‘Serious failures’ in care of baby who later developed cerebral palsy

There were “serious failures” regarding the care provided by a paediatrician to a baby who was deprived of oxygen at birth and later developed cerebral palsy, a medical council fitness to practice inquiry has heard.

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

The inquiry heard testimony on Tuesday from expert witness Dr Kevin Connolly, a former consultant paediatrician who had worked in Crumlin, Temple Street, Holles Street and Portiuncula hospitals until he retired in 2010.

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 adequately follow the National Neo-natal Transport guidelines; 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.

Dr Connolly said in his expert opinion, Dr Khan failed to provided adequate care to the patient in respect of the allegations.

When asked if he thought the allegations against Dr Khan amounted to poor professional performance, Dr Connolly said they did. “I would characterize them as serious failures,” he said.

Dr Connolly said the cooling treatment could have begun at South Tipperary General Hospital, before the baby was brought to Holles Street.

Dr Connolly told the inquiry on Monday there is “compelling evidence” of the benefits of cooling treatment on a baby if done within six hours of the child being born, which “significantly mitigates” the adverse effects of a lack of oxygen on the brain.

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, which deprived the baby of oxygen at birth. 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.

Ms Tobin requested the cooling treatment but Dr Khan did not think the baby was a suitable candidate, the inquiry heard.

The baby was transferred 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 Wednesday.