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Page I OUTLOOK Saturday a IMS Outlook Hal top Hills Dr Ford hearing Expert witness concerned with some procedures By BRIAN MacLEOD HeraM An expert witness for the Georgetown hospital testified Jan 12 that In three different cases he reviewed Dr Jack Ford showed poor judgement Dr Drew Allin a doctor at Toron- Hospital has con ducted reviewa for the Canadian Medical Detective Association He was asked by Georgetown Hospital Executive Director Mark to review charts for three of Dr Fords patients In a covering letter to Georgetown hospital lawyer Joshua about the cases Dr Allin said Dr Ford showed poor Judgement and a quality of care that was not up to standard After reviewing a further charts to gage Dr Fords practice at the same time Dr Allin who said he never met Dr Ford told the Board Bad things can happen to good peo ple but the sheer volume of bad things that has happened here over whelmed me In Involving the use of midforceps which eventually resulted in the baby suffering a broken neck Dr said the forceps were applied too quickly Dr Ford had previously testified that the average second stage of labor Is an hour before forceps are applied In this case the forceps were applied to minutes Into se cond stage said Dr Neither the mother nor the baby showed any signs of distress he said I felt was a very short time before a rather major step was taken he said The baby died at Sick Childrens Hospital In Toronto after growing to about pounds said Dr Alibi Dr Ford has also previously testified that he doesnt call an anaesthetist before deliveries because hospital policy says they But Dr Allin stressed that having an anaesthetist at arms length gives a doctor the psychological ad vantage of halting the midforceps delivery If It seems difficult An anaesthetist must be present if a doctor is to halt a mid- forceps delivery and perform a Caesarian Cathy The Herald Is pleased to an nounce the hiring of Cathy McGongb as the new advertis ing sales consultant She replaces Lowes who Is Joining the Dally Observer is a member of their sales staff Cathy was born and raised In Stratford Oot and has six years experience la advertising with the BesconHeratd a dally Pam Lowes wotted formerly for the Daily Reformer Braat- Expositor and the Halloo Hills Herald REGULAR TIME SILVER POLISHING CLOSETS CUPBOARDS LAUNDRY WINDOWS ETC REFERENCES To Suit Your Heed FREE ESTIMATES BONDED 8771724 section To walk Into these possibilities without having an anaesthetist ready for a Caesarian section Is had judgement he said Most of us agree there is no place or very Hide for a difficult midforceps delivery To initiate a difficult midforceps delivery In a hurry shows lack of Judgement he said The questioning then turned to Dr Fords choice of forceps The doctor earlier testified he uses Simpsons forceps because he feels more comfortable with them But Dr said rotating a baby during delivery as Dr Ford did in this case often requires use of Kieiland forceps The Kieiland forceps has a sliding lock to allow easier applica tion to the babys head said Dr Allin the baby Another case involved a baby who suffered a lacerated eye after a mid forceps delivery The baby was transferred to Sick Childrens Hospital In Toronto with a suspected scratched cornea Second stage of labor lasted only 39 minutes after a 27hour first stage said Mr Applying the forceps at that time was rushing the situation said Dr He questioned Dr Fords use of a local anaesthetic in the delivery Dr Ford has previously testified he prefers a local anaesthetic to an Epidural Block or a Pudendal Block One of the latter two of anaesthesia are necessary to per form a Caesarian section Local anaesthetic 1 feel is less than ideal when youre dealing with a midforceps delivery said Dr Allin He said an anaesthetist should always be present when performing a midforceps delivery which he called always potentially dangerous In case a Caesarian section Is need ed The third case Dr Allin examined was the muchdiscussed VBAC vaginal birth after Caesarian Dr Ford sold the woman had her first Caesarian section because of the presence of active herpes and the se cond Caesarian was performed because it was hospital policy at the time that once a Caesarian always a Caesarian He said the VBAC was high risk and facilities should be In place to perform a Caesarian section within naif an hour of labor However Dr Ford went to Toron to that day She was showing possi ble signs of labor but It may have He put himself beyond the time limit which is reasonable which Is half an hour by going to Toronto Mr said Mr said Dr Ford never officially transferred the case to Dr Kumar and never gave her the background information on the case la that an acceptable situation to carry out a VBAC asked Mr No it Is not replied Dr All in Dr Allin said he had five areas of concern In Fords practice His use of and and C operations Tor dysfunc tional uterine bleeding is not an ef fective treatment said Fords surgical treatment of urinary stress incontinence caused by an infection isnt usually effec tive he said In many cases the patient will respond medical treatment first He said many cases of urinary in continence require a workup farther investigation before surgery Volunteers needed Volunteers are In short supply Hal ton Centennial Manor There are vacancies available to help with bingo the Manor greenhouse adjuvant room or the craft room Call today and find out how you can help Single parent Arc you a single parent In terested In attending family ac tivities discussions card nights dances Join Parents Without Partners On January at m a membership information meeting will be held at the Bra ma lea Civic Centre A general meeting will begin I m munization The Regional Health Department Immunization Clinic is now held the first Wednesday of each month from m the Burlington office Brnnl Street and the second Tuesday of each month alter nating the Georgetown of fice Main St S and the Milton Main Street For an appointment call the Health Department office at ONION APPLE BAKE mediumsized onions mediumsized apples slices bacon soft bread crumbs chicken stock salted Peel onions peel core apples and cut ell Into thin slices Cook bacon then chop It Into fine pieces Use a little the drip pings to toss and barely coat the crumbs In a baking dish layer the onions apples and bacon Pour the stock over all and top with crumbs Cover and bake at 376 F tor 30 minutes then uncover bake about minutes to crtsp the crumbs Foodstuff Dr Allin said he also questioned Fords practice of performing midforceps deliveries with a local anaesthetic his tendency to reinsert Inter uterine devices in the presence of ab normal bleeding That is a glaring example of In appropriate use of an IUD he said Dr Allin said his final concern was Dr Fords management of pa tients with premature ruptured membranes Under crossexamination Dr Fords lawyer Gavin MacKenzie told Dr Allin that the doctor used midforceps In only five per cent of his deliveries during his eightyear practice Dr Allin testified that four to five per cent is average At that point Mr Llswood in dicated that be would introduce evidence saying Dr Ford used mid forceps In eight per cent of his deliveries In the last few years of his practice at a time when increased fees for midforceps deliveries were introduced Would your worries be alleviated if Dr Ford changed his practice asked Mr MacKenile I would be encouraged not necessarily alleviated replied Dr Allin Turning his attention to the VBAC case Mr MacKenzie asked Is it your understanding that Dr Ford came back and took care of the baby Dr Ford delivered the baby We can take it as a given that Dr Ford did deliver the baby said Board Chairman Thomas as Mr MacKenzie also questioned the use of chart review as sufficient means for review Chart review has withstood the test of time It Is an effective though Imperfect means of investigation said Dr He said the Ontario College of Physicians and Surgeons 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