THE CONSULTANT obstetrician and gynaecologist who treated Evelyn Flanagan at Mayo General Hospital before she died said yesterday he would not treat her differently if he had his time over.
Dr Murtada Mohamed said Ms Flanagan suffered only "moderate" blood loss after delivering her baby at 12.30pm on October 18th, 2007, and he wasn't concerned by the bleeding.
He said he had dealt with much more severe cases and the patients' lives had been saved. "I've dealt with more blood loss than that," he said.
He said a hysterectomy he performed had stemmed the blood flow and he believed if amniotic fluid hadn't entered Ms Flanagan's bloodstream (amniotic fluid embolism), she would still be alive.
He said amniotic fluid embolism was very rare, difficult to predict, difficult to diagnose and difficult to treat, something disputed by John Jordan, counsel for Ms Flanagan's husband.
He said the fact that Ms Flanagan's blood pressure was low after giving birth was not unusual after a woman had had an epidural.
Mr Jordan put it to him that Ms Flanagan had lost 1.5 litres of blood, when there are just five litres in a body, before being taken to theatre.
He put it to him that it was too late to save her by the time she was taken to theatre. "That is not true, I totally deny that," Dr Mohamed replied.
Mr Jordan also asked why he wasn't present at the birth when Ms Flanagan had retained him as her private consultant. He said she delivered the baby very quickly on the morning in question and the baby had been delivered quickly by another doctor when its heartbeat began to drop. He arrived just afterwards.
"You do not expect a consultant to sit in the labour ward for 24 hours," Dr Mohamed said. He said with private patients he could be there only "if conditions allow".
Mr Jordan also put it to him that had he looked up Ms Flanagan's medical records from her first pregnancy in 2005, he would have seen that she suffered a third degree tear after that delivery, and he could have then been on the lookout for another uterus tear after the second delivery.
He said he took a verbal history from Ms Flanagan and she only mentioned a slight bleed after the birth of her first child.
The inquest heard a 6cm tear in Ms Flanagan's uterus was only detected when she was taken to theatre some time after 3.30pm.
Asked by Mr Jordan why the source of her bleed wasn't investigated earlier, Dr Mohamed said the team at Mayo General dealt with her bleed in a very efficient way. She was given medication.
"We don't want to jump and take every woman's uterus out," he said.
He said when the amniotic fluid got into the blood stream it could cause acute respiratory distress syndrome and haemorrhage.