A woman who died following a late-stage abortion procedure after travelling from Ireland to England was discharged from the clinic despite vomiting and swaying so much she looked "drunk", an inquest has heard.
Aisha Chithira (31) travelled to England to have a termination at a Marie Stopes clinic in Ealing, west London, on January 21st, 2012.
She suffered a tear to her uterus during the “blind” procedure performed under anaesthetic, as a surgeon struggled to remove a 22-week-old foetus from a womb that had not fully dilated, West London Coroner’s Court heard.
Afterwards she vomited in a stairwell and complained of feeling unwell to her husband, but was helped into a taxi to a cousin’s home in Slough by staff at the clinic. They had told her she could not stay overnight.
One of the nurses denied they had pressured her to leave because they had wanted to go home.
Corinne Slingo, representing Marie Stopes, said: "The taxi driver says he saw his passenger walking out of the building. He was quite shocked, she didn't seem with it at all. She looked like she was drunk."
Reading from a statement, she added: “The nurse got her in a hug and she said ‘Don’t do that, you will break my bones’.”
Ms Chithira’s husband Ryan said he received a call from her at around 7.30pm as he cared for their daughter in Ireland.
“Aisha told me she had finished having the procedure and was going to get a taxi back to Slough,” a statement read to the court said.
“She just said ‘I cannot speak, I’m feeling too weak to speak’ and then she ended the call.
“I kept ringing her but there was no reply, Aisha didn’t ring back or reply to my texts – I thought at first she had arrived in Slough and just wanted to rest.
“Her sister called me, this was at 12.42am. She asked me where Aisha was and I said she was in Slough, she said she wasn’t in Slough.
“Ten minutes later she called me back and said someone had called her and Aisha was dead.”
Ms Chithira had suffered catastrophic internal bleeding and died the same night.
Dr Adedayo Adedeji, who performed the procedure, and nurses Gemma Pullen and Margaret Miller, were charged with manslaughter by gross negligence and a health-and-safety breach, but the case was dropped in 2016.
Ms Pullen said she helped out on the ward after other staff left in the evening.
She told the hearing Ms Chithira had been to the toilet where she passed blood with her urine – which was “consistent with a late stage termination”– and had “thrown herself” on the floor. Her blood pressure gave a normal reading once she was taken back to the ward.
“Come to about 8 o’clock and Aisha is the only one left on the ward and the taxi had been ordered for her. Margaret came and discussed with her that she couldn’t stay overnight, which is what she was asking for,” the nurse continued.
“We took her to the top of the stairs and she was sick.”
They led her back to the ward, where she stayed for another 20 to 30 minutes and her vital signs were checked, Ms Pullen said.
“Then she stood up and said ‘I’m ready to go now’. At that time I thought she was quite anxious.”
As she climbed into the taxi, “she said she was feeling hot, she had been complaining of feeling hot”, the nurse continued. She had also been hyperventilating.
Pressed by Ms Slingo on the taxi driver’s description of the swaying patient, she said: “That doesn’t sound right to me. She was walking unaided, she wasn’t swaying, she was walking normally.”
On the comments allegedly made by Ms Chithira, she said: “I’m saying that didn’t happen.”
Ms Slingo asked: “The point when you placed her in the taxi, did you have, as a nurse, any additional concerns?”
“No, if I did I wouldn’t have sent her,” the nurse replied.
“That she ‘wanted to leave’ because you all wanted to go home?” she was asked.
“That’s not true,” the nurse replied.
Dr Adedeji said they had noticed the tear during surgery but it had not been bleeding at the time.
Ms Chithira, who was from Malawi but had settled in the Republic of Ireland, had a history of non-cancerous growths around the womb called fibroids which made the procedure more complex.
She had decided to have an abortion after miscarrying twins and then having her baby delivered by C-section, making her worry that childbirth was too much of a risk.
The patient was given tablets to soften the neck of her womb five hours before the operation, but it had not dilated as expected, the doctor said.
The surgeon, who said he had performed about 2,000 terminations, said the procedure was performed “blind” but added: “On this occasion the head was really right up the uterus and I decided to use the (ultrasound) scan to look at exactly where it is.
“The neck of the womb was not that compliant in the sense it was not dilated, it was not satisfied.”
He denied the tear could have been caused by damage from his surgery or from him cutting a fibroid, adding: “There was no bleeding, it wasn’t at the time that it was bleeding.”
The delay in the bleeding starting could have been due to the drip Ms Chithira was attached to for two hours following surgery, he added.
Acting senior coroner for west London Dr Sean Cummings is expected to continue hearing the case on Friday at 10am. – PA