A condition so uncommon most doctors will never see it has been blamed for the death of a 36-year-old and her unborn son.
An inquest found that the “very rare” blood disorder claimed the life of Cara Louise Officer and her baby, but several different opportunities had arisen which may have made diagnosis possible.
The blood disorder – Thrombotic Thrombocytopaenic Purpura (TTP) – is so unusual that “the vast majority of doctors, midwives and nurses would never encounter it in the course of their careers”, said coroner John Leckey.
Ms Officer, from Bloomfield Road, Belfast, was admitted to the Ulster Hospital with stroke-like symptoms on June 12, 2011, but died despite efforts at resuscitation.
She had been 26 weeks pregnant, and her baby (her second child) was delivered stillborn by c-section.
The coroner found there were times when she had been in contact with medical professionals, that events could have been set in motion which could have led to the condition being identified.
For instance, on June 7 she went to the Day Obstetric Unit of the Ulster Hospital, where a high pulse rate was recorded.
She waited four-and-a-half hours before a junior doctor misinterpreted her symptoms as a migraine, and she was discharged without a full blood count being taken (which may have led to diagnosis).
However, the coroner said only a haematologist would have been able to identify the disorder correctly and experts offered evidence that a junior doctor would not have suspected TTP.
The South Eastern Health Trust offered its “deepest sympathy on the tragic death” adding that it “heightened the awareness of this rare disease which will make staff better prepared to manage a patient presenting with such an unusual condition like this in the future”.
On May 21 she complained to a GP of back pain and strange-coloured urine, and was treated for a urinary infection.
Her symptoms later included tiredness, diarrhoea, headache, and numbness of the face.
By June 10 she was so bad that friends, a midwife and locum doctor advised her to go to hospital – but she ignored the advice due to a previous long wait (see left), although by then there was a “compelling and urgent need” to attend, said the coroner.