A senior NHS doctor has been found guilty of medical misconduct when she caused an unborn baby to be accidentally decapitated in the mother’s womb in a delivery that happened in March 2014 at Ninewells Hospital in Dundee, Scotland, Telegraph UK reported.
Dr Vaishnavy Vilvanathan Laxman, 43, attempted a natural delivery even while the premature infant was in breech feet first position, instead of performing an emergency cesarean section, the Medical Practitioners Tribunal Service in Manchester said in its report. The patient had told the tribunal that the plan was to perform cesarean “if anything happened.”
When the doctor urged her 30-year-old patient to push while she applied traction to the baby’s legs, the head detached in the mother’s womb. 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,” according to the pathologist who came before the tribunal, the report added.
Two doctors then had to carry out the C-section to remove the head from the womb. The head was then “re-attached” to the body so that the mother could hold him.
The tribunal accepted the argument that that baby was already dead by the time its head got detached. “The central issue in this case is whether Dr Laxman’s decision to attempt a vaginal delivery of Baby B rather than an immediate cesarean section under general anesthetic was clinically indicated, or whether the only proper course in the circumstances would have been to proceed to an immediate cesarean section,” Tim Bradbury, the fact-finding panel chairman, said.
“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,” he added. “The decision to proceed with vaginal delivery represented a failure in her clinical decision-making on the evidence available to her at the time.”
Dr Laxman came to the United Kingdom in 2004, after having qualified as a doctor in India. She denied any wrongdoing before the panel, saying that she believed the baby would have died had a cesarean section been done.
According to the account given to the tribunal, the mother’s waters broke early — at 25 weeks — and the baby was found to have a prolapsed cord and a low heart rate. The baby was in a breech position and the mother’s cervix was 2-4 cm dilated. A fully dilated cervix is at 10 cm.
According to Bradbury, the body was delivered without difficulty. However, the head was trapped in the uterus with the neck in the cervix. It was after this, Bradbury pointed out, that Dr Laxman’s attempt to deliver the baby became desperate. “Because of the pain and distress that Patient A was by this time experiencing the decision was made to administer a general anesthetic following which further attempts were made to incise Patient A’s cervix and extract Baby B by means of traction. While Patient A was under general anesthetic, Dr Laxman continued to make attempts to deliver Baby B by traction and ultimately Baby B’s head became detached from his body.”
As the patient’s cervix was dilated 4 cm, the tribunal was of the view that it should have indicated to Dr Laxman that it was “insufficient” to deliver the baby’s head.
Further hearings are being scheduled to ascertain whether the doctor can continue practice or not.