Doctor 'failed to spot patient's blood loss'

A YOUNG doctor failed to spot that a patient had lost more than half of her blood just hours before she died, an inquiry has heard.

Dr Kate Mitchell, 28, had only six months' experience and had been left in charge just a handful of times when she was the on-call doctor for Marlene Wightman.

Mrs Wightman was bleeding to death following a breast cancer operation at the Western General Hospital.

But Dr Mitchell had never dealt with a breast surgery patient before that night and failed to take the woman's size into account when considering her blood loss.

Giving evidence at the inquiry into the 47-year-old's death, Dr Mitchell admitted that she did not appreciate the seriousness of the operation Mrs Wightman had undergone earlier that day.

The doctor said she looked to nurses caring for Mrs Wightman for reassurance after the patient – who weighed just 48kg – lost almost one-and-a-half litres of fluids from surgical wounds.

At Edinburgh Sheriff Court today, Dr Mitchell said she had qualified as a doctor in 2005 and had her first placement in Kirkcaldy Royal Infirmary in August that year.

She began work at the Western General in Edinburgh in February, just a month before mother-of-two Mrs Wightman died.

Dr Mitchell said she had begun her on-call shift at 1pm and was due to finish at 11pm on March 22, 2006 – the day before Mrs Wightman's death.

At 5pm she was left in charge of four wards and dozens of patients, but could call on consultants if need be.

She said she had only been left in this way for "one week and a couple of days" before tragedy struck with Mrs Wightman.

Dr Mitchell was bleeped by a nurse who asked her to examine Mrs Wightman. She found the patient to have lost 1,250ml of "blood stained fluids" into drain bottles connected to her surgical wounds.

She added that to the 235ml she believed Mrs Whiteman had lost during surgery but did not take account of how small the 4 ft 11 inches woman was.

When nurses told her it was a "normal" or "slightly more than normal" amount she said she was reassured.

But when asked by fiscal depute Pauline Shade for an estimate of Mrs Wightman's blood Dr Mitchell replied: "It would maybe be about 2,700ml, something like that, that's an approximate."

When asked if she took account of Mrs Whiteman's size she said: "I would have known that a patient's weight would have affected the circulating blood.

"I didn't know her weight. It's not something that is routinely checked when assessing patients on call. Maybe it should be."

Mrs Wightman died in the early hours of the next morning after her vital signs crashed later that night.

The inquiry continues.