An unborn baby was decapitated after a doctor chose the wrong method to try and deliver him, a medical tribunal has found.
Dr Vaishnavy Vilvanathan Laxman, a consultant gynaecologist, was working on the NHS maternity unit at Ninewells Hospital in Dundee when she failed to perform an emergency caesarean section on the 30-year-old first-time mother known as Patient A, according to a report by the Medical Practitioners Tribunal Service panel.
Instead, the 43-year-old obstetrician opted for a regular delivery, even though the boy – referred to as Baby B - was feet first in the breech position with a prolapsed cord and low heart rate.
The mother’s cervix was also less than 4cm dilated. She was 25 weeks pregnant at the time.
The panel found the decision to proceed with a vaginal delivery “set in train a course of events which ultimately resulted in the decapitation of Baby B”.
It added: “But for Dr Vilvanathan Laxman’s error of judgment in this regard, the decapitation would not have occurred.”
Dr Laxman, was suspended by NHS Tayside in the wake of the March 2014 incident.
Two other doctors 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, the baby was already dead.
A pathologist told the tribunal that the damage to the baby’s neck and decapitation “would most likely be attributed to the pulling and stretching forces applied to Baby B’s body during attempts to deliver the head”.
Dr Laxman, who qualified in Chennai, India before coming to the UK in 2004, denied any wrongdoing at a Medical Practitioners Tribunal Service in Manchester. She said she believed the baby would have died had a c-section been performed.
But the tribunal found that the mother was taken to theatre and given the complications, “the only appropriate course in these circumstances was a caesarean section which would have been the quickest mode of delivery given the risks attendant upon a vaginal delivery, namely head entrapment, which would inevitably have delayed the birth”.
Patient A told the tribunal she had previously been informed that the baby would be delivered by caesarean section “if anything happened”, because her baby was in breech.
“The only pain relief I was given was a spray on my tongue,” she told an earlier hearing, clutching a pair of teddy bears in her arms.
“I was told it was meant to loosen my cervix but I was not given gas and air – I was in pain. I had the doctors putting their hands inside me and I had them pushing on my stomach and then pulling me down.
“I tried to get off the bed but they pulled me back three times and just said they had to get the baby out. They twice tried to cut my cervix and nobody told me they were going to do it. There was no anaesthetic. I said to them ‘it doesn’t feel right, stop it, what’s going on, I don’t want to do it’ but nobody responded to me in any way.
“Afterwards I was in a cubicle with a curtain around me and the sister came over to me and told me my son had passed away”.
At the finding of facts hearing panel chairman Tim Bradbury said it was Dr Laxman’s choices 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 will decide at a later date whether Dr Laxman should be struck off.
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