Doctors say baby Jack could have survived

BABY Jack Brandao-Magalhaes may lived if he was born five minutes earlier, an expert witness revealed during the final day of the inquest into the newborn's death.

Paediatric neurologist Dr Michael Harbord said if the newborn was delivered via emergency c-section before he suffered a cardiac arrest he would have been "likely to survive".

Before giving her evidence, Neonatal and forensic pathologist, Dr Susan Arbuckle turned to Jack's parents, Amylee and Thiago Brandao-Magalhaes and apologised if her testimony causes any heartache.

Dr Arbuckle told the court in Ballina a "better outcome" may have eventuated for Jack on New Year's day in 2014 if he was delivered "well-before" 11pm.

However, Dr Arbuckle and Dr Michael Harbord said if Jack survived there was a strong chance of brain damage due to the lack of oxygen and blood flowing to his brain during the labour.

Jack's cause of death was pinned down by the pair as hypoxia, a lack of oxygen to the brain for a prolonged period of time.

The expert witnesses narrowed down the reason for Jack's death to compressions on the umbilical cord during the labour limiting the flow of oyxgen.

It was overwhelming news for Mr and Mrs Brandao-Magalhaes and her sister Katie Carter who teared up at the heart-wrenching evidence.

Murwillumbah District Hospital: Over-reaching its birthing unit capabilities?

MIDWIVES were "surprised" by the presence of a cardiotocography (CTG) monitor in the "low risk" birth unit at Murwillumbah District Hospital.

Expert witnesses, Professor of Midwifery at the University of Western Sydney, Hannah Dahlen and midwife, Pauline Costins questioned why the birthing unit used the device.

Professor Dahlen said using a CTG at the low-risk birthing centre might "muddy the waters" because the device should be in conjunction with a foetal scalp electrode and blood sample - an advanced heart and oxygen level test not available at Murwillumbah.

This point was elaborated on largely by Obstetrics expert Dr Andrew Child - who called CTG's "not all black and white" and labelled terms associated with reading the device as "crap".

Ms Costins said the CTG machine may have delayed nursing staff's decision to transfer when asked by Deputy State Coroner, Magistrate Helen Barry.

The pair both agreed midwives should be using other measures to monitor the foetal heart rate at the centre.

Considering the two dips in Jack's heart rate by 9.15pm, both midwives said transport to The Tweed Hospital should have been arranged by 9.40pm at the latest.

In Mrs Brandao-Magalhaes case, the transfer occurred about an hour later.

Barrister for the Northern NSW Local Health District, Ann Horvath later emphasised that Murwillumbah Hospital has since implemented a policy that transfers must be arranged when a CTG is used for any reason during labour.

Dr Child's suggestion to integrate the Murwillumbah birthing unit into The Tweed Hospital to ensure a safer birth with instant accessibility to doctors was met with resistance by the midwives.

The midwives criticised the recommendation by Dr Child, saying it risks "drives natural births underground" and limits choices for women to give birth in "low risk", non-medical settings.

Findings hoped to be released in coming weeks: Coroner

CORONER, Helen Barry hopes to release the findings of this week's inquest in the coming weeks.

Her announcement followed the final submissions from the Crown, thefamily's legal team, the Northern NSW Local Health District and the NSW Midwives and Nurses Union.

Shine Lawyers NSW medical negligence practise leader, Caryn Ger - who is representing Mrs and Mrs Brandao-Magalhaes - said it's been a hard week for the family.

She described the couple as lovely people who experienced a tragedy that "it seems to have been preventable."

"I think Amylee and Thiago have been really brave in being here every day and listening to very difficult evidence," Ms Ger said

In particular, Ms Ger said evidence provided by Dr Arbukcle and Dr Harbord was important, though difficult, for the family to hear. 

After the inquest, Dr Arbuckle once again expressed her condolences to Mrs Brandao-Magalhaes, who thanked Dr Arbuckle for giving her "that bit of closure" she needed.

In a statement, NNSWLHD chief executive, Wayne Jones, said his staff " are co-operating fully with the coronial inquest."

"No comment can be made at this time regarding the results of the investigation, and we await the coroner's findings. We continue to extend our sympathies to the family for their sad loss," Mr Jones said.

Ms Ger said the family's legal team will be pursuing litigation.

"I hope that this process (the inquest) and any litigation that follows offers some slim comfort," she said.

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