being diagnosed with gastroenteritis.
At 18 weeks pregnant she attended Holmesglen Private Hospital in Moorabbin with a temperature of 40C. She was vomiting and had diarrhoea and back pain.
When her waters broke, she was taken to St Vincent’s Private Hospital but died two hours after a still birth.
A two-week inquest before State Coroner John Cain, which began this week in Melbourne, is investigating her death.
On Tuesday, Dr Hui Shi, the emergency department physician who diagnosed Ms O’Brien at approximately 8:30pm, said that with the “benefit of hindsight” she would have tested her lactate levels before and after rehydration, a test that would have given Dr Shi a clearer indication of the existence of sepsis.
Dr Shi said she “did not think” Ms O’Brien was very sick, and told the inquiry she expected her to improve over the coming hours – although did not agree with her patient that she could go home that night.
Dr Shi was subjected to protracted questioning from barrister Sharon Keeling, who said as a “whole” Ms O’Brien’s symptoms pointed towards her having sepsis, not gastroenteritis.
Ms Keeling asked Dr Shi if she considered herself to be an “inexperienced” doctor in August 2017 and asked her multiple times if she should have tested Ms O’Brien’s lactate levels before and after she rehydrated.
Dr Shi was also repeatedly grilled as to why she assumed a diagnosis of gastroenteritis with Ms O’Brien
Dr Shi responded that Ms O’Brien did not show any signs of organ failure, which would have been more symptomatic of sepsis, and gave evidence that her condition seemed to be improving throughout the night.
Dr Shi said Ms O’Brien’s vital signs appeared to be improving throughout and her ECG results were “unremarkable.”
When Ms O’Brien’s membrane prematurely erupted shortly after 11:30 Dr Shi called obstetrician Dr Vicki Nott at St Vincent’s Hospital, where Ms O’Brien was transferred to before midnight.
Again, Dr Shi said with the “benefit of hindsight” she would have considered sepsis as a possibility after Ms O’Brien’s membrane broke.
The court also heard from the head of ED at Holmesglen, who told the court a laminated sepsis protocol sheet was available at emergency in August 2017.
Dr Raja Berua said under questioning that he attached the protocol sheet to the statutory declaration he provided the inquest and said it was his memory it was available at the time of Ms O’Brien’s presence there.
The inquest was shown a document where under the title “Sepsis Warning Signs” guidelines were written regarding a patient’s temperature, heart rate, respiratory rate and blood count.
The inquest continues.