The Facts
After a prolonged labor where there had been limited foetal descent, a senior obstetric registrar who had been called to assist with delivery felt that a difficult medical situation had arisen and sought the assistance of the on call consultant who was operating in another theatre at the time. In the meantime the registrar had discussed a possible caesarean section with the patient and her husband.
After approximately an hour waiting for the consultant to call, the registrar contacted him again, explained the situation to him and requested his attendance. The consultant advised the registrar to contact him when the patient was being moved into theatre.
The registrar duly advised the consultant at the time the patient was moved into theatre. Despite the registrar’s opinion that a caesarean section was indicated the consultant requested a vacuum to assist with a vaginal delivery. He said he was in a hurry as he had a party at home to get to.
After numerous attempts at vacuum extraction the consultant turned to the registrar and said ‘oh well we will have to do a caesar’ and patted the registrar on the back laughing and said ‘you’ll be right to do that won’t you?’
The registrar was very concerned about performing the caesarean section on her own and the consultant was very annoyed at the registrar’s request that he remain. This conversation took place in the presence of the patient and her husband.
During the caesarean section further complications occurred and the registrar raised a number of concerns with the consultant and found his responses dismissive of her.
The registrar was so distraught about the treatment by the consultant that she lodged a verbal complaint to the Director of Medical Services who appointed an independent obstetrician to conduct an investigation into the matter. Each staff member in the theatre at the time was interviewed including the registrar and the consultant. During his interview, the consultant was very critical of the registrar’s performance.
MIGA Steps In
The registrar contacted us for advice prior to her interview.
We advised the registrar about the need to be objective in her interview. While the registrar was understandably concerned about what she claimed was the consultant’s bullying attitude we strongly advised her that she explain in her interview objectively what occurred rather than provide opinions about people’s motives or state of mind. We recommended she avoided expressing opinions such as ‘he is a bully’ or ‘everyone knows he has had many other complaints’. It was important for the registrar to demonstrate insight and objectivity. We advised that if she made the investigation or comments personal then there was potential that the investigation would become side tracked.
The consultant was likely to aggressively crticise the registrar if he felt he was being attacked.
On our advice the registrar attended the interview with a colleague as a support person rather than a legal representative.
The registrar equipped herself very well during the interview and came across as an objective participant in the matter.
The Outcome
Ultimately the interviewer issued a report in which he was highly critical of the consultant and offered no criticism of the registrar. The investigator made the following comments:
‘The consultant appears to have given the registrar absolutely no support. He criticised the management of the labor, criticised her technique of ventouse delivery without offering any comment while this was proceeding and then criticised her caesarean section incision without having given any advice before the actual incision was made… The explanation was that the registrar was a senior registrar and should have known what to do. This is not a reasonable excuse; if it were true there would have been no need to call the consultant’.
The registrar was satisfied with the outcome of the investigation and was very grateful for the advice she received from MIGA prior to participating in the interview. She acknowledged the outcome was far better (and less stressful) than if she had lodged a personal written complaint against the consultant.
If you find yourself in a similar difficult situation and are unsure how to conduct yourself please contact our Claims Department to discuss the matter.
By:
Anthony Mennillo
Senior Claims Solicitor
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