Finding into death of Michelle Johnson

31y · Female·Ruptured splenic artery aneurysm with extensive retroperitoneal and intraperitoneal haemorrhage

Michelle Johnson, a 31-year-old pregnant woman at 32 weeks gestation, presented to the Royal Women's Hospital with sudden-onset severe left-sided abdominal pain and hypotension on 21 March 2010. She was assessed by registrar Dr F. and covering specialist Dr L., with initial low blood pressure attributed to musculoskeletal pain from dancing. Investigations were unremarkable. After discharge that evening, she collapsed the following morning and was found to have a ruptured splenic artery aneurysm, a rare but recognised pregnancy complication. The coroner found her initial assessment was appropriate and no failure to diagnose represents medical deficiency, given the condition's extreme rarity. However, communication breakdowns occurred between hospital staff and the private obstetrician. The key clinical lesson is that intra-abdominal haemorrhage must be considered in differential diagnosis when pregnant women present with severe abdominal pain requiring narcotic analgesia.