Obstetric Malpractice Conference

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1 PRESENTING THE 7th Annual Obstetric Malpractice Conference The only national conference for the prevention, management and defence of obstetric negligence claims 22nd - 23rd June 2015 Rydges Hotel, Melbourne Key Speakers: Professor Alec Welsh, Professor in Maternal- Fetal Medicine, School of Women s & Children s Health, University of New South Wales David Hirsch, Barrister, Selborne Chambers Michelle Newton, Vice-President, Australian College of Midwives and Lecturer in Midwifery, La Trobe University Janine McIlwraith, Senior Associate, Catherine Henry Partners, and General Editor, Australian Civil Liability Bulletin Mary Anne Hartley QC, Barrister, Victorian Bar David Amor, Medical Director, Victorian Clinical Genetics Services Dr Srinivas Bolisetty, Lead Clinician & Senior Neonatologist, Department of Newborn Care, Royal Hospital for Women, Randwick Sharon Keeling MBBS, PhD, JD, Barrister, Victorian Bar Anna Robertson, Barrister, Victorian Bar Dr. Danielle Wilkins, Director of Maternity Services, Cabrini Health Ruanne Brell, Senior Solicitor, Avant Mutual Group

2 DAY 1 Monday 22nd June Registration and coffee 8.45 Speed networking session 9.00 Introduction from the chair 9.10 eligibility, access and collaboration - past, present and future challenges in Australia. The Health Ministers endorsed the National Maternity Services Plan in 2010 promised to improve women s access to a range of models of care including private practice midwifery. MBS and PBS subsidies were introduced for antenatal, intrapartum (excluding homebirth) and postnatal care provided by eligible midwives. Since that time a number of states and territories have published frameworks and for implementation of collaborative arrangements for eligible midwives in hospitals, but this has translated to little advancement in the numbers of eligible midwives accessing public hospitals, and therefore no real improvement in choice for women. This presentation will explore the past, present and potential future for the role of the Eligible midwife in the Australian health care system. Michelle Newton, Vice-President, Australian College of Midwives and Lecturer in Midwifery, La Trobe University 9.50 More lifting of the drapes: What really happens in obstetric litigation? In this session barrister David Hirsch shares his experiences and insights from some of Australia s most fascinating obstetric litigation cases. Recent rulings are discussed. Trends and unique observations shared. David Hirsch, Barrister, Selborne Chambers Morning Tea Discussion Panel Litigation based policy against evidence based practice There is a disparity created in the clinical environment when evidence based practice comes up against litigation based policy. What the evidence says, and what the hospitals do, is different. This has created an ongoing conundrum for midwives and obstetricians and all concerned with birthing. From the malpractice point of view there is no one set guidelines from RANZCOG or College of Midwives. Every hospital has a different set of guidelines and the situation is even more pronounced when you cross a state boundary. Can a uniform standard be agreed upon and implemented nation-wide? Janine McIlwraith, Senior Associate, Catherine Henry Partners, and General Editor, Australian Civil Liability Bulletin Mary Anne Hartley QC, Barrister, Victorian Bar Jayne Reece, Principal Solicitor, ACT Government Solicitor Bad outcomes in Maternity Care: Do Obstetricians intervene enough? Obstetricians are under increasing pressure to reduce the caesarean section rate. Is this justified by the facts? What are the outcomes after caesarean section in comparison to those with planned vaginal birth? The high caesarean section rate is often blamed on defensive medicine : implying the medicolegal environment unnecessarily raises the caesarean section rate. But is the reverse effectively true: Is the legal system biassed against effective obstetric intervention that may prevent death or disability? Professor Michael Permezel, University of Melbourne & Mercy Hospital for Women and President, RANZCOG

3 Monday 22nd June Networking Lunch 1.30 Pre-pregnancy genetic screening until recently, the offer of pre-pregnancy genetic screening for recessive disorders such as cystic fibrosis has been limited by the lack of routine availability of tests and their relatively high cost. Rapid advances in genetic testing technology have now removed these barriers, but have created new challenges regarding what level of testing should routinely be offered to obstetric patients. Current guidelines have failed to keep pace with advances in genetic testing technology, and there is growing concern about litigious and negative medical outcomes if genetic screening is not offered. David Amor, Medical Director, Victorian Clinical Genetics Services 2.10 Ideal practice or reasonable practice? Health care providers may be concerned about being sued for not offering every possible investigation or treatment. Is the required standard of care ideal practice or reasonable practice? How is the line between ideal and reasonable practice determined? An approach to a patient who refuses to comply with medical advice will be discussed. Sharon Keeling MBBS, PhD, JD, Barrister, Victorian Bar 2.50 Afternoon Tea 3.20 What is the future for doctors, nurses and midwives who do the wrong thing? A consideration of recent disciplinary proceedings, class actions and litigation This seminar will address the following topics by reference to recent disciplinary proceedings and court cases including A v Schulberg & Ors [2014] VSC 258 (the Hepatitis C Class Action): When might obstetricians / gynaecologists / midwives face disciplinary or other court proceedings? What are the likely outcomes for the health practitioner? What can be done to avoid disciplinary proceedings and litigation generally? Anna Robertson, Barrister, Victorian Bar 4.00 Legal issues concerning homebirth In recent years there have been inquests around the country looking at homebirth deaths. Most of these cases involve women with risk factors. Against this backdrop private midwives face the end of the insurance exemption and the real possibility that they will not be able to legally attend births after June This presentation will explore the ongoing legal status of homebirth in Australia and look at the legal and professional obligations of midwives supporting women with obstetric risk factors. Ann Catchlove, Lawyer 4.40 Closing comments from the chair 4.50 Close of day one and networking drinks

4 DAY 2 Tuesday 23rd June Registration and coffee 8.45 Speed networking session 9.00 Introduction from the chair Professor Alec Welsh, Professor in Maternal- Fetal Medicine, School of Women s & Children s Health, University of New South Wales 9.10 Balancing the interest of your clients and mitigating litigation opportunities The Birth Plan can be an excellent tool to help couples work together to think about their options during labour and birth. It is often promoted during birthing classes. There are over 44 million hits for Birth Plan on google, some disclose that you cannot actually plan your labour and birth, whilst others promote that having a birth plan makes birth easier. They often suggest excluding students and junior staff from care, and asking for a second opinion if an operative delivery is needed. What happens when the birth plan becomes a rigid protocol? I don t want to be tied to a monitor, I won t have an epidural, I won t be induced, I will not come to hospital if you say I have to have a caesarean section. How do we work with these families to achieve a safe and satisfying outcome for all? Dr. Danielle Wilkins, Director of Maternity Services, Cabrini Health 9.50 International surrogacy Current regulatory framework for surrogacy in Australia Ramifications of international surrogacy Protecting parents and children rights The case for and against tighter regulation Janine McIlwraith, Senior Associate, Catherine Henry Partners, and General Editor, Australian Civil Liability Bulletin Morning Tea insurance and indemnity issues and trends in obstetrics and midwifery In this session, we will look at industry trends and data and some of the developments in obstetric litigation will be examined. We will then discuss the implications of these developments for indemnity providers and health professionals. Ruanne Brell, Senior Solicitor, Avant Mutual Group Why is the legal profession so heavily reliant upon CTGs when the evidence to support their use as a screening tool for hypoxic damage is so poor? For decades the most significant driver for cerebral palsy litigation has been the cardiotocography, despite little evidence to support its use. If introduced today, the CTG would not pass any current tests for efficacy as a screening test, and would not be introduced. Nonetheless, there are experts worldwide willing to make statements of certainty based upon the CTG trace, and a number of lawyers who following the opinions of these experts. This talk will address the evidence mismatch for CTGs and hypoxic damage / cerebral palsy. Professor Alec Welsh, Professor in Maternal- Fetal Medicine, School of Women s & Children s Health, University of New South Wales Networking Lunch

5 Tuesday 23rd June Border line viability and responsibility around resuscitating before 24 weeks. This joint session will examine the legal and ethical issues surrounding the birth and decision making by practitioners and parents of pre-term infants born before 24 and before 27 weeks in light of a survey of recent NSW and ACT data regarding their prospects of survival. Would only marginal results be achieved? Would you be liable if you didn t provide the help? Dr Srinivas Bolisetty, Lead Clinician & Senior Neonatologist, Department of Newborn Care, Royal Hospital for Women, Randwick Deborah Foy, Barrister, Victorian Bar 2.10 Mandatory reporting Kathryn Booth, Principal, Medical Negligence, Maurice Blackburn Lawyers 2.40 Afternoon tea 3.00 The role of the Coroners Court of Victoria when there is a reportable death during pregnancy childbirth and the perinatal period* Reporting a death to the Coroners court of Victoria The legal definition of reportable death and what constitutes a sign of life What is involved in a coronial investigation into a reportable death? What factors a coroner will take into account whether to conduct an inquest? What can you expect if you are asked to provide evidence in the form of a statement and/or at inquest? Ruth Bergman, Senior Clinical Nurse, Coroners Prevention Unit, Coroners Court of Victoria Acting Sergeant Tania Cristanio, Coroners Assistant, Police Coronial Support Unit, Victoria Police Jodie Burns, Senior Legal Counsel, Coroners Court of Victoria 3.50 Defensive Medicine It is hard to imagine that thoughts of litigation enter the minds of clinicians faced with a patient in need of their medical expertise and whom they no doubt want to assist. But Defensive Medicine does exist. It includes ordering a test or taking another step to avoid litigation or liability. How much good it does for patients, clinicians and the health economy is questionable. The emphasis should instead be on good clinical practice and decision-making underpinned by guidelines that draw on the latest learning. This in turn will satisfy the reasonable standard of care required of professionals. Dimitra Dubrow, Principal, Maurice Blackburn Lawyers 4.30 Closing comments from the chair 4.40 End of conference Comments from previous delegates: Excellent program with case reviews and discussion sessions AHPRA Very topical discussions with fiery debates and some interesting networking contacts Sunshine Coast Hospital Health Service Great discussion & networking between lawyers and clinicians NS LHD

6 22nd - 23rd June 2015 Rydges Hotel, Melbourne The 7th Annual Obstetric Malpractice Conference again brings together leading barristers, lawyers, obstetricians, midwives and academics in this must-attend legal forum which has become a calendar event. This event promises to deliver a top shelf educational experience full of case studies and the latest thinking and trends from academia, government, the bar and clinical practice. Topics covered include: Eligibility, access and collaboration - past, present and future challenges in Australia. More lifting of the drapes: What really happens in obstetric litigation? litigation based policy against evidence based practice Detecting and preventing uterine perforations: A medical response Pre-pregnancy genetic screening legal issues concerning homebirth Ideal practice or reasonable practice What is the future for doctors, nurses and midwives who do the wrong thing? A consideration of recent disciplinary proceedings, class actions and litigation Balancing the interest of your clients and mitigating litigation opportunities International surrogacy Insurance and indemnity issues and trends in obstetrics and midwifery Border line viability and responsibility around resuscitating before 24 weeks. What to expect if I get called to the coroners court? Don t miss this exciting and highly educational summit where you can network and learn from the industry leaders and colleagues alike and also pick up those valuable CPD points. The early bird registration discount is currently on offer, visit the website at and book now to save $440. For more information or assistance with your booking, contact our customer service desk on or

7 22nd - 23rd June 2015 Rydges Hotel, Melbourne Pricing Details Register Early & Save Early Bird Rate Book & pay on or before 24/4/15 Standard Rate Book & pay from 25/4/15 Conference Package PRICE GST TOTAL SAVE PRICE GST TOTAL Two day conference $1,795 $ $1, $440 $2,195 $ $2, Two day conference (Hospital & Healthcare Rate) $1,295 $ $1, $440 $1,695 $ $1, SPONSORSHIP AND EXHIBITION OPPORTUNITIES The 7th Annual Obstetrics and Malpractice Conference can provide your organisation an opportunity to be in front of a unique audience of influencers. Whether your goal is to project thought leadership, make new contacts, strengthen relationships, introduce products and services or establish and maintain your prominence in the industry we will work with you to develop a solution that meets your specific objectives. For further details, please contact: Damian Dulanovic Phone: VENUE DETAILS Rydges Hotel, Melbourne 186 Exhibition St, Melbourne VIC 3000 Phone: (03) For full terms and conditions, please visit: Use your QR Reader App on your smartphone and scan this code to take you directly to the website

8 22nd - 23rd June 2015 Rydges Hotel, Melbourne If undeliverable return to: PO BOX Q1439, SYDNEY NSW 1230 POSTAGE PAID AUSTRALIA 3 Easy Ways to Register Stay Connected WEB ObstetricMalpractice2015 in LinkedIn Twitter #obstetric15 Telephone +61 (0) Quoting P15A18 Blog YouTube Quoting P15A18 Google+ Slideshare

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