A Medical Council inquiry into 'Dr A' and his care of baby Mark Molloy at the Midland Regional Hospital, Portlaoise in January 2012 has resumed for a seventh day of hearings with evidence from a consultant obstetrician at the hospital.
The consultant, who is Witness 4, was called at 8.30am on the day of the birth.
Witness 4 has been taken through the CTG trace for baby Mark, which records the foetal and maternal heart rate.
Witness 4 said the normal average heart rate for a baby is 110 to 160 beats per minute.
Witness 4 said a doctor would be concerned to see a higher or lower heart rate and a prolonged deceleration, prolonged meaning over about 9 minutes.
A deceleration is a heart rate reduced by 15 beats per minute, lasting 15 seconds.
Witness 4 said that from the trace at about 6.33am, the foetal heart rate in this case is under 110 beats per minute.
The witness, who was not present at the labour at this time, said that, as an isolated event, the drop in heart rate was not serious, once it did not happen again.
Witness 4 said the CTG showed there was a deceleration at 6.46am and 6.49am.
They said that between 7.20am and 7.45am the CTG was not normal and non-reassuring.
Between 7.40am and 8.05 am the CTG was persistent and pathological.
Witness 4 told the inquiry that whether one considered the trace to be recording foetal heart rate, or maternal heart rate, it was of concern.
Witness 4 was called by phone by 'Dr A' at 8.30am and told the inquiry it was very clear there was a problem.
The witness arrived in the labour ward at 8.39am and it was very busy.
There was noise coming from the CTG machine.
Witness 4 said the baby could not be delivered in the ward and so decided Mrs Molloy be brought to theatre, to have the baby delivered.
It was decided delivery be by Caesarean section as the safest option.
Baby Mark died shortly after birth on 24 January 2012.
In relation to the Philips field safety notice issued in 2009, regarding these CTG monitors, Witness 4 said it was an old problem, which most doctors practising even back in 1989 would be aware of.
The safety notice would have gone to clinical engineering at Portlaoise.
Witness 4 told the inquiry that, where there is concern about low heart rate, the doctor should call the registrar or consultant.
The witness also said that Syntocinon, a drug to speed up delivery, should not have been administered in this case.
A call should have been made to the consultant obstetrician (Witness 4) at 6.33am and straight away after 7.55am, when Dr A attended in the labour ward, the inquiry was told by Witness 4.
The inquiry has directed that Witness 4 not be named and that the doctors' gender not be identified.
At this inquiry 'Dr A' is facing seven allegations of professional misconduct and/or poor professional performance.
Among the allegations, it is alleged that 'Dr A' failed to properly review the CTG machine, which records the foetal heart rate.
'Dr A' is representing himself and denies the allegations.
The inquiry has adjourned until tomorrow.
