Annie O’Brien’s obstetrician knew there was a golden hour to administer antibiotics for sepsis, but it took even longer for the expectant mother to get the drugs she needed.
The 37-year-old died of multiple organ failure caused by the infection hours after delivering her stillborn baby and less than 24 hours after falling ill in August 2017.
Another obstetrician earlier prescribed rest and paracetamol when she reported symptoms of gastroenteritis, but when her condition did not improve, Ms O’Brien went to private Holmesglen Hospital.
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When her membranes ruptured spontaneously at 18 weeks, she was rushed to St Vincent’s Private Hospital where her own obstetrician, Dr Vicki Nott, was due to meet her.
Dr Nott arrived around 1.30am – more than an hour after Ms O’Brien – and immediately diagnosed with sepsis.
She told an inquest into Ms O’Brien’s death on Thursday that there was a golden hour – a principle that antibiotics should be given within an hour of a diagnosis of sepsis.
Dr. Nott admitted to prioritizing delivering the baby over giving the antibiotics.
Ms O’Brien did not receive her first dose until 2.46am.
The drugs were then only administered when midwife Raechel Miller, who had been with Ms O’Brien since she arrived at 12.15am, noticed the syringe lying on a bedside table.
She didn’t know who ordered it or who put it there, but immediately asked Dr. Nott whether to give it to her and then administer the dose.
Ms Miller said she asked when Ms O’Brien arrived if she even had to be there because she was so ill.
“We wouldn’t normally have a patient appearing like that on the ward. I wondered in my mind if this was where Annie should be,” she said.
Almost an hour later, Ms Miller found a syringe containing a dose of a second antibiotic that had not been administered.
Ms O’Brien had already been transferred to the theater by then, said Ms Miller who was unaware the drug had even been ordered.
Ms O’Brien’s father, retired GP Brian Moylan, acknowledged the distress the young midwife had experienced caring for his daughter.
Ms Miller has since changed careers.
“Personally, the impact of this event meant that I was unable to continue working as a midwife or nurse, despite my efforts to do so,” she said.
“It was an incredibly traumatic experience.”
In an expert opinion, Professor Mark Umstad said Ms O’Brien had the classic symptoms of sepsis.
“There is an unexpected delay in the timely initiation of antibiotics, both at Holmesglen Private Hospital and upon arrival at St Vincent’s Private Hospital,” he wrote in a submission to the coroner. of State John Cain.
“As Ms O’Brien was clearly septic and ill, I am unable to determine the reason for the delay.”