Injuries from failed forceps delivery led to baby's death
Saturday November 21 2009
FAILED attempts at delivery using medical instruments left a baby boy with severe head injuries which led to his death the following day.
Baby Parker Meredith-Doyle died at the National Maternity Hospital in Holles Street, Dublin, just one day and 10 hours after his birth by emergency caesarean section on April 18 2008.
Yesterday, an inquest at Dublin City Coroner's Court heard that he suffered a brain haemorrhage as a result of "an attempted instrumental vaginal delivery" using a vacuum cup and forceps.
The hospital accepted there were shortcomings in the management of the delivery and that these led to Parker's death, solicitor for the hospital John Gleeson said.
Caroline Meredith, from Dublin 2, who had a failed forceps delivery 13 years earlier which resulted in injuries to her child, was admitted to the delivery ward at 10pm on April 17 and received an epidural. The baby's heart rate and progress was monitored.
At 2.40am on April 18, registrar in obstetrics Dr Rita Mehta attempted to deliver the baby with a vacuum device (ventouse cup) but delivery was not achieved.
She then applied a forceps before using another type of vacuum cup, to no effect.
At that point, the inquest was told, midwife Martina Cronin, who was "very concerned that the attempts at instrument deliveries had failed," suggested that Dr Mehta contact Dr Orla Sheil, a consultant in obstretrics.
Ms Cronin then telephoned Dr Sheil and when she returned to Caroline Meredith, found that Dr Mehta had reapplied forceps to deliver the baby.
Dr Mehta said she had stopped after two "pulls".
Dr Sheil arrived between 3.15am and 3.20am where she found Ms Meredith in a "distressed" state. She proceeded to emergency caesarean section and the baby was delivered at 3.53am.
"Baby Parker was very seriously ill at birth" said Dr Sheil, who told the inquest she found the position of the baby's head was different to Dr Metha's finding and not suitable for forceps delivery.
A post mortem found abrasions and bruising on the baby's head and neck, , bruising to his face and cheek and behind the ears, and bruising and abrasions on his forehead.
His scalp was swollen and there was a large amount of bleeding beneath the scalp.
Consultant perinatal pathologist Dr Peter Kelehan said there was haemorrhage, which can be a recognised complication and another type of haemorrhage, which he had never seen in a baby before.
He said this indicated "severe trauma to the baby's head" and consistent with the application of forceps and ventouse.
Coroner Dr Brian Farrell recorded a verdict of death by medical misadventure.
He said there were a number of risk factors, including Ms Meredith's previously failed forceps delivery.
"Failed instrumentation resulted in severe head injuries to the baby", he said. He expressed his condolences to the parents.
- Georgina O'Halloran
Irish Independent
