Midwife denies responsibility (From The Wiltshire Gazette and Herald)

Midwife denies responsibility

3:05pm Monday 21st January 2008 in Swindon By Gazette Reporter

A midwife on duty when a fatal epidural was given to a young mother, denied she was responsible for the blunder.

Marie To was caring for Mayra Cabrera, 30, a Filipino theatre nurse, as she gave birth to son Zac, who survived.

Mrs Cabrera died of a heart attack less than three hours after the birth on May 11 2004 at Great Western Hospital in Swindon.

It was discovered afterwards that a bag of Bupivacaine fluid had been wrongly administered via a drip into Mrs Cabrera's hand.

In evidence at Mrs Cabrera's inquest today, Ms To said although she was not sure about some of the events leading up to the death, she was sure that she had not administered Bupivacaine intravenously.

Ms To claimed at the hearing in Trowbridge that, following the delivery at 8.14am, Dr Gourab Misra had told her to put some saline solution up in a drip if Mrs Cabrera's blood pressure fell.

But, according to Ms To, she suggested using gelafusin, a blood volume expander to boost blood pressure, and the doctor agreed. However Dr Misra, in evidence last week, made no mention of this.

Ms To said she had intended to ask Dr Misra to double-check the bag of fluid, as policy requires, but that this never happened as he was out of the room when she put it up.

Wiltshire Coroner David Masters asked her: "Were you not sure about what you had done on that day at that time?"

"Not 100%," Ms To replied.

At 9am Mrs Cabrera began to fit, the hearing was told, and little over an hour later she was dead. The cause of death was found to be Bupivacaine toxicity.

During the failed resuscitation, a bag of the potent anaesthetic was found in the delivery suite, the inquest heard.

In a police statement afterwards, Ms To said: "To my knowledge and belief I did not administer this drug."

Mr Masters asked her: "Who do you believe did administer it, then?"

She said: "I don't know."

Swindon and Marlborough NHS Trust have admitted liability for the error.

Police investigated but the Crown Prosecution Service decided not to charge anyone.