The Court of Appeal has overturned a Supreme Court decision that prevented a couple, whose child was stillborn, from making a claim against the Republic of Vanuatu.

The claim is against Repulic of Vanuatu as representative of the midwives and ‘Port Vila hospital’ (Vila Central Hospital).

The Court cited midwives’ negligence as a contributing factor to the baby’s death and set aside the Supreme Court orders.

The appeal judges said that the case will be taken back to the Supreme Court and entered a judgment as to liability in favour of the couple and ordered the trial judge for a damages hearing.

Monique Joseph and Kalfatak Kalnaure had lost their second child after she was admitted to the maternity ward at VCH.

The Court heard that on May 20, 2014 the labour pain was high and tragically the next day the baby died in utero before the couple pursued the claim in the Supreme Court claiming negligence on the part of midwives that the baby was born dead.

After trial on liability only, the judge in the Supreme Court concluded there was no breach of duty of care and dismissed the claim.

Ms Joseph was examined by a midwife and was told that the heartbat of the baby was normal and she was sent home and told to return at about 3.30pm. She returned at 3.40pm with the contractions and some blood spotting.

The midwife checked again and noted she was having mild contractions meaning her cervical dilation was below 4cm and fetal heartbeat normal, the Court stated.

The midwife who admitted Ms Joseph said in her sworn statement that given her maternal assessment as normal standard medical procedures used in Vanuatu meant that she would be checked again after 8 hours.

She said that there was no fetal assessment of the heart rate every hour because of Ms Joseph pregnancy “was still in latent first stage of labour with mild vaginal contraction. According to the standard procedure in chapter 17, page 17 we checked the fetal heart rate after each strong contraction or around a time a contraction is stopping”.

The Court of Appeal said that the midwife made reference to Chapter 17 of the Standard Emergency Management in Obstetrics, Gynaecology and Neonates (SEMOGN).

Ms Joseph told the court that she had been told by the midwife that she would be checked every four hours but that did not happen.

About 7.30pm to 8pm she had a painful backache and someone who accompanied her to the hospital asked the nurses to check her but they claimed they were too busy.

The woman who accompanied Ms Joseph said that the nurses did not seem to be attending to other patients at the time.

At 11pm the first midwife ended her shift and the evidence is that the next midwife showed up at between 1am to 1.30am, two hours later, and when she checked the heartbeat of the baby, none could be found.

Then between 1.30 and 2am the midwife contacted the on-call doctor who attended later and checked the baby but there was no heartbeat.

“The baby was born dead,” the Court of Appeal said in its ruling.

The judges said that they are satisfied that the standard of care provided by the hospital to Ms Joseph fell below what was required and was negligent.

“This was in part because of a failure to adhere to the SEMOGN standard and partly because of other failure,” they said.

“The evidence given by the midwives was that this standard did not require hourly checking of the fetal heart rate while Ms Joseph was in the latent first stage of labour.

“We are satisfied that the midwives have misinterpreted or misunderstood the obligations in SEMOGN standard in relation to monitoring of the fetal heart rate.

“The SEMOGN standard is explicit and clear, once a woman is admitted to the hospital in labour (at whatever stage) the standard requires fetal heart rate be monitored hourly.

“Ms Joseph had been admitted to the hospital and was experiencing mild contractions and the standard does not exempt a woman in latent labour from this monitoring.

“The standard does not require strong contractions before such monitoring, the fact fetal heart was only monitored once at 3.40pm before the baby’s death 10 hours later was a serious failure.”

The Appeal Court judges said that Ms Joseph was not examined by midwives from 3.40pm until 1.30am and during that time her dilation went from 3cm to 7-8cm, well past the latent stage of labour.

They said the midwives’ care fell below standard. READ MORE

SOURCE: VANUATU DAILY POST