Merthyr baby's death 'could have been avoided'

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Tiffany Gillard and James FrancisImage source, Irwin Mitchel
Image caption,

Tiffany Gillard and James Francis's son Jenson died in June last year

A baby who died 40 minutes after being born could have survived if he was delivered sooner, an inquest has heard.

Tiffany Gillard's son Jenson James Francis died at Prince Charles Hospital in Merthyr Tydfil on 21 June 2018.

The inquest at Pontypridd Coroner's Court comes after Cwm Taf health board's maternity services were placed in special measures.

On-call consultant Dr Sreevidya Ambika said in hindsight she would have asked for Jenson to be delivered sooner.

The inquest heard Dr Alia Bashir was the only doctor responsible for all patients in the hospital's maternity unit during the night.

She described a phone call with Dr Ambika, where they discussed the recording of Jenson's heart rate.

Despite initial concerns, Dr Bashir said she was given reassurances by Dr Ambika, and did not ask her to attend the hospital.

Dr Bashir said she gave medication to Ms Gillard when her temperature spiked as she was concerned about an infection.

The inquest heard Dr Bashir then went to carry out a procedure on another patient. She said during this time she received no calls from the labour ward about concerns for Jenson's heart rate.

At 03:50 on 21 June, Dr Bashir assessed Ms Gillard and asked the theatre to prepare for delivery.

Dr Ambika said when she was informed by Dr Bashir of Jenson's condition and a spike in Miss Gillard's temperature she instructed her "don't waste time, just deliver straight away".

Image source, Google
Image caption,

Tiffany Gillard's son died as a result of failures by maternity staff, the inquest heard

Dr Bashir was asked why a category two Caesarean section was carried out to deliver Jenson and not a category one.

She replied: "It is my understanding a category one is when there is an immediate threat to baby or mum."

The inquest had previously heard from consultant obstetrician and gynaecologist Jonathan Rogers who said that based on the facts of this case a category one Caesarean section should have been carried out.

A category one delivery should take place within 30 minutes and a category two inside 75 minutes.

When the coroner asked Dr Bashir whether it occurred to her to carry out a category one delivery, she replied: "It did not come to mind."

Dr Ambika said it was not common practice for the on-call consultant to specify which category should be implemented and it would have been for the registrar to decide.

She told the inquest, that having now reviewed the cardiotocography recording of Jenson's foetal heart rate, she would have delivered him sooner.

The Coroner asked her whether he would have survived if he had been delivered sooner.

Dr Ambika replied: "The baby would have survived but I cannot say what effect the infection might have had."

The inquest continues.

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