A consultant obstetrician and gynaecologist at Cavan General Hospital has been cleared of poor professional performance in relation to six of seven allegations.
The guilty verdict in one case related to the fact that Dr Salah Aziz Ahmed failed to decide that the immediate delivery of a baby – the son of a woman referred to as Patient C – by emergency caesarian section was required.
By Liz Farsaci
Dr Aziz has also been cleared of professional misconduct on two counts following the 25 day medical council inquiry.
Previously, the inquiry determined that seven of the allegations had been proven "as to fact".
Patient C, who had a very poor obstetric history, gave birth to a baby boy by emergency caesarian section on 26 April 2014. He was born with no signs of life, and did not respond to resuscitation. It was later discovered Patient C had suffered from her third placental abruption.
Referring to the failure to decide that immediate surgery was required, Mary Duff, chair of the inquiry committee – which rules on the case – said: “The committee were satisfied that this was a serious failure to meet the standards of competence that can be reasonably expected of [an obstetrician].”
Sanctions will be determined at a later date by the Medical Council.
Legal counsel Eileen Barrington SC, for Dr Aziz, said he admitted as to fact the one allegation that was found to amount to poor professional performance. She said a sanction “should be on the lower end of the scale, and that more than adequately protects the public”.
Ms Barrington added that Dr Aziz has “demonstrated insight into the criticisms made of him”, adding there was no allegation that the outcome for Patient C’s baby would have been any different had he been delivered earlier.
The Medical Council inquiry has examined the care Dr Aziz provided to three women, one whose baby died in utero, one whose baby died two days after his birth and one whose baby was born in very poor condition.
Today marked the 25th day of the inquiry, which first began in November 2016.
It heard that Patient A gave birth to a baby boy by emergency caesarean section on 22 November 2012, but he died two days later.
The second patient, Deirdre Clarke – who waived her right to anonymity – also gave birth to a baby boy by emergency section, on 5 June 2013 after her uterus ruptured. Her baby was born in very poor condition, although he made an eventual recovery.
On 18 May, the inquiry committee – which rules on the case – found seven out of the 14 allegations against Dr Aziz in relation to these mothers to be proven as to fact.
In relation to Patient A, the committee found that on 22 November 2012, while Patient A was labouring, Dr Aziz instructed that the administration of labour drug syntocinon be increased from 90mls per hour at 9.40pm to 180mls per hour at 10.57pm in the presence of evidence of prior hyperstimulation.
Dr Aziz also performed an episiotomy on Patient A in circumstances where it was not justified, and failed to catheterise her prior to attempting a caesarian section delivery.
In relation to the care Dr Aziz provided to Ms Clarke, the committee found that he directed that the administration of syntocinon be increased at or around 6.05pm, while Ms Clarke was in labour, and he instructed for syntocinon to remain infusing at 60 mls at 10.30pm.
Syntocinon is drug used to progress labour, but can lead to hyper-stimulation of the uterus and extra strong contractions. This can distress a baby and increase the risk of uterine rupture in a mother such as Ms Clarke, who was trying for a vaginal birth after a caesarean section (VBAC).
In relation to Patient C, the committee found Dr Aziz failed to decide that immediate delivery of a baby by emergency caesarean section was required. He also failed to attend at Cavan General Hospital in order to assess Patient C within an adequate time frame on 26 April 2014.