Doctor takes the stand in Huntly death inquest

01:28, Feb 18 2014
Casey Nathan
TRAGIC END: Casey Nathan, kissed here by Hayden Tukiri, died six hours after giving birth.

A Waikato Hospital doctor could say only that it was "possible" the life of a young Huntly mother would have been saved if she'd been taken to hospital earlier.

Dr Aidan O'Donnell spent the morning of his second day on the stand at a coroner's inquest into the deaths of Casey Missy Turama Nathan, 20, and her son, Kymani, in Hamilton today.

Nathan died in Waikato Hospital on May 21, 2012, six hours after giving birth to Kymani, who died two days later.
When questioned by coroner Garry Evans, O'Donnell, who has 16 years' experience, said it appeared Nathan was suffering an amniotic fluid embolism (AFE) when she arrived at Waikato Hospital.

Casey Nathan family
SEEKING ANSWERS: Friends and family of Casey Nathan arrive at court. They provided a list of 10 concerns they wanted addressed.

AFE is a rare and incompletely understood obstetric emergency in which amniotic fluid, foetal cells, hair, or other debris enter the mother's bloodstream via the placental bed of the uterus and trigger an allergic reaction.

This results in the heart and lung collapsing.

The coroner asked O'Donnell if the hospital had had access to Nathan earlier, would AFE have been diagnosed earlier?


"Yes," O'Donnell replied.

However, he said it was only "possible" that her life would have been saved.

He told counsel representing the Nathan whanau and Hayden Tukiri - Nathan's partner - that when Nathan arrived at hospital she had suffered extreme blood loss, estimated at 2 litres. This was classified as Class 4 - the most severe loss that a person can experience.

O'Donnell said he was surprised at Nathan's state, given the hospital had been told she'd lost less than that.
Counsel Kay Hoult asked him whether the underestimation of blood loss was acceptable.

Nathan's lead maternity carer - who has name suppression - had recorded that she had lost just 480 millilitres of blood at Huntly Birth Care, Hoult said.

O'Donnell said a healthy woman going through labour would normally lose about 500ml.

Asked why the midwives didn't insert an intravenous line into Nathan sooner - at Huntly Birth Care - O'Donnell said that by then Kymani had been born, and "there were conflicting demands on their time".

O'Donnell said the delay in the midwives getting an IV line in was "slightly disappointing". However, even his own staff struggled to do the same at Waikato Hospital.

The doctor said it was his opinion, from the evidence that he had read, that Kymani suffered an event during delivery which resulted in his brain damage.

Therefore, O'Donnell said, by the time the ambulance arrived the damage had already been done.

The coroner's court heard up to 14 doctors worked to save Nathan.