Paediatrician tells inquiry he was ‘delighted’ at baby’s improvements

A paediatrician accused of allegations of poor professional performance has defended his treatment of a baby born following an emergency caesarean section who later developed cerebral palsy.

Paediatrician Dr Mohammad Ilyas Khan has been accused of poor professional performance for allegedly failing to order a head-cooling treatment for the baby, who was subsequently left with brain damage.

Dr Khan told a Medical Council fitness to practice inquiry the baby was born flat and was not breathing but came around thanks to the care of the medical team. "I was delighted as a clinician at the huge improvement the baby made," he said,

Dr Khan was working as a locum consultant paediatrician at South Tipperary General Hospital in June 2012 when the alleged incident occurred.

Among the allegations Dr Khan faces are failing to put an adequate plan in place for the treatment of the baby’s diagnosis of hypoxia (lack of oxygen at birth) after he was born; failing to arrange for the transfer of the baby to another hospital for cooling treatment; failing to consider of adequately follow the National Neo-natal Transport guidelines; and telling the baby’s parents the child was “fine” when he was having seizures, when he knew or ought to have known it was not the case.

Head-cooling treatment is used to lessen the chance of brain damage resulting from oxygen deprivation during birth. Current protocols require cooling to begin within a maximum of six hours after birth and suggest that cooling as early as possible is the ideal.

A lack of oxygen around the time of birth can result in cerebral palsy, learning disabilities and epilepsy.

The baby's mother, Noelle Tobin, suffered a ruptured uterus. The baby was brought to the special care unit of South Tipperary General Hospital in Clonmel after he was born and given anti-seizure medication.

Dr Khan said he arrived at the labour ward several minutes after the baby was born and said his condition was critical. He said the baby was born “flat” and was “blue, lifeless and limp”.

He said he resusitated the baby and told the inquiry how the baby’s vital signs began to improve and he was transferred to an intensive care unit.

He said a diagnois of hypoxic ischaemic encephalopathy (hypoxia), or lack of oxygen to the brain was agreed and a clear plan was made to continue close monitoring of the bay in the special care unit at Tipperary.

Dr Khan told the inquiry he did not consider the baby a suitable candidate for cooling treatment because his condition had improved.

The baby was later transferred on the request of his mother Noelle Tobin, to Holles Street maternity hospital, Dublin, where doctors told the parents he might die or be left with a disability.

The baby is now two-years-old and has cerebral palsy. He attends the Central Remedial Clinic and receives occupational, physical and speech therapy.

The inquiry continues on June 24th and 25th.