999 pregnant patient rethink after tragic death of mum-to-be
A&E staff at Whittington were unaware ill woman was expecting a baby
25 October, 2019 — By Emily Finch
The Whittington Hospital
THE Whittington and the London Ambulance Service (LAS) have changed the way they treat critically ill pregnant patients following the death of a 40-year-old woman.
Senior coroner Mary Hassell, at St Pancras Coroner’s Court, recommended that the Archway hospital and the LAS make changes after Fern-Marie Choya, of Highbury Crescent, died in February when she went into respiratory arrest.
In her Prevention of Future Deaths report, Ms Hassell was critical of how the “crucial” detail of Ms Choya’s pregnancy was not conveyed to the Whittington’s A&E department before her arrival by ambulance.
She wrote that it took “16 minutes post-arrival for the pregnancy to be recognised and the obstetric team to be called” meaning Ms Choya’s initial treatment did not consider her pregnancy.
Ms Hassell added: “By the time of the laparotomy [a surgical incision into the abdominal cavity] it was too late to save Ms Choya.”
The report highlighted how the ambulance crew who initially treated Ms Choya were told she was pregnant “at the very outset” by her husband.
But Garrett Emmerson, the chief executive officer of the LAS, said in his response to the coroner that the ambulance crew did not “confirm” Ms Choya’s pregnancy to the control room who act as the intermediary between them and hospitals.
The person in the control room did not in turn “pursue and confirm this possibility” of Ms Choya’s pregnancy either.
Mr Emmerson noted that “this is why that information was not passed on in the pre-alert information call to the emergency department”.
Workers at the control room of the LAS convey patient details to A&E departments within a “pre-alert” call when they are critically ill.
Mr Emmerson added: “Had the correct information been passed, the focus of Ms Choya’s treatment may have been different.”
As a result of her death, the LAS has now “re-issued” and “extended” their guidance “to clarify the relevant details expected during pre-alert calls, to ensure that the appropriate clinical team is present on a patient’s arrival” at hospital.
The LAS have also planned a joint training session with the Whittington on how they manage pregnant patients.
Staff at the hospital’s emergency department have also been provided with “modified” guidance that prompts them to ask if a patient is pregnant when liaising with the ambulance service before arrival.
Ms Choya was a devoted Arsenal fan and a keen blogger who often chronicled her travels around the globe and her struggles with living with the chronic disease Lupus.
Ms Hassell gave Ms Choya’s main cause of death as “hypovolaemic shock due to massive intro abdominal bleeding” and “rupture of the abnormal gravid uterus”.