Tribunal told of specialist’s shock over stillbirth

On-call consultant obstetrician Catherine Reiss told the General Medical Council hearing she had not been alerted to concerns about patient Marianne Steel’s labour at Pontefract General Infirmary on October 31 2007.

The fitness to practise panel has been told signs of distress in baby Joseph’s heartbeat had emerged as much as four hours before Miss Reiss came on duty at 1pm.

No ward round took place when she arrived because staff were too busy but she said she was not told of there being “any patients of concern” and that Mrs Steel was making good progress.

In a conversation at 1.30pm, she said specialist trainee Grace Barden did not alert her to problems despite writing in medical notes of her serious concerns about the heart trace.

Instead the specialist said the information Dr Barden “gave and the way she said it” was reassuring and she advised that Mrs Steel should push for 20 minutes before a review.

“She seemed quite satisfied with the advice she was given,” she said.

Miss Reiss said she went to examine to another patient she described as a “potential emergency”. She was then approached by a senior nurse to be told patients were arriving for a gynaecology clinic which should have been cancelled because the consultant was on holiday but there was particular concern about one patient who was an “urgent potential cancer case”.

She decided to see the woman but during the consultation she was called by Dr Barden and was surprised to be told Mrs Steel had not yet delivered and was being taken to an operating theatre to have her baby.

Miss Reiss said she was assured there were no problems but 20 minutes later “they were ringing me from the delivery suite to say they couldn’t hear the baby’s heartbeat”.

She immediately went to the theatre and helped work on Mrs Steel, whose womb had ruptured. Afterwards she, Dr Barden and another junior doctor were taken to an office where all three were in tears over what had happened.

She said she “shocked” to see the heart trace had been of concern for some time.

She accepted Dr Barden had accurately recorded the position at 1.30pm in the medical notes but said it was “so far removed and different from the information I had been given”.

In retrospect she made assumptions about the case because she “hadn’t had any messages of concern” and it was presented in a “positive light”, accepting she had not asked enough questions.

Nigel Grundy, counsel for the GMC, put it to her that she had been given all the information and had “made the wrong call” but she maintained she had not got the full picture.

Panel chairman Clive Richards said he found it “astonishing” that as a consultant who had been “possibly misled” by a junior colleague that she had not raised it with her later. He also expressed surprise there had been no debrief among staff over what had been a “major tragedy for everybody”.

Miss Reiss faces charges she did not at all times provide a consultant presence on the labour ward, failed to advise Dr Barden that Joseph needed delivering immediately, check on his mother or review his heart trace. A case against Dr Barden was thrown out by the panel last week. The hearing continues.