Friday, July 06, 2007

Doctor hastened babies' death, court told

hospital doctor administered a massive dose of a paralysing drug to two terminally ill babies, hastening their deaths, the General Medical Council heard yesterday.

Dr Munro denies misconduct
Michael Munro, a consultant neonatologist, gave 23 times the normal dose of pancuronium, a muscle relaxant, to the children moments before their deaths, contrary to medical guidelines in an act "tantamount to euthanasia", the GMC was told.
The doctor failed to record his actions in the medical notes of either child.
Dr Munro, 41, was working in the neonatal unit of Aberdeen Maternity Hospital on Dec 5, 2005, when a child, known only as Baby X, was born more than three months premature.
The GMC's fitness to practise panel, sitting in Manchester, heard that the child suffered a brain haemorrhage and the decision was taken to withdraw treatment after its condition worsened.
Shortly after 11.30am on December 20, the baby's breathing tube was removed and doctors began a course of morphine to ease the child's suffering.
As Baby X became weak, it began to struggle to breathe - a normal consequence of treatment withdrawal and a condition known as agonal gasping.
Dr Munro told Baby X's parents he could give the child a drug but "it was on the verge of what society finds acceptable", the hearing was told.
He then injected the child with 2,000 milligrams of the drug which, he admits, hastened the death of Baby X.
Colleagues raised doubts about the treatment and an investigation was launched into the doctor's actions.
Despite telling investigators that he had never administered pancuronium before, the inquiry discovered he had injected another child with the muscle relaxant six months earlier.
Andrew Long, outlining the case for the GMC, said: "Dr Munro administered a muscle relaxant drug called pancuronium to both babies which stopped them breathing and hastened their death. These primary facts are admitted and indeed Dr Munro admits his conduct was outside accepted professional practice, but Dr Munro does not accept it was inappropriate, contrary to guidelines or below the standard expected of a medical practitioner.
"The GMC asserts it was all of these things and tantamount to a form of euthanasia even though death was inevitable."
Dr Munro denies his conduct was below standard, dishonest or inappropriate.
Mr Long described how Baby Y was born on June 20, 2005, two weeks premature.
Following complications in pregnancy, the child was born with pulmonary hypoplasia and pulmonary hypotension and needed help breathing.
Again, after consultation with the family, the decision was made to withdraw care.
Mr Long said: "At about 8.30pm care was discontinued and the child was started on a morphine injection and was then given to his parents to nurse while his life ebbed away.
"In the terminal phase of life the child began gasping. This can be painful and distressing for both parents and staff to see."
Dr Munro instructed a nurse to get a phial of pancuronium and he administered a dose to the child.
The doctor admits he failed to note in the child's medical records that he had administered the drug.
Mr Long stressed that neither set of parents was unhappy with the doctor's treatment of their children.
The hearing continues.


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