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Ultrasounds did not show signs of pregnancy, Medical Council inquiry told

Laura Esmonde said the hospital told her not to contact a junior doctor
Laura Esmonde said the hospital told her not to contact a junior doctor

A Medical Council inquiry into allegations that a consultant obstetrician at South Tipperary General Hospital wrongly diagnosed an ectopic pregnancy when it might have been viable has adjourned until tomorrow.

The patient, Laura Esmonde, said that when she went searching for answers as to what happened, South Tipperary General wrote to her telling her not to contact a junior doctor.

Ms Esmonde told the inquiry, which began yesterday, that the junior doctor had administered the drug Methotrexate to stop her pregnancy on the advice of 'Dr A'.

She said that when she contacted the hospital to speak to the junior doctor and get her surname, they would not give it out and suggested the doctor might be abroad.

Ms Esmonde said she felt "disillusioned" at how she had been treated.

She finally got an internal review report around September 2013.

The inquiry has already heard that after tests in January 2013 the consultant obstetrician 'Dr A' recommended a drug for the ectopic pregnancy as the safest option.

Later that month Ms Esmonde was transferred to Cork University Hospital to treat a blood clot and doctors there said the pregnancy was in the womb, was not ectopic but was now not viable.

Barrister Simon Mills, for 'Dr A', told the inquiry that his client will say he informed Ms Esmonde in early January that there was no evidence of a pregnancy in the womb, and that he did not know where the pregnancy was but he believed it most likely to be ectopic.

A radiographer told the inquiry she conducted an ultrasound scan on Ms Esmonde's left leg, to check for a blood clot, on 7 January 2013 at South Tipperary General.

She also found an abnormal mass on the right side of her pelvis and did not see an embryo in her womb.

She said that at this point she called a consultant radiologist for an opinion and he did a scan.

She said he also saw nothing in the womb but saw something suggestive of an ectopic pregnancy near the pelvis.

The radiographer, who the inquiry asked not be named, said she was not trained in obstetric scanning.

South Tipperary General consultant radiologist Dr John Hynes said that ultrasound scans performed on Ms Esmonde showed no obvious signs of an early pregnancy.

He said she had a life-threatening leg clot.

Dr Hynes said nothing was seen in the uterus, although this was not unusual, as it was very early in her pregnancy and it was also an external ultrasound scan.

He added that there was a mass on the right side of her body and it raised the suspicion it might be an ectopic pregnancy.

Any possibility of an ectopic pregnancy in this case was significant, he said, given that Ms Esmonde was on anti-blood clotting treatment and if there was a rupture, it could be a catastrophic event.

Dr Hynes said the case was unusual as Ms Esmonde had two life-threatening conditions, a major leg clot and a suspected ectopic pregnancy.

Dr Keelin O'Donoghue, consultant obstetrician and gynaecologist at Cork University Hospital, said she performed an ultrasound on Ms Esmonde at the hospital on 27 January 2013, with another consultant colleague present.

She said she saw what looked like an early pregnancy in the womb, but she could not say if it was viable.

Dr O'Donoghue said that at South Tipperary General, Ms Esmonde had been given methotrexate, which is embryo-toxic and she had been transferred to Cork to manage her leg clot.

Dr O'Donoghue said she told Ms Esmonde the news that it might have all along been a pregnancy in the womb, which she said was probably a shocking thing to say.

She also explained that it was likely the pregnancy would not now be successful.