Doctor in baby death case forced to delay C-section as no nurses were free
Published 17/06/2014 | 02:30
A CONSULTANT obstetrician delayed an emergency Caesarean section because there was no nursing staff available to man the operating theatre.
An inquest heard how baby Jamie Flynn died two days after his birth at Cavan General Hospital on November 22, 2012.
Health Minister James Reilly has instructed the State's health watchdog HIQA to undertake a review of maternity services at Cavan General following a series of baby deaths at the hospital.
Two other newborns died within the space of three weeks at the hospital, in April and May this year.
At yesterday's inquest, consultant obstetrician Dr Salah Aziz told how he opted to try delivering Jamie using instruments first because he knew that on-call nursing staff were already tied up at another emergency C-section.
Dublin Coroner's Court heard that expectant mother Fiona Watters was admitted to the hospital for induction on November 20. She was given Prostaglandin, a hormone used to induce labour, over the next two days.
She was seen by Dr Aziz for the first time on the morning of November 22. He said they discussed the possibility of a C-section but she told him that she would like to try a "normal delivery". He broke her waters and the baby's heart rate was monitored over the course of the day.
At 10.30pm midwife Breege Lavin contacted him to say that Ms Watters had been pushing for an hour but the head was not visible.
The obstetrics registrar and special house officer on duty were carrying out an emergency C-Section on another woman and were not available.
Dr Aziz arrived at the hospital at 10.45pm. Because nursing staff were already at another procedure he was "left with no choice" but to try delivery using a vacuum or forceps in the labour ward.
The instrumental delivery failed and Ms Watters was transferred to theatre where the emergency C-section was carried out. Nursing staff had become available after the other patient stabilised, the court heard.
"I was fully aware from my previous experience that there could be a significant time delay before a second theatre could be opened," Dr Aziz said.
He said that evidence of hypoxia – or lack of oxygen – was not "clear cut" on the baby's foetal heart monitor.
Baby Jamie, of Tara Court Square, Navan, Co Meath, was born shortly before midnight in very poor health. He was transferred to the Rotunda Hospital in Dublin where he died in his mother's arms two days later.
At post mortem, pathologist Dr Deirdre Devaney found that Jamie suffered a brain injury prior to birth.
The post mortem found no apparent cause, however, Dr Devaney said she was not given the placenta to examine despite requesting it. As a result, an issue with the placenta cannot be excluded as a potential cause.
Ms Lavin told the court that there were three C-sections carried out that day and when she went to collect the placenta there were three and she could not determine which one belonged to Jamie.
Coroner Dr Brian Farrell said he was adjourning the inquest to consider the evidence and whether expert opinion was required.
The inquest was put in for further mention on July 29.