Dr Vicki Nott testifies at inquest into pregnant lawyer’s death at St Vincent’s Hospital

A senior doctor at a Melbourne hospital has denied any knowledge a pregnant mother was as sick as she was in the hours before her death, defying the testimony of multiple medical professionals in an extraordinary day of evidence.

Obstetrician Dr Vicki Nott told a coronial inquest on Wednesday she acted as quickly as she could when Annie O’Brien arrived at St Vincent’s Hospital shortly after midnight on August 15, 2017, but lacked vital information into Ms O’Brien’s condition from her previous doctor which would have encouraged her to act faster.

An inquest began on Monday into the death of Ms O’Brien, who was 18 weeks’ pregnant when she died of sepsis after initially being diagnosed with gastroenteritis.

On August 14, Ms O’Brien, who was 37 in 2017, presented to Holmesglen Private Hospital in Moorabbin with a temperature of 40 degrees, vomiting, diarrhoea and back pains.

Holmesglen’s emergency doctor, Dr Hui Shi, told the inquest this week she did not think Ms O’Brien was “really sick” but said “with the benefit of hindsight” she would have tested Ms O’Brien for sepsis.

Shortly before midnight, Dr Shi transferred Ms O’Brien to St Vincent’s Hospital after a premature membrane rupture, and Ms O’Brien delivered her stillborn baby at 2:12am, the inquest has heard.

But in stark contrast with Dr Shi’s evidence, Dr Nott said the former doctor did not mention Ms O’Brien’s abnormally high temperature and was not aware she had received morphine.

When Ms O’Brien arrived at St Vincent’s Hospital, where she died the following afternoon, midwife Gillia Codd told the inquest she was “concerned” over the patient’s condition.

Dr Nott arrived at Ms O’Brien’s bedside at approximately 1:30am, and told the inquest she was “taken aback” by Ms O’Brien’s “grossly bloated” and “clearly agitated” condition, and further noted her “mental state was not normal” – a defining symptom of sepsis.

But contrary to midwife Gillian Codd’s evidence, Dr Nott said she had not been told how sick the patient was, and said she did not know of her concerning respiratory rate and oxygen saturation.

If she did, Dr Nott told the inquest, she would have contacted ICU immediately.

She said that by 1:30am she had considered a diagnosis of sepsis, and by 2:00am “was concerned the next stage would be cardiovascular collapse”.

Dr Nott said the ICU doctors “disagreed” with her assessment of Ms O’Brien at the time, who was ultimately rushed to the hospital’s operating theatre when Dr Nott noticed her stomach was blue and mottled.

“Her body’s shutting down,” Ms Nott said at the time, according to her colleagues from an earlier testimony.

When Dr Nott was grilled by barrister Sharon Keeling over why it took her 45 minutes from being first paged to arriving at Ms O’Brien’s bedside, Dr Nott replied she had “no idea” the patient was as sick as she was.