Director of Proceedings v Scherp
Health Practitioners Disciplinary Tribunal Decision No. 532/Mid 12/221D (22 April 2013)
The Director of Proceedings brought an unsuccessful disciplinary prosecution of Ms Jan Scherp, a midwife who practises in Queenstown and the surrounding areas. She attended on the birth of a baby boy to Ms Sara Gutzewitz on 6/7 February 2010. Also present were Ms Gutzewitz's husband and mother. Ms Gutzewitz, because of an earlier birth experience, had decided that she wished to give birth to her second baby at Southland Hospital in Invercargill where an obstetrician would be on hand if needed.
During the birthing process Ms Scherp considered that it was necessary to cut an episiotomy due to blanching of the perineal tissue with descent of the baby's head on to the perineum. Ms Scherp required the assistance from a staff member to access equipment for this procedure which she carried out prior to the birth of the baby. The baby was born through the buttonhole tear in her perineum. Evidence was given at the hearing about what occurred at this time during the birth of the baby, including who was present and at which point in time Ms Scherp left the room.
Ms Scherp in her evidence said that she had had a history of supraventricular tachycardia (SVT), a heart rhythm disturbance characterised by palpitations, and she had an episode of this on the day in question when she was caring for Ms Gutzewtiz. It comprised a significant aspect of Ms Scherp's explanation of having left the room when and in the manner she did.
On the occasion in question Ms Scherp said that it was when she needed to perform the episiotomy on Ms Gutzewitz that she began to feel unwell with SVT. She said that she believed she would be able to manage the symptoms with her usual breathing technique. She acknowledged that she did not tell the staff midwife present that she was experiencing SVT or that she was feeling unwell because she did not believe that it would have any impact on the care she was providing. She said her previous experience had been that the symptoms passed quickly and there was nothing to alert her that this episode of SVT might differ.
On various points in issue the Tribunal preferred the evidence of Ms Scherp to the evidence of Ms Gutzewitz, her husband, her mother, the staff midwife who had been assisting Ms Scherp, another member of staff, and an obstetrician who was called and arrived after the baby was born.
Despite the evidence of the family (that they were left alone immediately after the baby was born), the midwife assisting Ms Scherp (that she left the room), and the obstetrician (that there were no staff in the room when he arrived) the Tribunal found there was "some uncertainty in the evidence as to whether the family were left alone in the birthing room immediately after delivery of the baby without any professional care". The Tribunal was prepared to give Ms Scherp "the benefit of the doubt" about whether she left the family on their own in the room at all.
Significantly, the Tribunal found that Ms Scherp left the room requesting the staff midwife to stay with the family because of the condition she was experiencing with her SVT at the time. The Tribunal found that this was "not an inappropriate action on her part". The Tribunal said that it may have been that she could have given more detailed instructions to the staff midwife as to how to deal with the third stage of labour. It was not however, inappropriate, in the Tribunal's view, for a midwife experiencing health or personal issues to leave a birthing room with a simple request to another midwife to continue on "what was by then a relatively straight-forward procedure". "A baby had been born, albeit painfully and with difficulties, but was apparently well and breathing."
The Director had called expert evidence from a midwife that (among other things) Ms Scherp did not communicate that she was feeling unwell to her colleagues or to the family and therefore did not meet accepted professional standards. The expert opined that this would be regarded by peers as a moderate to severe departure.
However, the Tribunal concluded that the decision on these matters lay with the Tribunal which includes senior members of the profession "who are indeed the peers of Ms Scherp". The Tribunal considered that they can form their own view of whether there has been a departure from standards and, if so, whether and how these would be viewed.
The Tribunal decided that in all the circumstances the charge was not made out despite the expert's views on the matter.
The Tribunal's decision is available at: https://www.hpdt.org.nz/Charge-Details?file=Mid12/221D
Last reviewed February 2019