Baby Hollie Maguire death not preventable, expert tells court
A senior medic has told an inquest that medical staff at Belfast's Royal Victoria Hospital did "everything by the book" but nothing could have prevented the death of a newborn baby.
A post-mortem examination of Hollie Maguire found the cause of her death on October 25, 2016, was Congenital Pneumonia (Group B Streptococcus).
Brendan Maguire and wife Susan Ho-Maguire, from Dunmurry, attended court to hear the evidence of consultant obstetrician and gynaecologist Edwin Chandraharan on the final day of the inquest at Laganside Courts.
Mr Chandraharan, lead clinician for the Labour Ward at St George's University Hospitals in London, explained that the infection was so severe nothing could have been done to prevent Hollie's death shortly after birth.
And while he conceded a simple scan could have revealed the complications at an earlier stage, he said there was nothing currently in place to provide for such a measure.
Questions had also been raised about foetal monitoring in the final stages of labour. While Mr Chandraharan acknowledged medical staff had monitored Hollie correctly during Mrs Ho-Maguire's labour, inherent errors in that system, in his opinion, needed urgent attention.
Royal Jubilee Maternity obstetrician Dr Mary Murnaghan had previously told the inquest that medical staff had followed all procedures as normal and Mr Chandraharan agreed it was clear this was a system failure, not an individual failure.
He explained: "What we have is a series of tick boxes when looking at the cardiotocography (CTG), monitoring the baby's heart rate and the contractions. If boxes are ticked then abnormalities can be missed.
"We have to remember that not every baby is the same. They all react differently. The system treats all the same and it's easy for abnormalities to be missed.
"You will naturally get decelerations in heart rate as a result of contractions, which squeeze on the umbilical chord, but these spikes will not be acted on unless they go on longer than half an hour.
"Only then are midwives instructed to intervene. According to the guidelines, the medical staff were right not to intervene.
"I have lots of concerns over the training. We treat all the same and no other branch of medicine does that.
"I know the hospital has now changed its approach to CTG monitoring, but we always have to remember guidelines are a guide. Training has to move away from set patterns.
"These guidelines are set by the National Institute for Health and Care Excellence (NICE) and they got it badly wrong. They've now corrected it - but it's sad, so sad, that there was an over-reliance on the tick box system."
Mr and Mrs Maguire have previously said there were no concerns raised during what seemed a normal pregnancy, but the court heard how Hollie was 'floppy' and 'lifeless' when born.
Mr Chandraharan explained that this would have been because her body had diverted blood away from less vital organs and muscle to keep the brain and heart alive in an attempt to fight the infection.
Asked if hypoxic stress, caused by contractions, could have been a contributing factor, Mr Chandraharan said some babies can withstand this better than others, but all babies experience it in a natural birth.
When asked by Mr Maguire if an earlier delivery would have given his daughter a better chance of survival, Mr Chandraharan said there was nothing in place that could have alerted staff to streptococcal infections.
The consultant added: "Once the umbilical chord was cut it would be up to a baby to breathe for his or herself. Sadly the infection was so severe in Hollie there was nothing that could have been done.
"There is nothing in place either that could have detected infection at an earlier stage. Nothing would have been done differently to save Hollie.
The coroner will deliver his findings today.