An expert witness has told a Medical Council inquiry that he provided training to Portlaoise Hospital, regarding limitations to using the CTG machine, which records the foetal and maternal heart rate.
He was giving evidence via Skype, on the 11th day of the fitness-to-practise inquiry, into seven allegations of professional misconduct and or poor professional performance against Dr A.
It concerns Dr A’s care of baby Mark Molloy at the Midland Regional Hospital Portlaoise.
Mark Molloy died on 24 January 2012, shortly after birth.
The witness, who cannot be identified, is a qualified midwife and provided training for cardiac services.
He said staff were made aware that the CTG machine could confuse the maternal heart rate, with the foetal heart rate.
The makers Philips had also issued hospitals with a field safety notice on the issue in December 2009.
It is alleged Dr A failed to properly review the CTG machine and failed to interpret it as abnormal.
Dr A denies the allegations and is representing himself.
Under questioning by Dr A, the expert witness said he was not aware of any statutory or legal requirement that would require staff to attend the CTG training sessions.
Dr Elizabeth Sarah Cooper, consultant obstetrician and gynecologist at the Royal Infirmary in Edinburgh, gave expert witness evidence in the case for the council.
She said that CTG machines are used to establish if a baby is developing hypoxia - a deprivation of adequate oxygen supply.
Dr Cooper has gone though the CTG trace for baby Mark, which was started at 5.10am on 24 January 2012.
She said that, when Dr A arrived and signed the CTG trace around 7.55am, the baby was not managing to achieve a normal heart rate and the trace was 'pathological'.
She said the trace was most likely monitoring the baby's heart rate.
Dr Cooper said the failure to adequately review the CTG was poor professional performance.
She said the action by Dr A should have been to examine Mrs Molloy to see whether the baby could be delivered by forceps in the delivery room, or if a caesarean section in theatre was needed.
She added that, by 8.05am, Dr A should have telephoned the consultant for assistance, but instead he allowed more time to pass, when the baby was short of oxygen.
Dr Cooper told the inquiry that Dr A's actions contributed to asphyxia, which led to the death of baby Mark.
She said he was not solely responsible, as there were midwifery failures also.
She described his decision to retrospectively change the notes on the CTG trace from 'satisfactory' to 'unsatisfactory' as an attempt to deceive.
Dr Cooper said that a midwife at Portlaoise should have called a doctor at 6.32am when the CTG trace was abnormal.
She was surprised the midwife did not alert people earlier.
Dr Cooper also said that the delivery of baby Mark should have been performed by someone by 7.30am.
Dr Cooper said that Dr A was just one piece in the jigsaw of how the entire events unfolded at the hospital.
She said that before Dr A was called and arrived at 7.55am, there were failings by midwives.
She also said the consultant who came at 8.39am should have acted sooner.
The inquiry has adjourned until tomorrow when it will hear closing submissions.
