Belfast Telegraph

Thursday 21 August 2014

Tragic mum may have put off A&E visit because of long wait

Blood clots: Cara Officer
Blood clots: Cara Officer

A mother who died from a rare blood condition may have been put off going to A&E for treatment because of a five-hour wait just days before her death, an inquest has heard.

Cara Officer (36), from east Belfast, was 26 weeks' pregnant when she died on June 12, 2011, at the Ulster Hospital after contracting thrombotic thrombocytopenic purpura (TTP), which causes the formation of blood clots within the circulation.

The hearing marks the first time there has been an inquest in Northern Ireland into the stillbirth of a baby.

On the afternoon of Friday, June 10, 2011, Ms Officer's friend Angela Campbell telephoned the Linen Court Surgery on the Beersbridge Road to inform a doctor that Ms Officer was feeling unwell.

Mrs Campbell told Dr Thomas McCaw that her friend's face had fallen to one side, and that her left arm was numb.

Dr McCaw proceeded to try and telephone Ms Officer, without success. He called her twice and left a voicemail message.

During a telephone conversation with Mrs Campbell a short time later, Dr McCaw said that he offered to phone an ambulance for Ms Officer and told Mrs Campbell that Cara should go to A&E.

Mrs Campbell said that she would check with Ms Officer before calling him back.

Dr McCaw told the inquest that Mrs Campbell said Ms Officer was upset she had called the doctor and insisted she did not need help.

Counsel for Ms Officer's family asked the doctor if a house visit would have been an appropriate response since Ms Officer's home was just 50 metres away from the surgery.

Dr McCaw admitted that "with hindsight it would have been right to do a house visit.

"Her friend Ms Officer did not want any further contact, so I accepted that as being her decision."

Dr Lorna Holmes, who had been Ms Officer's GP for nearly 12 years, since April 2000, but was not in the practice when Ms Officer fell ill, also gave evidence to the inquest.

Dr Holmes said that her patient's long wait the last time she was admitted to hospital was possibly a factor in her not wanting to return to hospital.

The GP said: "I think the wait on the Tuesday might have put her off. I think she found that wait quite horrific."

Ms Officer's lawyer asked Dr Holmes why she didn't request a blood test when she saw Ms Officer in the weeks leading up to her death, when she was complaining of headaches and diahorrea.

Dr Holmes explained how Cara had been tired after caring for her daughter who had been ill, and put her illness down to this.

Dr Gary Benson, a consultant haematologist with the Belfast Trust, told the inquest that this was the first case of TTP in pregnancy in Northern Ireland.

The inquest continues.

FACTFILE

Thrombotic thrombocytopenic purpura (TTP or Moschcowitz syndrome) is a rare disorder of the blood-coagulation system, causing extensive microscopic clots to form in the small blood vessels throughout the body.

These small blood clots, called thrombi, can damage many organs including the kidneys, heart and brain. In the era before effective treatment with plasma exchange, the fatality rate was about 90%.

Pregnancy can be a predisposing factor in the disease. The symptoms of TTP may at first be subtle, starting with malaise, fever, headache, and sometimes diahorrea.

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