Antibiotics left in hospital room as woman miscarried then died

Potentially lifesaving antibiotics prescribed to a pregnant woman as her health deteriorated at a Melbourne hospital were left forgotten by her bedside and not administered as she miscarried her unborn baby and later died.

An inquest into the death of Annie Moylan heard things happened “quite fast” once she arrived at St Vincent’s Private Hospital via ambulance, just after midnight on August 14, 2017. The patient had come from Holmesglen Private Hospital’s emergency department, where a doctor had diagnosed her with gastroenteritis.

Midwife Gillian Codd leaves the inquest into death of Annie Moylan.Credit:Jason South

But on Wednesday, the midwife in charge of the St Vincent’s Hospital maternity ward, Gillian Codd said she believed Moylan was seriously unwell when she arrived.

“It no longer looked like gastro or food poisoning,” Codd said.

“I was wondering whether [Moylan] was suffering from an infection.

“I was concerned about her.”

Annie Moylan, who had a miscarriage and died aged 37 after a failure to diagnose her sepsis.

State Coroner John Cain is investigating the death Moylan, who was 37 years old, and 18 weeks and five days pregnant when she arrived at Holmesglen Private Hospital in Moorabbin earlier that night with severe vomiting, pain, a high temperature and diarrhoea.

There, emergency department doctor Hui Shi diagnosed Moylan with gastroenteritis before she began to miscarry. Moylan was then taken by ambulance to St Vincent’s Private Hospital, where her obstetrician, Vicky Nott, worked.

Moylan’s condition worsened and she died there at 2pm.

A post-mortem examination determined her cause of death was intrapartum septicaemia, secondary to a group A streptococcal infection.

On Wednesday, Codd told the coroner she was working as the midwife in charge on August 14, 2017, when she received a call from Nott advising her Moylan was coming to the hospital in an ambulance.

Codd said she chose room eight, away from the main ward to give Moylan and her family some privacy as they were told she may miscarry her baby.

Moylan arrived about 12.15am with a high temperature of 39 degrees and appeared very unwell, Codd said.

The inquest was told one of the male paramedics who arrived with Moylan then asked the midwife “what is normal blood loss?” and said he’d noticed about 400 millilitres when loading the patient for transfer.

The paramedic told Codd that when he had queried this with Holmesglen staff, he was told it was “all fine”.

Codd said she called Moylan’s obstetrician – who was on her way to the hospital – soon after to advise her of the patient’s condition.

Over the hours that followed, the inquest heard, Moylan continued to lose blood and her temperature remained high.

Hospital records showed Moylan’s obstetrician arrived about 1.30am and at 2.10am asked that antibiotics Ceftriaxone and Flagyl be administered.

But when Moylan delivered her stillborn baby at 2.12am, Codd said another midwife left those antibiotics on top of the patient’s locker while other medications were prioritised to address the miscarriage.

The inquest heard by 3am, Moylan had lost about 830 millilitres of blood and while changing her gown, Codd said she noticed the colour of her chest changing.

Another staff member then said “her body is shutting down” before Moylan was taken to an operating theatre.

Codd said about 4.10am she learned the unused Flagyl antibiotic had been found in room eight on top of a cabinet after staff failed to administer it. By then Moylan was already in theatre.

She died at 2pm.

“Antoinette has never left my thoughts since I met her that night. My thoughts and deepest condolences to her whole family. I believe the whole team did everything possible and the best they could, given the circumstances,” Codd said.

The inquest continues.

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