Woman who died from rare aneurysm had no ultrasound due to lost form, inquest hears

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By court reporter Candice Marcus

A young pregnant woman who died at Adelaide’s Women’s and Children’s Hospital from a rare aneurysm did not undergo a scan because the form requesting the ultrasound was lost, an inquest has heard.

The Coroners Court heard Mellanie Joanne Paltridge, 25, was 23 weeks pregnant when she collapsed at a shopping centre in April 2012.

She was taken by ambulance to the Women’s and Children’s Hospital complaining of severe pain in her upper left abdomen.

She died the next day during emergency surgery and her premature baby, Mackenzie Rose Paltridge, also died.

The court heard Mrs Paltridge suffered a rare pregnancy-related condition of a ruptured splenic artery aneurysm.

The court also heard an ultrasound was ordered for Mrs Paltridge, but it did not take place because the request form never reached the sonographer.

Counsel assisting the coroner, Naomi Kereru, said sonographer Catrina Panuccio will give evidence that she never received the form.

“Ms Panuccio conducted two scans on the 15th of April 2012, neither of those scans were with Mrs Mellanie Paltridge,” Ms Kereru said.

“She will give evidence that she does not recall seeing a request form for Mrs Paltridge.

“Extensive inquiries by the court have not been able to locate the request form necessary for the scan to be done.”

Eight reported deaths in Australia from rare aneurysm

Ms Kereru said there had been only eight reported deaths in Australia relating to the condition in pregnant women since 2000.

But she said that included a pregnant woman who was treated and died at the Women’s and Children’s Hospital in 2009.

The inquest will examine whether adequate training was given to medical staff in the wake of that death.

A lawyer for the hospital objected to case notes being tendered in the inquest into Mrs Paltridge’s death.

Ms Kereru said expert witnesses will give evidence that Mrs Paltridge presented with textbook symptoms of the rare aneurysm and her death could have been prevented.

She said the inquest would look into whether a ruptured splenic artery aneurysm should have been considered before Mrs Paltridge collapsed, and if it had have been detected, whether it would have saved her life and the life of her daughter, Mackenzie.

The inquest will also look into why the ultrasound did not take place, whether a splenic artery aneurysm could have been been visualised and whether Mrs Paltridge should have been given a pre-operative blood transfusion to prepare for the anaesthesia.