Your scenario definitely is the higher possibility, but it's still not the only one. If you run out of your resources/cooldowns you will run out of mana shortly after. There is an exponential increase in power whenever you pull more groups.
Mitigation cool downs become more powerful
Offensive buffs become so much more powerful
If people use a decent number of their cooldowns on the first pack, the second pack is going to take longer to kill, you're not doing to have the cool downs (mit/heals/offensive) you need, you're possibly not going to have regenerated enough resources, etc.
Certain abilities (mainly resource based heals) are a big source of MP regeneration for healers. So if you don't have them not only are you losing out on a "free heal", but you're also not gaining MP and instead losing MP. That's another exponential issue.
If I'm playing SGE and have 6000 MP left, I could:
Use Druochole for an Addersgall for 700 cure potency and end up with 6700 MP
Use Physis for a HoT and stay at 6000MP
Use Eukrasian Diagnosis for 840 cure potency and end up with 5100 MP
If I don't have the resource for Druochole or the cooldown for Physis, then I am 1600 MP "worse off" than if I did. The game definitely makes it easy to stay in the realm of "Everything is Ok", but that's partially because of the exponential gains in the "efficient" way of playing the game (i.e. wall to wall pulls). Once you start peeling away certain efficiencies, you can really get to "Everything is not ok" fairly fast.
BUT, misplaying is still the more likely reason that a healer will run out of mana, yes.



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