£12,500 award in medical negligence suit

Damages of £12,500, plus costs, were awarded against the South Eastern Health Board in Waterford Circuit Court yesterday in a…

Damages of £12,500, plus costs, were awarded against the South Eastern Health Board in Waterford Circuit Court yesterday in a medical negligence suit arising from the death of a baby just 13 hours after his birth at Waterford Regional Hospital.

A claim against a Waterford gynaecologist, Dr John Gallagher, as co-defendant, was dismissed by the court, which found that he had acted at all times with due care and attention.

The action was brought by Dr Samina Khan and Dr Syed Amjed, who moved to Ireland from Pakistan in 1988. They claimed that failure to implement correct procedures in the delivery of their third child on August 9th, 1995, had resulted in his death from a condition known as myconium aspiration syndrome.

Evidence was given that post-mortem results showed the baby was also suffering from severe bronchial pneumonia, which a number of expert witnesses for the plaintiffs maintained would cause the foetus to asphyxiate.

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In trying to breathe, the baby ingested a foetal bowel product known as myconium, the presence of which indicates foetal distress. The mother, Dr Samina Khan, who is herself an experienced obstetrician, said that despite the presence of myconium from the time of her admission to the hospital on August 8th, Dr Gallagher had decided not to induce the birth but prescribed her antibiotics to fight off infection.

Evidence was given by nursing and midwifery staff at the hospital that a foetal CTG monitor indicated variable decelerations of the baby's heart rate during the early morning of August 9th. Dr Gallagher was contacted at 7.10 a.m. and arrived at the hospital between 7.40 a.m. and 7.50 a.m.

After he examined Mrs Khan, an emergency Caesarean section was carried out at 9.30 a.m, but when the baby was born at 10.02 a.m, he was blue all over, had a low heart rate and poor respiration, and there was myconium around the head. He was transferred to Our Lady's Hospital, Crumlin, but died 13 hours after birth.

Dr Gallagher said in evidence that when he had seen Mrs Khan at 6 p.m. on August 8th she was happy and comfortable and not in established labour.

He had discussed with her that his policy would be to wait for the onset of spontaneous labour, and she was happy with that. If she had not gone into labour that night, his intention was to induce her the following morning.

Dr Gallagher said that if he had been called to the labour ward earlier and had seen the CTG trace, he would have carried out a Caesarean section.

Judge Pat McCartan said Dr Khan had had two previous, relatively short and uncomplicated pregnancies. He was satisfied that the presence of slight traces of myconium at the early stages after her admission was not a significant factor in the outcome.

Myconium presence did become a significant factor at later stages, and it had been a significant factor in the baby's demise. But the most significant factor in the baby's death had been the pneumonia.

He could not accept that there had been any failure on Dr Gallagher's part, as he had left Mrs Khan in capable hands on the evening of August 8th and could have been readily contacted. There was also a senior house officer on duty at all times.

Judge McCartan said the evidence showed the regime at the hospital was clearly of the highest standard.

However, he was satisfied the decision was taken in the labour ward that night to wait and see how matters would develop.

This was, in his view, a wrong decision. The other factors which had arisen should have prompted action. "It was a clear failure of the duty to take reasonable care that the senior house officer or Dr Gallagher was not contacted," he said.

He found that Dr Gallagher had acted at all times with due care and attention, but the hospital had failed to act in its general duty of care.