Investigation of Midwife, South London

[DigitalAunt]

Hi All,

I'm an auntie to my sister's 2 little ones and am posting on her behalf.

We're currently trying to find out information regarding a Midwife at a South London hospital due to an incident that happened during my sister's 2nd pregnancy, however the hospital seems to be covering it up and will not divulge this information. I don't want to give too many specifics just in case it reveals too much about my sister, but we're considering getting lawyers and the press involved as this hospital doesn't have a very good track record. Does anyone know what steps to take going forward?

Thank you!

lf you have a problem with the treatment your sister received at a hospital then your issue is with the hospital and not with a particular midwife, because she will have been working under their supervision and on their insurance.

You should raise your complaint in the first instant via PALS and you could also take advice from a solicitor as to whether you have a potential legal claim.

What information are you trying to get about the midwife? Whatever it is, if you have a legal claim and if the information is relevant to that claim then it would be disclosed during discovery.

You can request your notes from the hospital.

Ask via PALS. Or write to the Supervisor of Midwives at the relevant hospital.

What information are you looking for. If something happened during the birth your sister can go through her records with the doctor.

My sister's stay at the hospital included an unlicensed personnel not gaining her consent for delivery under the supervision of a particular midwife, not being provided pain relief when asked numerous times during labour, blood sample being misplaced and administration of medication that was not prescribed to her via IM.

That's as much as I can say at this point.

Thank you for your suggestions so far, we will talk through what you've all mentioned .

Mot sure about the unlicensed staff, do you mean a student midwife or medical student, did she specify that she didn't want a student. What injection was she given, do you know. It sounds like you are better off requesting her maternity and hospital notes, setting up a meeting with the unit manager and doctor either directly or through pals. It depends what information yours looking for about what member of staff. If you feel the midwife was negligent you can report it to the nmc.

I'm a retired midwife, OP.
I'm sorry so many things were less than optimal.

All women are entitled to a debrief with a midwife after their delivery.

That seems like a good place to start. All the questions you've posed here can be answered.

Hi All,

Thank you for your replies.

My sister was able to get the notes from her stay and it was noted that she had requested for an epidural but no further notes about whether it was given or not. She had explicitly asked for an epidural prior since her first birth she did not receive one either.

It was a student midwife that had delivered her baby, despite her not being informed that would happen and her consent not given.

Not sure about the medication, but it was not stated in her notes so essentially omitted.

She had a response from the hospital, 4 months after they did an "investigation" saying they cannot identify the midwife (which I believe is BS).

She has now called the NMC and they have advised her to complete a form so that they will see if they have grounds for the NMC to investigate.

Because of this ordeal she had postpartum depression and no longer wants anymore children despite wanting 3 children.

It's been a lot for her and I just hope she gets the justice she and her family deserve.

Are you hoping to pursue a legal claim, OP?

What harm are you alleging was done ? You have to be clear on this. You need to request the medical notes and you have to complain via PALS and then take it further before pursuing legal action but you need to be clear on what harm was actually done.

I hope she finds the answers to her concerns but it's the anaesthetics who give the epidural, who did she speak with about it. The epidural and any injections would be on her drug chart .I would expect a student midwife to deliver babies , they have to so they can qualify, I would expect the staff to ask though but I wouldn't object especially in a teaching hospital. I wouldn't expect the hospital to reveal the name of the midwife during an internal investigation.

Hospitals don't ask patients to give their consent for student midwives to deliver them.
Students are always under the supervision of qualified midwives.

And if there isn't an anaesthetist available, an epidural can't be inserted. That is outwith the midwife's control.

Also, if labour is advanced, it may not be clinically possible/realistic for the woman to have an epidural.

it sounds like she was pretty unhappy with events but I am not sure from what you have said that there are that many grounds for formal action. Have you submitted a complaint via PALS? It’s usually the best way to at least get things started and you might get some answers without needing to go further. Not getting an epidural and possibly some medication being given that you don’t think was prescribed but don’t know if a verbal order etc was given is genuinely not a cause for legal action.

So this was her second delivery?
I can easily see a situation where your sister was asking for an epidural, but labour advanced rapidly and there was no time to get it set up.

No midwife, or student, would ever have administered unprescribed medication by injection.

Midwives have standing orders to prescribe a wide variety of medications during and after labour. This is because midwives are practitioners in their own right, and it would be difficult to have to ask a doctor every time something was needed, especially in an emergency.

Honestly I think she needs to see a counsellor and put this behind her, none of what you stated seems an issue to me.

Epidurals can be requested but are not always available if the anaesthetist in in theatre for instance. Student midwives work under supervision, what's the issue (I had a student midwife). As to medication, only the hospital can explain. You can't sue a hospital for not giving you an epidural or training the next generation!

Hey OP, I'm a midwife specialising in risk and patient safety.

The Trust won't disclose information to you about the student or midwife. If you seek a legal claim they may disclose the information to your solicitors in order for them to investigate your claim.

As for the unlicenced part of your query, no student midwife has an NMC Pin or 'license' for want of a better word, until they're qualified. They would have been working under the direct (or indirect of they're 3rd year students) supervision of a qualified midwife.

Hi All,

Thanks for the replies. Okay, so I really should have been more clear when I first wrote this but I didn't want to say too much that could indicate my sister.

This is my sister's second pregnancy, she's an ex Ophthalmology surgeon. She had told the MDT that her 1st pregnancy wasn't the best and had requested to have an epidural for this pregnancy.

She requested for the epidural a few times during labour and was then told the anaesthetic doctor was busy in surgery, but I suppose with her knowledge she knew the protocol was to have another doctor available? (I'm not to sure on this hospital). She said she was administered blood thinners (warfarin) via IM that was meant for the patient opposite her (my sister had a vaginal birth and the other patient a C section) and that they had "misplaced" (their words) her blood sample and had to do another one.

I think she didn't have very good rapport with her midwife and it deteriorated as her stay went on. The hospital did the investigation but they won't say which midwife it is and her notes that she had available to her were from the midwife who took over from the midwife that she had the issue with, which makes my sister very frustrated as she feels likes there's an intentional omission.

What is she hoping to gain by involving lawyers?

epidural- not ideal but if there was someone available they would have done it. The hospital probably need to examine whether they have enough anaesthetic cover. However as has been said above they prioritise and an epidural is not a certainty.

You can’t physically give warfarin IM- assume you mean heparin SC (but presume she has the facts right on this in her complaint).This will not have done harm unless she was already bleeding a lot but is indeed a drug error which will have been investigated as in a different case could have caused harm and is a concern. Again an internal investigation is warranted to avoid it happening again.

Didn’t have good rapport with midwife? Not everyone does. Not a grounds for complaint

Honestly? No. Not grounds for “getting the press involved”. More likely an over stretched hospital

Personally, I'd put it behind me but she's been very upset by all of this, went through postpartum depression and had difficulty bonding with her second child. She also wanted to have a third but seems to not want to go through that again. Her first pregnancy wasn't easy either with her 1st child being in NICU right after birth.

I understand all your points. I was just reaching out to see if I could do something to help her in any way.

Thank you all those that responded so kindly and with empathy. I appreciate your patience xx

OP I understand that your sister was disappointed.

As a doctor herself, she would know that there isn't always an anaesthetist available for non-essential procedures.

It sounds like she didn't get on with her midwife. That's unfortunate, but not grounds for a court case.

The medication error needs to be investigated, though.

The error could be the injection but as pp said it wasn't warfarin. It sounds like another midwife took over, how did that come about, was it a change of shift or a request for a different midwife from either side. There will be a drug chart. She could ask for the notes that were written by the first midwife if they were actually written.

I don't feel you have much grounds for a legal claim tbh. However if you decide to pursue you will need to get a lawyer, access all medical notes. You can request these from the hospital. I've worked with people who have claimed against the nhs and it can be quite a painful journey and their lawyers will always be better and more ruthless than the one you can fine. I wish your sister wel op