Inquest into death of four-day-old baby of Karolina Rewers and Louis Rogers from Gravesend hears from doctor
A doctor told an inquest of his "desperate" attempts to arrange for an ambulance to transfer a critically ill four-day-old baby in need of specialist care.
Dr Adbul Hasib, consultant paediatrician at Darent Valley Hospital, made several phone calls to three teams responsible for emergency transport.
However, it was almost five hours before Vincent Rewers, who was suffering from an extensive bleed on his brain likely to have been caused at birth, was able to be "safely" transferred to King's College Hospital in London.
Old Town Hall in Gravesend High Street
At one stage, and several hours after King's had agreed to admit the baby, a doctor at King's telephoned the Dartford hospital to say his transfer was "urgent".
Dr Hasib told the hearing at Gravesend's Old Town Hall that he made numerous calls to try to arrange transportation by teams including Medway Neonatal Transport Team and the Kent, Sussex and Surrey Neonatal Transport Service.
They were either unable to transfer Vincent "safely" with all necessary equipment, or were busy transferring other ill babies.
"We were desperately trying to fulfil this (the transfer) from our end," he said, adding that he later reported the difficulties he had experienced.
However, Dr Hasib said that although it was essential to transfer a patient as soon as possible after a brain injury diagnosis, with babies it was important they were stable.
"It’s not scoop and run, it is not a case of take the baby and run. The word is stabilisation. We cannot move a baby from point A to point B unless the baby is stable."
"It’s not scoop and run, it is not a case of take the baby and run. The word is stabilisation. We cannot move a baby from point A to point B unless the baby is stable" - Dr Abdul Hasib
Dr Hasib added that the situation would be "dire straits" if complications occurred while en route to another hospital and the baby could not be stabilised.
“Babies this small are very fragile and we have to balance the risk and the benefit. It’s not just transporting, but transporting safely is equally important.”
Vincent had been born by ventouse, a vacuum-like device, at the hospital on October 4, 2012, but died at King's on October 8 from a brain injury and subdural haematoma.
This is a serious condition when blood collects between the skull and the surface of the brain and is often caused by a head injury.
Consultant paediatric pathologist Liina Kiho told the inquest it was "probable" that the instrumental delivery was a significant cause for the baby's head injury.
However, other medical experts described Vincent's birth as an "easy and "straightforward" delivery requiring just two pulls with the ventouse.
Despite weighing less than 5lbs, he was said to be healthy with no visible markings to his head.
Vincent was the first baby for Karolina Rewers, 23, and Louis Rogers, 29, from Gravesend.
But within a day of his birth, and while still on a ward, the baby was having difficulty feeding and suffering from low blood sugar levels.
He was transferred to the special care baby unit at Darent Valley in the early hours of October 5. Doctors later feared he was suffering from an infection, in particular meningitis, after he started having seizures.
Vincent was given medication but it was not until Dr Hasib first became involved at 2.30pm that day that a CT scan was requested and emergency transfer considered.
Darent Valley Hospital in Dartford
While Dr Hasib spoke to colleagues at the special care baby unit at Medway Maritime Hospital and the neurological unit at King's, Vincent continued to have seizures and his parents were informed the prognosis was "very poor".
Dr Hasib added that by 5.30pm, 37 hours after the baby was born, the opinion of doctors at King's was that Vincent would not survive such an extensive bleed. He had, by this stage, been intubated and put on a ventilator.
But, having decided to accept his transfer following consultation with King's paediatric team, the inquest heard it was not until after 9pm that evening that Vincent left Darent Valley.
By the time he arrived at King's College, the neurosurgical team decided that intervention was not possible because of "substantial risk".
Even if Vincent had survived surgery, the hearing was told he would have been profoundly disabled, unable to walk, speak or see.
Dr Hasib also told the inquest that with the benefit of his colleagues' assessments of Vincent's condition, he had not "lost a second" once he became involved in the youngster's care.
But, expressing his condolences to the family, he added that he did not believe the "considerable delay" in transferring Vincent affected his chances of survival.
"I am really sorry to say this but there was nothing much to do," he said.
He continued: “It is so very unfortunate and I feel deeply sorry for the parents and grandparents that he passed away despite best efforts.”
Dr Hasib also said that the development of a subdural haematoma was a very gradual process, with most not requiring any treatment, and that there had to be "pressing" indications for a CT scan to be carried out.
He added that he could not say whether an earlier CT scan would have helped Vincent, but that his care at Darent Valley was in accordance with national guidelines.
The inquest heard that since Vincent's death, improvements in the transfer system had been made.
The hearing continues.
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