Midwife wrote 'the bare bones,' lied by omission

By Tracey Roxburgh of the Otago Daily Times

Photo / File
Photo / File

A midwife facing allegations of professional misconduct was yesterday accused of "lying by omission" by Health and Disability Commissioner Director of Proceedings Aaron Martin during the second day of a Health Practitioners Disciplinary Tribunal hearing in Queenstown.

The midwife, known as "Ms P", is charged under the Health Practitioners Competence Assurance Act 2003, relating to her care of Sara Gutzewitz and her son Francis (Frankie) between January 20, 2010 and February 7, 2010.

Ms P, who suffers from supraventricular tachycardia (SVT), alleged she experienced an "unusually severe episode" while Ms Gutzewitz was in labour and just after Frankie was born felt she could faint, so left the birthing room.

She believed she had asked another midwife, Valerie Drake, to remain in the room to care for Ms Gutzewitz after she left. However, that was disputed.

Giving evidence yesterday, Ms P said she "completely" accepted it was not "appropriate midwifery care to leave a woman and a newborn baby alone immediately after birth - particularly in circumstances where the mother had suffered a serious tear during the birth".

Ms P said she had never before had an episode of SVT - which caused her heart rate to increase, at times up to 280 beats a minute - which had impacted on her ability to provide midwifery care.

Following the incident, Ms P had formalised a management plan in relation to her SVT, which had initially included telling expectant mothers about her condition and what it could mean for them during the labour and birth visits. She advised the women when they were between 34 and 38 weeks pregnant.

"At that stage, I would have a relationship with the woman."

However, Mr Martin contended by raising the issue at that "late stage" it was a "very difficult time" for a pregnant woman to change her lead maternity carer, leaving them with "no real choice".

Ms P said she had since changed her management plan again and now told women during the first meeting.

Ms P said her "absolute, honest recollection" was that Ms Drake had been present during Frankie's birth and she had asked Ms Drake to remain in the room and look after Ms Gutzewitz and the baby as she "needed to leave the room for a minute".

"It was my expectation that the other midwife would provide the necessary care and assistance to Sara and her baby until I could return.

"I can only rely on my recall of events that I first wrote down in the weeks after the birth."

She denied allegations she had spoken in graphic terms about Ms Gutzewitz's delivery while in the nurses' station and said she "deeply" regretted her condition "momentarily impacted on the care that I provided to Sara and her baby".

Mr Martin referred Ms P to a copy of the clinical notes written about 7.50am - almost two and a-half hours after Frankie's birth at 5.29am.

There was no mention Ms P felt unwell, had been compromised by SVT, had asked another midwife to take over caring for Ms Gutzewitz and her child or had left the room - all of which Ms P agreed should have been in the notes.

"Documentation is always something that could be done better," Ms P said.

"My documentation at this time could have reflected more truly what went on.

"I had been at a birth ... the birth had been complex ... I had gone to theatre [with Ms Gutzewitz], it was 7.50am.

"I wrote down ... the bare bones."

Mr Martin said despite a comprehensive retrospective account prepared in the following weeks, clinical notes recorded the baby's birth at 5.29am, through the perineum, with the next note stating "obstetrician then attended".

"That doesn't truly reflect what occurred ... this is not a true account of what happened," Mr Martin said.

"You're lying by omission because you've left out events ... that are the subject of this case."

The hearing is expected to conclude today.

- Otago Daily Times

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