THE FAILURE by an obstetrician to carry out a growth scan on a baby who subsequently died of a genetic disorder was at a minimum “poor professional performance” and at most “professional misconduct”, an expert witness told a Medical Council fitness-to-practise inquiry yesterday.
Dr Joanne Gillham, a UK-based consultant obstetrician, said if she felt a baby was undersized, she would have arranged a growth scan to assess its size.
“No matter where you practise, if you have recourse to a growth scan, I cannot reconcile not using it,” she said.
David Mortell, a consultant at the Midlands Regional Hospital in Mullingar, faces seven allegations of professional misconduct at the inquiry. Allegations include that he failed to carry out adequate scans and measurements during the pregnancy of one of his patients and that he failed to communicate with her properly.
Ruairi Kenny was born by Caesarean section to Jane Kenny, from Mullingar, on December 5th, 2009, at 38 weeks.
He weighed 4lbs and was transferred to Our Lady’s Children’s Hospital, Crumlin, Dublin. He died there six days later, on December 11th, of Edwards syndrome, a condition that affects the heart and kidneys.
Solicitor for the Medical Council JP McDowell told the committee that Ms Kenny had been under the care of Dr Mortell during her previous pregnancy, when her first son Thomas was born by Caesarean section weighing almost 10lbs. She returned to Dr Mortell as a private patient when she became pregnant with Ruairi at the age of 43. She was also under the care of her GP.
Dr Mortell carried out five scans during Ms Kenny’s visits, but did not tell her he thought her baby might be small and did not send her for a special growth scan that could have indicated there was a problem with her baby. After the baby died and Ms Kenny had made a complaint to the Medical Council, Dr Mortell wrote a letter saying he was sorry he did not explain to her that the baby was small, although he had been happy with its progress.
Dr Gillham told the committee that in England if a doctor who had concerns about a baby’s size did not refer the mother for a growth scan, it would be considered professional misconduct. She accepted circumstances were different in Ireland, but “at a minimum I feel it would have to be poor professional performance”, she said.
Ms Kenny, a housekeeping manager at Trinity College Dublin, gave evidence that she and her husband decided to take their baby off his ventilator after his condition was confirmed as being not compatible with life. It was switched off at 4pm and he died in his parents’ arms just after 5pm. “That was the second time I managed to hold him,” Ms Kenny said. She told the committee if she had known there was a problem with Ruairi, she would have had him in a maternity hospital where he could have stayed with her. She would not have subjected him to the discomfort of tests and scans and she would have made the most of “every minute and every second”. “I would have rather had six hours that I could have held him myself,” she said.
“I would have been better prepared. I had no clothes to fit him . . . one of the hardest things, the day he died we left him in the hospital wrapped in a towel.”
Afterwards, Dr Mortell did not contact her and she did not see him again.
Counsel for Dr Mortell, Dr Simon Mills, said his client did not tell Ms Kenny he thought the baby might be small because he did not want to worry her.
The hearing has been adjourned to November 15th.
