'Frustration' over delays during critical hospital transfer

THERE was "tension in the air" and "frustration" when two paramedics arrived at a North Coast hospital where a pregnant woman was having a difficult labour.

Paramedic and registered nurse Rohan Miller and his colleague, Greg Golds, were tasked with transferring Amylee Brandao Magalhaes from the Murwillumbah District Hospital to Tweed Heads Hospital late on January 1, 2014.

Both men gave evidence at the NSW Coroner's Court in Ballina yesterday, which is investigating the circumstances leading up to the birth of baby Jack, who died just three days later when his life support was turned off.

Mr Miller said he spoke to the expectant mother and her support person before the hospital transfer and "sensed tension".

He told the court Mrs Brandao Magalhaes' waters broke on the ambulance stretcher.

Mr Miller said her waters contained about "one litre or more" of liquid stained with meconium, which is a baby's first stool.

Based on his years of experience, he told the barrister for the Crown, Adam Casselden SC, that meconium-stained liquid was an indicator of a baby in distress.

But Northern NSW Local Health District barrister, Ann Horvath, referred to conflicting accounts of the colour of the expectant mother's waters, from brown, brown red to red.

She asked Mr Miller to reconsider his initial description of the waters.

He reaffirmed the waters were meconium-stained and cited the colour as a "yellowy green colour" as justification.

A similar description was given by Tweed Hospital midwife, Sandra Ball when she said baby Jack "was covered in meconium" that was coloured a "dark green" after he was birthed via emergency c-section.

Fellow paramedic Greg Golds told the court he also knew baby Jack was in distress in the womb at Murwillumbah Hospital and said he "made his feelings known the transfer should get going".

Mr Golds said he was "frustrated" at delays holding up the transfer, mainly what he thought was nursing staff trying to apply an IV fluid into an "emotionally distressed" Mrs Brandao Magalhaes.

When Deputy State Coroner, Magistrate Helen Barry asked how often birth transfers to the Tweed occurred, Mr Golds answered "reasonably often" and said he has observed an increase in the last five years.

Flanked by her husband Thiago and her sister Katie Carter, Mrs Brandao Magalhaes yesterday sat in the front row of the gallery as the evidence was presented on day three of the inquest.

The two women clutched tissues as Ms Ball, the final witness for the day, walked lawyers through her recollections of baby Jack's birth.

When asked by the Crown about baby Jack's heart decelerations, Ms Ball said she didn't realise the "enormity" of the situation surrounding the baby's heart beat until later in the evening after more testing.

Ms Ball said the full extent of the decelerations wasn't communicated by Murwillumbah Hospital midwife, Robyn Brazel.

In saying that, Ms Ball also said she'd seen "appalling" CTG heart rate tracers, but the baby had come out screaming, fit and healthy.

The inquest continues tomorrow.

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