AN OBSTETRICIAN who cared for a woman who bled to death after giving birth ... says he did not perform a potentially life-saving hysterectomy because her anaesthetist refused to participate.
Dr Maurice Lichter, an obstetrician with more than 30 years' experience, told the Victorian Civil and Administrative Tribunal yesterday that he packed Piyanat Siriwan's uterus with gauze about 90 minutes after she delivered a healthy baby girl ... because she was bleeding heavily.
After the procedure ... he left the ... mother in the care of anaesthetist Dr Emlyn Williams ... for more than an hour because he expected they would closely monitor her and report any further bleeding to him.
... when he returned to Mrs Siriwan ... he was angry and appalled to find that she had deteriorated and no one had contacted him.
... Dr Lichter ... decided that she needed an urgent hysterectomy and asked Dr Williams if he would help perform the procedure at the hospital.
''... (Dr Williams') response was something like, 'No this is the wrong place …we need to have an intensive care unit for her recovery,''' ...
Dr Lichter did not believe he could find another anaesthetist to assist, so transferred Mrs Siriwan ... Dr Lichter took more than an hour to arrange the transfer and by the time Mrs Siriwan was in the ambulance ... she had lost an estimated four litres of blood ...
Doctors ... performed an emergency hysterectomy about six hours after she gave birth, but Mrs Siriwan died a short time later.
Dr Williams told the tribunal that he did not refuse to perform the hysterectomy, but advised against it being done at South Eastern Private as it did not have the right resources, including an intensive care unit.
''If he (Dr Lichter) told me the patient would die if we didn't do it, then I would have given her the anaesthetic,'' he said.
Dr Lichter said that if a similar case presented in future, he would try to perform a hysterectomy sooner or transfer the patient to another hospital for the procedure faster ...
The Medical Practitioners Board of Victoria has accused Dr Lichter of failing to manage Mrs Siriwan's condition appropriately. It has alleged that he should have monitored Mrs Siriwan himself and that he did not give appropriate orders to others caring for her in his absence.
The board has also alleged that Dr Lichter should have performed a hysterectomy and that his decision to transfer her to another hospital was inappropriate.
Dr Williams is also accused of failing to manage Mrs Siriwan's condition appropriately ... The hearing continues.