Annie O’Brien: St Vincent’s Private Hospital midwife gives evidence to Coroners Court

Senior doctors at Melbourne’s St Vincent’s Hospital disagreed whether Annie O’Brien needed to be transferred to intensive care just hours before her undiagnosed sepsis death in August 2017, an inquest into her treatment has heard.

Gillian Codd, the on-duty midwife at St Vincent’s when Ms O’Brien arrived violently ill and 18 weeks’ pregnant shortly after midnight on August 17, also told the inquest on Wednesday she did not know why an unused dose of antibiotics was found in the room where Ms O’Brien was treated, but said “the whole team did everything possible” to save the young lawyer’s life.

Ms O’Brien, 37, was diagnosed with gastroenteritis at Holmesglen Private Hospital in Moorabbin on the evening of August 16 after presenting with a fever of 40 degrees, diarrhoea, vomiting and back pains, but was transferred to St Vincent’s when her membrane prematurely ruptured shortly before midnight.

She died the following afternoon, after miscarrying at St Vincent’s Hospital in Fitzroy.

An inquest into Ms O’Brien’s death began before State Coroner John Cain on Monday, the first two days of which have been spent hearing the testimony of Dr Hui Shi, the emergency doctor at Holmesglen, who was repeatedly grilled by lawyers over why Ms O’Brien was not tested for sepsis.

In her testimony, Dr Shi, who said Ms O’Brien did not appear “very sick”, conceded “with the benefit of hindsight” she would have run a crucial sepsis test on the night of her death.

On Wednesday, the inquest heard there was a disagreement over whether Ms O’Brien needed to be transferred to ICU, as witnesses testified to the worsening and “agitation” of her condition, even after the administration of seven litres of oxygen per minute and antibiotics.

Ms Codd said she was “concerned” when Ms O’Brien arrived, and told the inquest her temperature was not consistent with gastroenteritis.

She said after Ms O’Brien delivered her stillborn baby at 2:12am, which Ms Codd had been told was “probable” after her premature membrane rupture, the patient received Ergometrine, Zofran, Ceftriaxone, Syntocinon and other injections over the next hour.

Ms Codd said that at 2:55am, St Vincent’s ICU doctor attended Ms O’Brien at the request of obstetrician Dr Vicki Nott, who believed she needed to be transferred to ICU, but the ICU doctor disagreed.

In her testimony, Ms Codd said Ms O’Brien “appeared to become more agitated,” and at 3:10am was further administered Piperacillin and Tazobactum.

At 3:20am, Ms Codd lifted Ms O’Brien’s shirt, noticed her chest was mottled, and feared “her body was shutting down”.

At 4:10am, she said she was made aware of an unused dose of Flagyl in the room where Ms O’Brien was initially taken, but did not know why it hadn’t been administered.

In another troubling passage of evidence, Ms Codd said a male paramedic, who transferred Ms O’Brien from Holmesglen to St Vincent’s, asked the midwife if the amount of blood being discharged from Ms O’Brien’s vagina was normal, and added that “it seemed like a lot” but had been told it was “fine” by staff at Holmesglen.

Ms Codd testified that Ms O’Brien “certainly became more unwell” during her time at St Vincent’s, but said she did not appear to be “critical” when she first arrived.

Ms Codd, who at times needed to pause during her testimony, said Ms O’Brien “has never left” her thoughts.

“I believe that the whole team did everything possible,” Ms Codd said.

She said Ms O’Brien joked to her when she arrived at St Vincent’s about having “felt better”.

The inquest continues.