PN midwife suspended indefinitely

A midwife has been suspended indefinitely after failing to take the appropriate actions when a woman in labour was experiencing seizure-like symptoms.

The midwife, Tracey Jayne Goff, of Palmerston North, was later found to have been a serious risk to the public because she had no understanding of the symptoms.

In a recent decision, the New Zealand Health Practitioners Disciplinary Tribunal censured Goff for misconduct in the case.

While the name of Goff’s patient and the time when the misconduct took place are suppressed, all other details of Goff’s actions can be reported. She started practising as a midwife in Palmerston North in 2009, and took the patient under her care some time before the due date. During a check the patient was found to have a high blood pressure of 140/100, significantly above her booking pressure of 110/60.

Goff and the patient discussed symptoms of pre-eclampsia – a condition that can result in impaired liver function, kidney dysfunction and poor outcomes for both the mother and child. Mothers can experience seizures if it is left untreated, at which point they go from pre-eclampsia to eclampsia.

Goff discussed further symptoms with the patient, but she was not told how serious her symptoms were or advised to see a specialist. The patient sent Goff a text message on a later date, complaining about ‘‘spots in the eyes’’ and headaches.

Goff did not get back in touch immediately or arrange to assess her patient. The patient arrived at the delivery suite at 11pm on the day she went into labour, and was found to have a blood pressure of 167/97.

Goff told her it was high ‘‘probably due to being in labour and tired’’, and did not ask about any other pre-eclampsia symptoms. Goff also failed to consult a specialist, and did not re-check the patient’s blood pressure for another two hours, by which time she was pale and feeling faint.

Her pressure was 188/106, which a student midwife recognised as high. Goff sent the student to get help, rather than using an emergency button. By the time an obstetric registrar turned up, the patient was shaky, pale, had a sense of impending doom and felt faint – all signs of an impending seizure. The patient was managed for severe preeclampsia during the labour, during which time her blood pressure shot up to 233/144 and she had to be given seizure prevention medication. The baby was born and appeared well.

Goff accepted the charges. She was suspended by the Midwifery Council after the patient complained, with the council finding she appeared to have no understanding of pre-eclampsia and was a serious risk to the public.

The suspension was to remain in place until a full assessment took place and she took part in an education programme. The tribunal censured Goff and ordered her to comply with all Midwifery Council directions. She also had to be supervised for at least 18 months after resuming midwifery, have a limited caseload for three years and was ordered to pay $9000 in costs.