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"Misdiagnosed miscarriage"

About: King Edward Memorial Hospital / Emergency Department

(as the patient),

I recently called the health hotline as I had experienced mild bleeding - a few tablespoons of blood with mild cramping and trace clots at 9 weeks pregnant after my 6th round of IVF. They advised me to go to the emergency room to see a doctor as soon as I could.

I presented to the emergency department of King Edwards Memorial Hospital thinking this would be the best place I could go and described my symptoms.

The nurse needed my blood information but could not find my blood records with Australian Clinical Labs even though I had been going for bloods almost weekly for years doing IVF. They asked the student doctor if they could take bloods. The student doctor said they were not comfortable, the nurse then attempted to take my bood but failed. This made me more distressed and uncomfortable that they couldn't take simple bloods or find my records.

The student doctor took my history and I explained it was not more than a few tablespoons of blood and I was not in much pain.

My friend had come to support me as I have no family in Australia and she'd also had fertility struggles and experiences.

A few hours later a doctor came in and said they would perform a pelvic exam however they may not be able to perform an ultrasound as it was the weekend and this was not an emergency so they wouldn't be calling in an ultrasound technician. The doctor said it may not be indicative but the pelvic exam may show the cause of bleeding and potentially rule out miscarriage. My friend asked if there was anywhere else we could go, maybe a private hospital that might have a radiologist, King Eddie's didn't know if any place or any technicians that could provide the service.

A while later a midwife and the doctor performed the pelvic exam and explained that my cervix was dilated and that "product" was coming out and that I was indeed miscarrying. I was distressed and cried very heavily and was uncomfortable to say the least, considering there were no stirrups on the bed and they didn't take the speculum out. I had to wait for them to get the resident doctor to also view and confirm my state so waited with a speculum inserted for quite a while. The other doctor finally came, had a look and confirmed that my cervix was open and I was miscarrying and there was nothing that could be done. They took a sample of the "product" for analysis.

The doctor said they would not be writing me a referral for an ultrasound as they were sure I had miscarried and there would be no point as there would be nothing left in there to scan. I was given a small plastic sample cup and asked if I would collect and return additional "product" for them to analyse if large clots came out. My friend had multiple miscarriages and persisted to ask if I could have a scan and if there was any other follow up or monitoring required (which was standard in her past experience). We were told no, there was nothing more to be done and it would not be standard to request a scan or follow-up as they were sure I was miscarrying. 

I was told I was no longer pregnant so there would be no risk of drinking or any pain medication or any other activity that would normally be a risk while pregnant and that pain medication would likely be required.

We even talked about the intention of drinking with the midwife and doctor and they were not opposed.

The doctor provided me with a medical certificate for 7 days and I was discharged without any further paperwork or direction.

After returning home I drank wine for the first time in 9 weeks and took a Tramadol, a Celebrex and had a very hot bath and mourned. I cried very heavily for days and continued to drink wine. I took a sauna and had a massage and allowed the practitioner to use pressure points not suggested during pregnancy. I cancelled my obstetrician appointments, contacted the IVF clinic and told my friends and family I had lost the baby, all of which was very painful. I went to work and continued to eat drink, took medication and generally conducted myself as if I were not pregnant. Strangely enough I only had minor spotting following my hospital admittance.

The IVF clinic said I would need to book in for an ultrasound and bloods as soon as possible so that they could monitor the pregnancy loss and determine if I require a D&C. Not something I was looking forward to.

I returned from work in the evening 10 days after I went to the ED and presented to the radiologist for an ultrasound the next day. The ultrasound confirmed a very active, live baby, with a stable heartbeat!

I was in disbelief and grateful for the apparent miracle. Then realised it was no miracle, but a complete blunder on the part of the doctors at King Edwards. 

This misdiagnosis put both myself and my unborn child under extreme distress and the misinformation and guidance provided put my unborn child at risk of birth defects and miscarriage. I believe I should have been provided the ultrasound to confirm my diagnosis or at the very least a referral. I believe I should have never been told they were certain I was miscarrying, and if any doubt was had, I should have been told to wait a certain period of time and have a follow-up scan. 

My obstetrician said you can't determine if a cervix is dilated a small amount visually, that you need to manually inspect, something that was not done. 

I truly hope that no one ever has to go through the pain, loss, and distress that I've experienced. The anger and frustration with the misdiagnosis, misinformation and guidance I was given that has now put my unborn child at risk is indescribable.

Responses

Response from Jodi Graham, Executive Director, Women and Newborn Health Service 2 months ago
We are preparing to make a change
Jodi Graham
Executive Director,
Women and Newborn Health Service
Submitted on 27/08/2021 at 14:00
Published on Care Opinion at 14:01


picture of Jodi Graham

Dear MKMKMKM,

Thank you for reaching out to us via Care Opinion to share your experience with the Women and Newborn Health Service (WNHS).

I am sorry to read of the incredibly stressful situation that you went through when you attended the King Edward Memorial Hospital (KEMH) Emergency Centre (EC). For an expectant mother or family who are eagerly awaiting their baby’s arrival, especially after undergoing IVF, hearing that they have miscarried is distressing. I understand that receiving the information sometime later from your IVF clinic that you in fact were still pregnant would have been shocking and confusing to you, and I am so sorry that this situation occurred and put you in a situation that led you to believe you weren’t pregnant.

The events that you have described are very serious and our service would like the opportunity to provide you with an investigation into this situation so that we can provide you with a personalised response and assurance we will strive to improve our service. Should you agree, I encourage you to contact the WNHS Consumer Liaison Service on (08) 6458 1444 or via email WNHSCLS@health.wa.gov.au.

Thank you for providing me with the feedback regarding the access to your blood tests. Your feedback identified that a change in our procedure is required. KEMH are now in discussion with ClinicalLabs to implement a system to provide our clinicians with access to results for patients that present to our EC.

I can reassure you that our staff work as hard as they can to be able to provide ultrasound examination at all times. While we are always prepared to attend to any emergency with all our resources at different times, skills like the use of an ultrasound can be in high demand. Our teams are always striving to provide an exceptional level of care to patients and this may involve different diagnostic techniques and examination to diagnose the problem. However, we are working to ensure that ultrasound is available to our patients 24/7.

I would again like to apologise to you for the experience you had at KEMH and encourage you to contact the Consumer Liaison Service so that a full investigation can be carried out. Thank you for taking the time to share your experience with me. I understand that this would not have been an easy task for you. I wish you and your family all the best for the future and I do hope that we hear from you soon.

Kind regards,

Jodi Graham

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