Woman says ectopic pregnancy was wrongly diagnosed

A mother who allegedly received a wrong diagnosis of an ectopic pregnancy has told a disciplinary hearing of her distressing experience.
Woman says ectopic pregnancy was wrongly diagnosed

It is claimed a consultant obstetric and gynaecologist, referred to yesterday as Dr A, wrongly diagnosed an ectopic pregnancy in the case of mother-of-three Laura Esmonde, when she presented at South Tipperary General Hospital.

Ms Esmonde, 38, from just outside Tipperary Town, attended the hospital’s A&E on January 6, 2013, with a swollen leg. A routine urine test revealed she was pregnant, which she had not known. The following day, an ultrasound of her leg showed she had a clot.

Ms Esmonde also asked for an ultrasound of her pelvis because she wanted to see the baby. Her husband was due into the hospitaland she wanted to tell him the good news. The stenographer said she could not see anything, and called in a consultant radiologist. He performed a scan, and Ms Esmonde said he told her there was a possibility she had an ectopic pregnancy. On January 8, Dr A performed a transvaginal scan, and, according to Ms Esmonde, told her she had “an ectopic pregnancy of unknown location”.

“He told me my uterus was empty,” she added.

Dr A advised she take methotrexate, a medication used to stop cells from growing which can be used to treat ectopic pregnancies. Surgery was not an option, according to Dr A, because of the blood thinners she was taking for the clot in her leg.

“He was very nice to me, so I had trust in him,” said Ms Esmonde.

On the evening of January 8, Ms Esmonde took her first dose of methotrexate. On January 17, she was readmitted for a second dose which she took on January 18. No further ultrasound was conducted before this second dose, she said, although her husband requested one.

On January 26, she was transferred to Cork University Hospital for treatment of the leg clot, but a scan indicated her pregnancy was not ectopic. A further scan showed an intrauterine gestational sac, but the pregnancy was no longer viable. The possibility of doing a D&C — a procedure to remove products from the uterus — later in the week was discussed.

After that conversation with doctors, Ms Esmonde returned to the ward. “I was very upset. It was the eeriest of things. It was very distressing,” she said.

On January 29, a consultant came in to discuss the possibility of holding off on a D&C, and perhaps putting her on folic acid. “For one split second, I thought maybe everything was going to be OK but immediately, I thought about the two doses of methotrexate and the damage that had been done to the baby,” she said. “I was very upset. I was so angry.”

Ms Esmonde miscarried on February 2.

She later made a complaint about Dr A to the Medical Council.

Dr A faces the allegation of poor professional performance, based on eight factual allegations relating to his alleged diagnosis of an ectopic pregnancy despite the ultrasound images not being diagnostic of an ectopic pregnancy. The case continues.

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