Babies charge midwife admits error
A midwife has refused to defend herself against a raft of misconduct charges, including that her conduct contributed to the deaths of two babies, saying that she accepts that she has made mistakes.
Marie Teresa Ratcliffe did not show up for her fitness to practise hearing at the Nursing & Midwifery Council (NMC) and did not send a lawyer to represent her.
Amanda Hamilton, representing the NMC, read out a letter written by Ms Ratcliffe which said that she willl "regret what happened for the rest of my life" and that she is not now a midwife and has no intention of returning to the profession.
The panel has been told that Ms Ratcliffe accepts 77 allegations relating to her involvement in the treatment of 14 patients at the scandal-hit Furness General Hospital in Cumbria between February 2004 and September 2013.
They include the allegations that in relation to two babies - one who died in February 2004 and another in September 2008 - that Ms Ratcliffe's conduct had "contributed to the death" of and/or caused the patient's baby "to lose a significant chance of survival".
In the letter read to the NMC panel, sitting in Stratford, east London, Ms Ratcliffe said: "I am a human being of good will and I accept that I have made mistakes and apologise to those affected by them."
In the letter Ms Ratcliffe said she felt "it was important not to delay" proceedings any further or efforts for people to look in to what happened by "defending myself against these charges".
She denied being part of any cover-up or collusion of what had happened or effort to "conceal the truth".
She noted that the system had been flawed but that she was governed by those procedures. She stated that "in writing these words I seek no leniency" adding "I accept things I cannot change."
Panel chairman Gary Leong said: "By her letter Ms Ratcliffe is aware of the proceedings. She has voluntarily absentented herself. She is very clear that she does not wish to defend herself against these charges.
"In light of that the panel considers that an adjournment would not change the circumstances. She does not wish to come."
In the case of Patient A, Ms Ratcliffe has been accused of failing to ensure the foetal heart rate was adequately monitored and failing to request assistance from a doctor or other medical professional when she had difficulty with the heart rate.
The mother recalls the baby was placed by her side and was "purple, blue and lifeless," Ms Hamilton told the tribunal.
Among the claims made against Ms Ratcliffe in the case of a woman named as Patient B, is that she failed to document her discussions with the mother regarding her pain relief and also failed to ensure the full and adequate monitoring of the foetal heart rate .
Failures to properly monitor and record a range of procedures and make maternal observations during labour are among the raft of allegations against Ms Ratcliffe.
She worked for the hospital, which was run by the University Hospitals of Morecambe Bay Trust's (UHMBT), as a band 7 midwife.
Ms Hamilton noted that the Trust has faced "significant scrutiny" following the death of Baby A in February 2004.
An inquest into her death was eventually held in June 2011 and South Cumbria Coroner Ian Smith commented that there had been no collusion in the preparation for the hearing. Cumbria Police also investigated these claims and fears of collusion can be "put to one side", Ms Hamilton said.
An independent inquiry into the management, delivery and outcomes of care provided by the UHMBT's maternity and neonatal services between January 2004 and June 2013 was set up by the Health Secretary in September 2013. Care Quality Commission (CQC) officials have been accused of covering up a failure to properly investigate UHMBT.
Dr Bill Kirkup, who chaired the Morecambe Bay investigation, said his report detailed a "distressing chain of events" which led to avoidable harm to mothers and their babies at the "dysfunctional" maternity unit.
The Kirkup investigation found there had been a "lethal mix" of failures at the Cumbrian hospital which led to the unnecessary deaths of 11 babies and one mother. It called the avoidable incidents "serious and shocking". It criticised the wider NHS for the way it had monitored and regulated events at the hospital.
In the letter to the tribunal, Ms Ratcliffe also stated: "Stillbirth is a devastating and tragic event in the lives of those involved. I hope that the recently published Kirkup report into Morecambe Bay maternity services may have begun the long delayed process of closure for the families affected and I feel it is important not to delay that further by defending myself against these charges.
"I accept the part that I, along with many others at all levels of the Morecambe Bay Trust and beyond, must take in the course of that reconciliation".
She noted: "I recognise that those monitoring, supervisory and regulatory systems have subsequently been found to be inadequate and flawed, but I was subject to them as they were then.
"I had no control over them, nor did I have control over the way in which they were implemented or the individuals who chose to implement them in the way that they did."
Ms Ratcliffe is accused of a series of failings such as not conducting or adequately recording maternal observations and not recording the foetal heart rate on the appropriate equipment with regard to a woman - named as Patient N - in August 2009.
An internal investigation and review was then launched and Ms Ratcliffe carried out 180 hours of supervised practice in 2010.
Ms Hamilton told the panel that the first referral against Ms Ratcliffe came after a "clinicial incident" involving a woman, identified as Patient O, in September 2013.
The baby needed intubation but it is alleged that Ms Ratcliffe failed to check on the patient between approximately 10.15pm and 3.20am and did not ask for medical assistance when she became aware of problems with the foetal heart rate.
The baby was later discharged and is now healthy, the tribunal heard.
Ms Ratcliffe was referred to the NMC in January 2014.