Anaesthetist censured and fined after woman's painful C-section

Other people in the operating theatre gave evidence that Mrs S was in a large amount of pain. Photo/stock

An anaesthetist has been censured and fined for not doing enough to prevent a woman's "excruciating" pain during a caesarean surgery.

Uwe Seidenfaden can now be named after the Court of Appeal cancelled previous name suppression orders.

Seidenfaden was originally cleared of professional misconduct by the Health Practitioners Disciplinary Tribunal, but the ruling was overturned in the High Court. Seidenfaden appealed the High Court's decision, but that has been declined.

The tribunal had found he should have been more "situationally aware" - such as when the woman kicked the surgeon when the incision into her uterus began and had to have her legs held down by nursing assistants.

The woman, "Mrs S", now a mother of two, was giving birth to her first child, a healthy son, in February 2013. A normal delivery was planned but it progressed to a medical induction, a non-reassuring fetal heart trace and then caesarean done with epidural anaesthesia.

Mrs S said she told Seidenfaden the surgery was hurting but he assured her she was feeling pressure, not pain. She heard questions about pain relief, to which the anaesthetist replied, "it would be over soon anyway".

Her husband, Mr S, said she repeatedly told him she was hurting. He asked Seidenfaden if she could have something for her pain, but Seidenfaden told the woman he had given her enough pain relief.

The tribunal ruled that Mrs S' pain was not sufficiently communicated to Seidenfaden, but Justice Simon France said in the High Court the tribunal was asking the wrong question.

In the judgment from the Court of Appeal, Justice Harrison agreed with the High Court, saying the "critical question" raised by the charge of professional misconduct was not whether or how much of the patient's pain was communicated or understood by Seidenfaden, but whether he ought to have been aware of her pain and discomfort during the operation.

"The Judge was satisfied that Dr Seidenfaden was not properly focusing on his task and missed the vital signs of pain of which he should have been aware," Justice Harrison said.

"The evidence not only disclosed a lack of Dr Seidenfaden's situational awareness, but also his lack of interest in and concern for his patient."

The tribunal also weighed up the evidence incorrectly, accepting Seidenfaden's explanation that he didn't remember specifically, but would not have acted in such a way, against the evidence of everyone else in the operating theatre.

Justice Harrison said the tribunal appeared to accept Mrs S' pain was "excruciating".

The High Court made a finding of professional misconduct, made an order for censure, and fined Seidenfaden $9000 and costs.

The Court of Appeal declined Seidenfaden's leave to appeal and cancelled previous name suppression orders.