A woman died at home after three doctors failed to notice she had a hernia.

Hull Coroners' Court heard Elizabeth Sarah Smith, 34, of Whitehope Close, Bransholme, died on April 8 after she was twice discharged from Hull Royal Infirmary on April 5 and 6.

The mother-of-four had gone to accident and emergency on both occasions complaining of severe pain in her abdomen and vomiting.

However, three doctors failed to notice she had a hernia, despite it having been diagnosed on April 3 by a nurse practitioner at her GP's surgery.

Instead, they diagnosed her as having constipation and sent her home with medication.

Mrs Smith died from peritonitis - a huge infection of the body - after the untreated hernia ruptured.

The court heard written evidence from two independent experts, which concluded she had received substandard care on each occasion.

Dr Francis Morris, a clinical director in emergency medicine with 23 years experience, said to check the groins of a patient with Ms Smith's symptoms for hernias during an abdominal examination was "standard practice".

However, not one of the three doctors who examined her had recorded in their notes whether they had examined the groins.

The experts concluded Mrs Smith would not have died if the hernia had been spotted.

Speaking to the court, her husband Simon Smith said he had told medical staff treating his wife she had been previously diagnosed with a hernia.

The court also heard the first nurse to assess Mrs Smith when she attended hospital had made a note of a possible hernia.

However, all three of the doctors who later examined her said they did not recall being told she had been previously diagnosed with the hernia.

Hull and East Yorkshire Hospitals NHS Trust has launched an internal investigation into Mrs Smith's death.

Her family are also taking legal action against the trust.

Coroner Geoffrey Saul returned a narrative verdict, in which he summarised the evidence given throughout the inquest.

He said: "Elizabeth Sarah Smith died at home on April 8 from peritonitis, as a result of a ruptured incarcerated inguinal hernia.

"The presence of the hernia was not identified on examination at hospital on April 5 and 6.

"If it had been identified on either of those dates, it is likely that surgical intervention would have followed prior to the development of peritonitis and, with such intervention, there is a likelihood that Elizabeth Smith would have survived."

Adrienne D'Arcy, acting on behalf of Hull and East Yorkshire Hospitals NHS Trust, said: "The expert opinion will be fed back to the trust, whose investigation into this incident is continuing.

"The trust wants to establish the root cause and learn lessons from this case."

The trust said it could not comment further as legal proceedings are now active.