Doctor 'dismissive' of concern over woman's pain during c-section

The doctor is facing a charge of professional misconduct over the Caesarean section. Photo / iStock

As a mother having her baby delivered by Caesarean section was experiencing sharp pain, a doctor responsible for giving her relief sat "slouched in his chair".

He'd moved away from his normal bedside position, but the surgeon cutting into the woman's uterus and abdomen mentioned the mother's discomfort.

"[The doctor] appeared disinterested. He was slouched in his chair still sitting next to the door. I was reassured by him that she was 'fine and feeling pressure'," the surgeon told a Health Practitioners Disciplinary Tribunal hearing in Wellington today.

The doctor, who has name suppression, is facing a charge of professional misconduct over the Caesarean section.

As he was the anesthetist, it was his role to deliver pain relief.

Both the mother and the surgeon also have name suppression.

The surgeon said the operation in February 2013 was made more complicated because the mother was moving around.

She dismissed suggestions from the doctor's lawyer that she only reached such conclusions later and said as the procedure continued, after the baby was delivered, she asked a midwife present to tell the doctor about the pain.

"He remained seated in the chair at the far corner of the operating theatre. I heard [the doctor] say to her that 'soon the surgery will be over'."

The surgeon was concerned about the level of pain the mother was in and said she felt "frustrated" by the anesthetist not acting in accordance with normal practice.

She described the anesthetist as being "dismissive" of concerns raised by others in the operating theatre.

Afterwards the surgeon spoke to the midwife about the "suboptimal anaesthesia" and wrote that in her notes.

"[The mother] shared with us her dissatisfaction with the anaesthesia during surgery. She asked if it was normal for women to experience that level of pain during surgery. I stated in my experience that it was not so."

The surgeon said she'd never experienced a Caesarean like that in her decades of work.

When questioned by the doctor's lawyer Harry Waalkens, QC, the surgeon denied that she only later came to believe the anesthetist acted apathetically or dismissively.

She said "in hindsight" she should have been more assertive and should have asked to speak with the anesthetist during the operation.

Mr Waalkens asked why the surgeon didn't report any concerns she said she held to hospital management.

"The midwives did," she said.

"You didn't do anything did you?" Mr Waalkens asked.

"No, I did not."

For the first time the tribunal has heard what the doctor will say in his defence.

Mr Waalkens said he would deny ever slouching in a chair away from the bed.

"I'm certain that's where he was," the surgeon said.

The doctor will also say he regrets he didn't get the chance to discuss with the mother concerns about him.

Mr Waalkens said the surgeon surely would have said something to him so he could do that.

The surgeon said "maybe" she should have given him the opportunity.

"I've worked with him before. I've worked with him after, but that day it was different," she said.

"For some reason on that day he wasn't willing to engage."

The hearing continues.