The National Maternity Hospital, the biggest maternity hospital in the State, did not have full ultrasound scan services at weekends in 1992, the High Court has been told. Dr Joseph Stanley, a retired consultant obstetrician, said full scan services were not available when Mrs Avril Gallagher, of Moneystown, Roundwood, Co Wicklow, one of his private patients, was admitted to the hospital at Holles Street, Dublin. It would have been helpful if such services were available, he said. Dr Stanley was giving evidence on the 21st day of an action for alleged negligence taken against himself and the hospital by Mrs Gallagher's son, Blaise (6), who is quadriplegic, has cerebral palsy and will require lifelong care.
Blaise was born at the NMH on April 27th, 1992, during the 29th week of his mother's pregnancy. The defendants deny negligence.
Yesterday, on the opening day of the defence case, Dr Stanley, who is 66 and retired, said he had first seen Mrs Gallagher in his private consulting rooms in June 1990 after she had suffered a spontaneous miscarriage. He saw her at an ante-natal visit in November 1991, when there was nothing abnormal, and on later dates. When he saw her on April 14th, 1992, everything was normal and he had no reason to anticipate any untoward developments in her pregnancy. Early on April 25th, a Saturday, Mrs Gallagher had phoned to say she felt her "waters had gone" and he arranged for her to go to Holles Street, where she was admitted about 5 a.m. He saw her there between 9 and 9.30 a.m. when he carried out an examination. If rupture of the membranes was unconfirmed, Mrs Gallagher could go home, he said.
He was informed at 8 p.m. that rupture had been confirmed. He indicated Mrs Gallagher was for an ultrasound scan the next morning. One of the serious effects of spontaneous rupture was the possibility of foetal abnormality. The ultrasound department would not be geared to deal with the special examination he might request, Dr Stanley said. A simple ultrasound would be available but biophysical profile of this baby would be part of the Monday-Friday service only. His problem was to get a scan for foetal abnormality.
When he saw Mrs Gallagher about 11 a.m. on the Sunday he told her of his intention to deliver by Caesarean section. Her condition and that of the baby were satisfactory. Early on Monday he got a phone call from Mrs Gallagher's husband to say she had phoned from the hospital saying she had been in labour from about 10 p.m. Dr Stanley said he phoned the hospital to ask what the situation was. The information he received was quite satisfactory. A nurse said Mrs Gallagher was asleep.
When he got the information that Mrs Gallagher had been transferred to the delivery ward with a breech presentation in labour, he instructed the nurses in delivery to arrange for theatre, to call the assistant master and to get the anaesthetic registrar. He said he himself would be in the hospital within 10 minutes.
When he got there he and the assistant master delivered the baby within five minutes. He agreed with his counsel, Mr Murray McGrath SC, that a number of events had occurred in the hospital involving Mrs Gallagher of which he had not been informed. He would have appreciated a phone call from the hospital after Mrs Gallagher had told of experiencing a flush of water and, later, twinges or impulses. Dr Stanley said he should have been informed by the hospital when Mrs Gallagher later complained of pains. Had he received such a call, he believed he would have had her transferred to the delivery room for observation where she would have received more intensive attention.
Dr Stanley said he would have absolute confidence in the judgment of Nurse McCarthy, the principal midwife on duty that night. He was not phoned when Mrs Gallagher told Nurse McCarthy about 2 a.m. that her pains had got worse and had asked that Dr Stanley and her husband be phoned.
Dr Stanley said he was in the NMH that day about 2.15 a.m. delivering a baby for another woman, but was not aware of the events surrounding Mrs Gallagher. When Mrs Gallagher complained at about 5.20 a.m. that her pains were very strong, Dr Stanley said he would have expected her to be re-examined.
"She would probably be in labour," he told Mr Justice Quirke. If he had been notified, he would have gone in and delivered the baby.
Cross-examined by Mr Richard Nesbitt SC, for Blaise and his mother, Dr Stanley said he would have expected to be informed of any change in the patient's condition by the nursing staff.
The hearing continues today.