A senior gynaecologist caused an unborn baby to be accidentally decapitated in her mother’s womb, a tribunal has found.
Dr Vaishnavy Laxman, 43, should have given the 30-year old patient an emergency caesarean section as the premature infant was in a breech position, but instead tried to carry out a natural delivery.
When the doctor urged the patient to push whilst she applied traction to the baby’s legs, the head became detached in the mother’s womb.
Two other doctors subsequently carried out a c-section to remove the head, which was “re-attached” to his body so that his mother could hold him.
The tribunal said it accepted that by the time the head became detached, during the bungled delivery at Ninewells Hospital, Dundee, in March 2014, the baby was already dead.
Dr Laxman, who qualified in India before coming to the UK in 2004, denied any wrongdoing at a Medical Practitioners Tribunal Service in Manchester, and said she believed the baby would have died had a c-section been carried out.
But at a “finding of facts” the panel chairman Tim Bradbury said it was her decisions and her “increasingly desperate” attempts to deliver the head that caused the decapitation.
He added: “…the central issue in this case is whether Dr Laxman’s decision to attempt a vaginal delivery of Baby B rather than an immediate caesarean section under general anaesthetic was clinically indicated, or whether the only proper course in the circumstances would have been to proceed to an immediate caesarean section.
“Dr Laxman had not sufficiently addressed in her mind the risk to Baby B by proceeding with a vaginal delivery – namely the risk of head entrapment and the delay this complication would inevitably cause.”
The tribunal also said she should not have assumed a c-section would have no prospect of success.
The chairman added: “The decision to proceed with vaginal delivery represented a failure in her clinical decision-making on the evidence available to her at the time.”
The tribunal heard that the mother’s waters had broken early at 25 weeks and her baby was found to have a prolapsed cord, and was in a breech position whilst the mother’s cervix was between 2-4cm dilated. It can be 10cm fully dilated.
Mr Bradbury said the body was delivered without difficulty, but the head became trapped in the uterus, with the neck in the cervix.
He added: “There then followed what was to become, in the tribunal’s view, an increasingly desperate attempt to deliver Baby B’s head.
“Because of the pain and distress that Patient A was by this time experiencing the decision was made to administer a general anaesthetic following which further attempts were made to incise Patient A’s cervix and extract Baby B by means of traction.
“While Patient A was under general anaesthetic, Dr Laxman continued to make attempts to deliver Baby B by traction and ultimately Baby B’s head became detached from his body.”
He also said that as the patient was only 4cm dilated it should have indicated to Dr Laxman that it was “insufficient” to deliver the baby’s head.
Mr Bradbury said: “Dr Laxman made a decision which was not clinically indicated, in that she failed to perform an immediate delivery by caesarean section under general anaesthetic and instead proceeded with a vaginal delivery.
“Her conduct set in train a course of events which ultimately resulted in the decapitation of Baby B and to this extent contributed to that decapitation. But for Dr Laxman’s error of judgement in this regard, the decapitation would not have occurred.”
The hearing continues.
Article Source : https://www.telegraph.co.uk/news/2018/06/04/baby-decapitated-doctors-actions-tribunal-rules/