Obstetrician made ‘astonishing mistake’, inquiry told

A doctor made “an astonishing mistake” while performing a Caesarean section, a Medical Council inquiry heard on Thursday.

Dr Andrea Hermann allegedly left the lower half of a mother's uterus "in the breeze" after failing to suture the section properly, Dr Hermann's former supervisor claimed.

On Thursday, consultant obstetrician and gynaecologist Dr Heather Langan, from Sligo General Hospital, gave evidence in relation to Dr Hermann, who is facing a number of allegations regarding the care she provided to six patients at the hospital in 2013 and 2014.

Dr Langan told the inquiry of the chaotic scene in the operating theatre on January 22nd, 2014, while Dr Hermann was performing an elective Caesarean section on a mother referred to as Patient F.

Dr Langan, who was in the theatre observing Dr Hermann, said the baby was delivered swiftly.

But Dr Langan then saw the baby had a serious laceration on her head that was about half a centimetre deep and 1½ centimetres long. Dr Langan ran next door to get the general surgeon, in case they needed help with suturing the baby’s laceration.

Concern

Upon her return, she found Patient F’s husband collapsed on the floor, having fainted, and staff were attending to him. Dr Langan then turned her attention to the mother, and she remembered that Dr Hermann told her that she couldn’t see the ovaries.

Dr Langan became concerned when she looked at the mother, as she couldn’t see the bladder, and asked Dr Hermann to stop.

“What I found was that she had managed to suture the abdominal wall to the uterus, and had left the lower part of the uterus in the breeze, effectively,” said Dr Langan.

“My concern was that what she had done in surgical terms made absolutely no sense. To miss the entire lower part of the uterus and not suture it – I’d never seen anyone do that. It’s an astonishing mistake.”

Dr Langan, who completed the surgery, said she was concerned the mother would bleed heavily if she had not intervened, pointing out that massive obstetric haemorrhages were still one of the biggest killers of mothers today.

Dr Langan said that after concerns had been raised about Dr Hermann, they looked at the number of Caesarean sections she had done at the Sligo hospital, and found she had only carried out 12. Dr Langan said, however, that Dr Hermann must have performed many others, as she had previously worked at the consultant level.

Expert witness Dr Philip Owen, a consultant obstetrician and gynaecologist based in Glasgow, told the inquiry on Thursday that Dr Hermann demonstrated a "very sub-standard approach" to the closing of Patient F's uterus.

“The approach to closing a uterotomy is recognised and straightforward,” said Dr Owen. “Somewhat remarkably, Dr Hermann has completely failed to take these basic steps.”

Surgical skill

Dr Hermann, who previously worked as an obstetric and gynaecology registrar at Sligo General Hospital, faces allegations of professional misconduct and poor professional performance, as well as a contravention of a provision of the Medical Practitioners Act 2007.

In relation to Patient F, it is alleged that Dr Hermann failed to display any or adequate surgical skill during the closure of a uterotomy. A uterotomy refers to the opening of the uterus during, in this case, an elective Caesarean section.

Patrick Leonard, senior counsel on behalf of the chief executive of the Medical Council, pointed out to the inquiry that Dr Hermann does not face any allegations in relation to the laceration on the baby's head.

The inquiry continues at a later date.