Wednesday 7 December 2016

Patient received unnecessarily high dose of labour medication, inquiry told

Liz Farsaci

Published 14/11/2016 | 16:17

Dr Salah Abdel-Aziz Ahmed, a consultant obstetrician leaves a fitness to practice enquiry by the medical council at Finnstown House in Lucan. Picture credit: Damien Eagers
Dr Salah Abdel-Aziz Ahmed, a consultant obstetrician leaves a fitness to practice enquiry by the medical council at Finnstown House in Lucan. Picture credit: Damien Eagers

An inquiry into the care of three mothers by a consultant obstetrician heard a patient received an unnecessarily high dose of a labour medication that can lead to foetal distress.

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Dr Salah Aziz Ahmed faces allegations of poor professional performance and professional misconduct relating to three women who gave birth at Cavan General Hospital between November 2012 and April 2014.

The Medical Council inquiry, which began last week, continued today in Lucan, Co. Dublin.

Last week, the inquiry heard details involving one of the patients, a 37-year-old woman, referred to as Patient One, whose baby passed away 32 hours after he was born.

The baby was born by emergency caesarean section on the night of 22 November 2012 and it is alleged that Dr Aziz failed to proceed to the section in a timely manner.

Expert witness Joanna Gillham, a consultant obstetrician based in St Mary’s Hospital in Manchester, told the inquiry this morning that the Syntocinon administered to Patient One during her labour exceeded the dosages outlined in hospital guidelines.

Dr Gillham said Syntocinon, a medication used during labour to strengthen and increase contractions, can be used to very good effect to help progress labour. However, if used incorrectly, she said, it can cause foetal distress.

On the evening of 22 November, the Syntocinon administered to Patient One was increased from 90 mls per hour to 150 mls. This sharp increase in the medication “was unnecessary and could lead to foetal compromise”, Dr Gillham said.

She also raised concerns regarding the findings of the CTG machine that monitored the baby’s heart-rate throughout the afternoon and evening of 22 November.

Looking at a copy of the trace, she said: “There are ongoing areas of foetal heart rate concerns for many hours before Dr Aziz entered the hospital [at 10.45pm].”

Dr Aziz faces an allegation that he instructed that the administration of Syntocinon be increased from 90 mls pr hour at 9.40pm [on 22 November] to 180 mls per hour at 10.57pm in the presence of prior hyper-stimulation or evidence of a pathological CTG.

Dr Gillham also testified that the notes from the abdominal exam which Dr Aziz performed on Patient One shortly after he arrived at hospital indicated the head was too high for an operative (instrumental) vaginal delivery to be possible.

The allegations before the inquiry also claim that Dr Aziz engaged in prolonged attempts at an operative vaginal delivery in inappropriate circumstances and that he failed to proceed to a caesarean section with adequate expedition. Dr Aziz denies the allegations against him.

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