Midwives opinion disregarded by doctor

Trust to pay millions after brain damaged boy's 'mismanaged birth'
This story was reported in The Independent UK, it is a sad story of a mother’s (Kristi Riches) labour & subsequent birth in 2001 that went wrong and resulted in her child (Oscar) being born with catastrophic cerebral palsy, severe cognitive deficit, impaired vision, epilepsy and painful muscle spasms. The midwives involved in the care of Kristi were very troubled and tried to influence the doctor’s course of action, to no avail.

Oscar Riches would have been unharmed and grown up to live a normal life if he had been born swiftly by emergency Caesarean, Mr Justice Holroyde heard at London's High Court.
But the delay at Eastbourne District General Hospital had left the now seven-year-old with catastrophic cerebral palsy.
Oscar's counsel, James Badenoch QC, said that East Sussex Hospitals NHS Trust had admitted liability because of the behaviour of the locum obstetric registrar - an overseas doctor who has now left the UK - who "grossly mismanaged" his birth. Mr Badenoch said that before Oscar's birth, the heart-rate trace showed that he was in great jeopardy but not yet damaged.
But the locum "inexplicably" insisted that Mrs Riches should continue in labour and then failed in a ventouse delivery. Eventually extracted by forceps, Oscar was severely asphyxiated with the umbilical cord tightly around his neck and did not breathe spontaneously for 20 minutes.

"It was effectively an admission of negligence against the doctor - it was not a system failure... and we are happy to acknowledge that the midwives were very concerned and did seek to influence the doctor to take prompt and effective action."

Mr Badenoch said that the locum refused to speak to the midwives, hummed and whistled while attending to Mrs Riches after the birth and wrongly recorded the amount of blood lost when she suffered a potentially dangerous haemorrhage.

"It was effectively an admission of negligence against the doctor - it was not a system failure... and we are happy to acknowledge that the midwives were very concerned and did seek to influence the doctor to take prompt and effective action."
Mr Badenoch said that the locum refused to speak to the midwives, hummed and whistled while attending to Mrs Riches after the birth and wrongly recorded the amount of blood lost when she suffered a potentially dangerous haemorrhage.
It was also reported that as a result of the trauma of Oscars’ birth in December 2001, Kristi (mother) suffered stress and anxiety that she could not contemplate having any more children.
It was not believed that he had worked again in this country but his present whereabouts were unknown.
Oscar is totally helpless and would require constant care long as he lived, which was likely to be into his 20s, funded by an agreed lump sum payment of £1.118m plus annual payments.

Mrs Riches who, with her husband Clive, cares devotedly for Oscar at their home in Glenleigh Park Road, Bexhill-on-Sea, East Sussex, has reached a further undisclosed settlement with the authority for her psychiatric injury.

It is interesting to see the CTG submitted as evidence relating to the fetus’ well being; however there was no mention of any fetal scalp sampling or cord bloods. Also the midwives documentation and concern were duly noted, it would be good to examine this case further to see what other options the midwives may of had in relation to the doctors who were leading this case.


Reference:Posted by The Independent
Friday, 30 January 2009 at 06:54 pm
Published: 2009-01-30 14:18:38
Author: By Jan Colley, Press Association

e-learning: Introducing the K2ms fetal monitoring (CTG) teaching package.

e-learning is this the way of the future? Yes, is the answer, the question is, how do we balance the present with the future? Our institution has introduced the K2ms (medical system) Fetal Monitoring ( http://www.k2ms.com/contact/index.html) self directed learning package. Personally I think this is a great package, it is systematic and clear, you can work at your own pace. You can repeat sections until you are satisfied that you understand the concepts being taught and you can move ahead quickly if you need to. The instructions are reasonable to follow. The program provides case studies for you to work through, it is the fun bit like a virtual game, however providing good learning examples. However I am very familiar with computers and make sure that I keep up with current trends. This program may not be so easy for someone who is not use to learning in this way.
There are some aspects of the computer world I find quite frustrating, such as, trying to add new features to my blog. Working with computer programs can be very frustrating and time consuming, and at times even a waist of time. So how does someone cope who has never used a computer?

Yes all our students now currently use computers, however if the average age of a midwife is 45yrs old - it would stand to reason that there are some midwives that will find it very challenging to move to a e-learning framework.

Do all health professionals have a personal computer? do they like using a computer, do they all use email? do they know about Facebook, myspace, Internet banking, eBay etc...... there are so many areas in life that are influenced by technology, yet e-learning is very challenging. Is this because there are issues that may influence this such as: eye strain, concentration of looking at computer screen, do they actually learn in this way if they do not like this method. For some people interaction in its self enhances the learning experience.

We have many e-learning packages, such as: Breastfeeding modules, manual handling package, emergency preparedness and the list goes on.

Are we losing the face to face teaching? is there room for both methods? do we need to ensure that both methods of teaching are still available for our health professionals?

What are some of your experiences regarding e-learning?

How can we make the transition smoother for our less technologically minded colleagues?