The relationship between midwives and doctors came under the spotlight at a Health Practitioners Disciplinary Tribunal hearing in Invercargill today which is considering a charge of professional misconduct against United States doctor Enrique Tomeu.
In evidence to the panel Anil Sharma, a consultant obstetrician and gynaecologist of Auckland, criticised Dr
Tomeu's manner and actions during the delivery of baby Ella Irihapti McMillan-Meager who was born on June 10, 2006, at Southland Hospital.
During the delivery Ella's umbilical cord snapped. It is alleged Dr Tomeu used excessive force when he tried to pull it over her head. Ella died three days later in Dunedin Hospital from a fatal brain bleed.
Mr Sharma's opinion was based on a review of the case on behalf of the Health and Disability Commissioner.
He said if witness accounts were true about sarcasm and rudeness to other medical staff and Ella's mother Felicity McMillan then Dr Tomeu's behaviour was "totally unacceptable and unprofessional". However, he acknowledged there were other issues that played an important part that day.
"Most significantly is that of the impression of a markedly dysfunctional relationship between the independent midwife, Ms (Bernie) Archer and Dr Tomeu, with bilaterally poor communication and disrespect for each other as witnessed by a number of parties."
During cross-examination, Mr Sharma agreed Ms Archer had over-stimulated Ms McMillan's cervix using a labour-inducing gel, prostaglandin, and there was already tension in the room before Dr Tomeu was called to help.
Mr Sharma also acknowledged there was a strong impression Ms Archer didn't want Ms McMillan to have a caesarean section, even though both Dr Tomeu and Dr Lolita Macaballug, the registrar of obstetrics and gynaecology, believed it to be the appropriate course of action.
He agreed it would have been "disconcerting" for Dr Tomeu to arrive at the birthing room expecting a caesarean only to find it had been curtailed.
Mr Sharma acknowledged it was possible Ella's umbilical cord ruptured during delivery because there was something wrong with it and that if it was short or weak due to an underlying cause it could break if it was pulled on with reasonable force.
In her evidence, Dr Macaballug said when she told Ms McMillan she needed to prepare her for the caesarean Ms Archer intervened and said it wasn't necessary. She also contradicted Dr Macaballug and said IV hydration wasn't necessary either.
Dr Macaballug said Dr Tomeu looked angry when he arrived at the room and was told about Ms Archer's comments.
The hearing continues tomorrow.
- NZPA
