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"Tired" midwife admits catalogue of errors at Royal Derby Hospital

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A midwife has admitted a catalogue of errors when caring for a pregnant mother who gave birth to a stillborn baby at Royal Derby Hospital. Helen Grimwade failed to raise the alarm when the 27-year-old woman went into labour while suffering from high blood pressure. She did not put a plan in place to check the expectant mother's pulse every 15 minutes, and left at the end of the shift without updating records properly because she was 'tired'. The midwife has admitted a string of mistakes to the Nursing and Midwifery Council (NMC) in her treatment of the woman, known as Patient A. But she denies she failed to use specialist equipment to monitor the baby's heart rate when there were problems with the normal equipment. The pregnant woman later gave birth to a baby born without a heart rate, the tribunal in central London heard. Although attempts to resuscitate the baby were made, it died soon afterwards. Matthew Kewley, for the NMC, said Grimwade's mistakes did not contribute to the baby's death, but the quality of care provided to Patient A on May 28, 2011, was not up to standard. He said: "The allegations stem from the care the registrant provided to Patient A during the course of a single shift. "Patient A was 27 years old and a high-risk patient having previously undergone a Cesarean section. "The registrant took over the care of Patient A at 2.35pm. At 2.48pm the registrant made an entry indicating that Patient A's blood pressure was high. "But no plan of care was made as a result of the high reading - the appropriate care in this situation would have been repeated readings every 15 minutes." Mr Kewley added that Grimwade failed to use a foetal scalp electrode to produce a CTG reading when contact with the baby was lost. The tribunal heard Grimwade also failed to keep bosses at Royal Derby Hospital informed about Patient A's increased pulse rate. She then failed to maintain adequate records of her treatment of the expectant mother, including any notes, after 7.23pm. Grimwade also allegedly did not record her rationale for doubling the dose of Patient A's syntocinon, a substance used to stimulate contractions, to two millilitres an hour. The midwife then left the hospital at the end of her shift without updating Patient A's records because she was "tired", the hearing was told. "The registrant said she was tired at the end of her shift and went home instead of ensuring labour records were entirely accurate", Mr Kewley added. "Patient A's baby was then delivered by Caesarean section, no heartbeat was found, and there were attempts to resuscitate. "At 8.45pm resuscitation was stopped. "The NMC alleges that in no way that the registrant contributed to the baby's death - this case concerns solely on the quality of care provided to Patient A'. Grimwade, who is not at the tribunal and is unrepresented, admits failing to make a care plan for Patient A after identifying she had raised blood pressure. She admits not making a care plan when identifying an abnormal CTG, not waiting 30 minutes before increasing the syntocinon infusion rate, and failing to inform her shift coordinator and document a care plan after recording a raised maternal pulse. Grimwade admits not recording her attempts to catheterise Patient A, not making any record of care provided to Patient A after 7.23pm, and not recording the rationale for increasing the syntocinon infusion at 4.25pm. The midwife denies twice failing to use a foetal scalp electrode when there were difficulties in obtaining a CTG recording, that she did not seek a review from the obstetric team prior to increasing the rate of syntocinon, and that she did not document or check the maternal pulse after 5.30pm. If found guilty of misconduct, Grimwade could be permanently removed from the professional register. The hearing continues.


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