Medic may have ended pregnancy by mistake, inquiry told

A doctor probably mistook fluid in a woman’s ovary for an ectopic pregnancy before giving her medication to terminate it, an expert has said.

Dr Philip Owen also said it was more than likely the woman had a continuing normal pregnancy in her womb when she was given the medication.

It is alleged at a Medical Council inquiry that a consultant obstetric and gynaecologist, identified as Dr A, wrongly diagnosed an ectopic pregnancy in the case of mother-of-three Laura Esmonde at South Tipperary General Hospital in January 2013 when the pregnancy was actually in the womb.

The Medical Council inquiry previously heard that Dr A advised the woman that the safest course of action was for her to take two courses of methotrexate, a medication used to stop ectopic pregnancies from growing.

Surgery was not an option, according to Dr A, because of the blood thinners she was taking for a clot in her leg.

On the evening of January 8th, Ms Esmonde took her first dose of methotrexate. On January 17th, she was readmitted for a second dose.

No further ultrasound was conducted before this second dose, she said, although her husband requested one.

On January 26th, she was transferred to Cork University Hospital for treatment of the leg clot, where a scan indicated her pregnancy was not ectopic.

A further scan showed a normal intrauterine pregnancy but it was no longer viable. Ms Esmonde miscarried on February 2nd.

No detected heartbeat

On day five of the hearing, Dr Owen, a consultant obstetrician and gynaecologist in Glasgow, said he couldn’t say for sure that an ectopic pregnancy didn’t exist but that it was “extremely unlikely”.

He also told the committee hearing the case that he couldn’t be certain the woman had an ongoing normal pregnancy because no one ever detected a heartbeat but that it “seems overwhelmingly likely” she did.

The inquiry heard that the woman underwent four ultrasound scans and that three medical professionals said they believed they were “at least suspicious of an ectopic pregnancy.”

The committee asked Dr Owen about the assertion by one doctor that one of scans showed a “right tubal ectopic pregnancy”.

“My interpretation is he was looking at small fluid area within the right ovary and mistook it for an ectopic pregnancy,” Dr Owen said.

The committee asked him if it was possible that “group-think” could take hold in these situations, with everyone agreeing with the first diagnosis.

Dr Owen said this can happen and that is why a consultant must step back and assess the situation “because the final decision rests with him.”

The inquiry continues on Wednesday.