Doctor defends botched birth charges

A United States doctor accused of pulling on a baby's umbilical cord so hard during delivery that it snapped has returned to New Zealand to defend a charge of professional misconduct.

Dr Enrique Tomeu appeared before the Health Practitioners Disciplinary Tribunal at a hearing in Invercargill today, which will focus on the care he gave to Felicity McMillan during the birth of her first baby, Ella Irihapti McMillan-Meager, in June 2006.

An inquest found Dr Tomeu contributed to the baby's death when he climbed on to the birthing bed to get better leverage for his pull on suction cups.

Dr Tomeu subsequently resigned and returned to the United States to continue working as an obstetrician.

Jason Tamm, counsel for the director of proceedings, today told the tribunal Dr Tomeu was rude and sarcastic after he arrived at the delivery suite at Southland Hospital to help the lead maternity carer, midwife Bernadette Archer, and an obstetric registrar deliver baby Ella.

Mr Tamm said Dr Tomeu delivered the baby's head then left the rest to Ms Archer. She told him the cord was caught around Ella's neck and she needed to clamp and cut it.

"Dr Tomeu then reached for the cord and with two hands attempted to wrench it over baby Ella's head," he said.

The cord snapped as a result.

Ella was transferred to Dunedin Hospital the following morning but died the next day.

Ms McMillan told the tribunal she sensed tension between Dr Tomeu and Ms Archer as soon as he entered the room.

"I was aware of it even though I was in the middle of labour. I don't recall anything being said between them."

She said Dr Tomeu was rude and aggressive and commented "that if I don't push her out in two goes he would take me upstairs and cut Ella out of me".

Her husband, Nathan Meager, described watching events unfold.

"Bernie was using her hands to take (the cord) off Ella's head. She turned around, I presume to get a clamp. All of a sudden there was a lot of blood squirting everywhere from Ella.

"Ella's umbilical cord had been ripped away from her belly button. There was only about an inch or an inch-and-a-half of umbilical cord left on Ella's belly button."

In her evidence, Ms Archer told the tribunal she didn't expect to do the rest of the delivery once Dr Tomeu had delivered Ella's head.

Ms Archer said she had never seen anyone use the type of force Dr Tomeu used to pull the cord.

In cross-examination by Dr Tomeu's counsel, Harry Waalkens, it was put it to Ms Archer that she "had it in" for his client and that she was known to aggravate other practitioners and get their "backs up".

Mr Waalkens suggested Ms Archer had given Ms McMillan too much prostaglandin, used to induce labour, and in doing so caused her client unnecessary and immense pain and discomfort.

"You created the tense environment that Dr Tomeu walked into."

Ms Archer was trying to down play the amount of prostaglandin she had used in her evidence to the tribunal, he said.

The hearing continues tomorrow.

- NZPA