Decision Report 201500451

Summary

Mrs C complained about the management of her child's birth at Aberdeen Maternity Hospital. Mrs C's waters broke prior to labour, and although labour then commenced naturally, she made slow progress and developed a high temperature. In view of this, Mrs C was taken to the delivery theatre and, after a failed attempt with forceps, her baby was delivered via caesarean. Mrs C felt staff should have arranged a caesarean earlier and said she asked for this during her labour. She also raised concerns about the caesarean, in particular that there were retained products of conception (pieces of placenta left in the uterus) which caused ongoing complications and further surgery. Mrs C said the doctor was rude, did not adequately explain her treatment, and lied in their response to her complaint.

The board responded to several letters and met with Mrs C twice to discuss her concerns. They apologised that she felt the doctor had been rude to her, and the doctor attended the second meeting to offer their personal assurance that this was not their intention. The board considered Mrs C's medical treatment was appropriate (although they gave conflicting information about whether Mrs C had asked for a caesarean during her labour). They explained that Mrs C had a CT scan (which uses x-rays and a computer to create detailed images of the inside of the body) after the birth. They said that the CT scan was clear, so staff did not consider there were retained products of conception at that time (although they were sorry Mrs C experienced complications from this).

After taking independent medical advice from a consultant obstetrician and gynaecologist, we did not uphold Mrs C's complaints. We found staff had appropriately discussed Mrs C's treatment options, and there was no evidence that she asked for a caesarean during labour. The adviser said the retained products of conception were quite small, so it was not unreasonable that staff missed these (they also noted that cleaning the uterus too thoroughly can cause scarring and reduced fertility). We also found it was reasonable that staff did not identify Mrs C's retained products of conception during her admission, based on her CT scan and symptoms at the time.