"she was on a bit of a warpath."
A consultant gynaecologist has been suspended for three weeks after a disciplinary tribunal found she bullied a first-time mother into agreeing to a forceps delivery against her wishes during a traumatic birth.
Dr Premila Thampi, from South London, was working at Milton Keynes University Hospital in Buckinghamshire when the incident occurred in October 2016.
The Medical Practitioners Tribunal Service (MPTS) found she failed to obtain informed consent and used inappropriate language and pressure on the patient, known as Patient A.
Patient A, who was 41 weeks and three days into her pregnancy and suffers from a neuromuscular condition, had requested a caesarean section.
But Dr Thampi allegedly dismissed her pleas, insisting on using forceps.
According to Patient A’s testimony, Dr Thampi said: “What you need to understand and appreciate is that I am a Consultant and it is after six o’clock and I could have gone home and left one of my Registrars to deliver this baby!”
The patient told the tribunal she felt “intimidated” and “bullied” during the delivery and said Dr Thampi’s tone and manner made her feel unsafe.
Patient A said: “I remember thinking at the time she was on a bit of a warpath.
“I could tell Dr Thampi was angry by her demeanour, how abrupt she was being with me and her poor bedside manner.
“She was giving me no explanation as to anything; she just kept waltzing in and out of the room.”
Dr Thampi was also accused of pressuring the woman by saying: “You need to let me do this as I don’t know what is going to happen to your baby. You are putting your own baby at risk.”
Patient A claimed she finally agreed out of fear, shouting: “I hate you, you haven’t listened”, as the forceps were applied.
She said her baby suffered injuries to the head and face, and that the trauma from the birth still affects her today.
Her mother, who was present during the delivery, backed the account and said: “Miss Thampi said that she was a consultant and that Patient A needed to listen to her.
“She said that it was now after 6 pm and she could have gone home and left a junior to deliver the baby.”
During the hearing, the General Medical Council’s barrister, Simon Jackson KC, said:
“No patient should be ‘pressured’ into agreeing to any procedure that they make clear they do not want.
“Dr Thampi’s way of treating patients, and her own decision-making processes in relation to the key issues of consenting to an instrumental delivery showed a rigidity of approach, and a lack of willingness to reflect on how things could and should have been done differently.”
Patient A stated that her concerns about forceps were known to the hospital in advance and had been communicated to the midwifery and antenatal team.
But she said the consultant gynaecologist ignored these objections and offered little to no alternative.
Patient A explained: “She was implying that I would receive a substandard level of care from her registrar.
“I felt forced into consenting to the use of forceps. I just said, ‘Do what the f**k you want, you’re going to f**king do it anyway, you haven’t listened to me all day!’”
In her defence, Dr Thampi said: “I discussed the option of an assisted delivery with Patient A, advised her about the use of Ventouse and also the possible use of forceps.”
She insisted the patient consented after she offered reassurance.
“She was happy when I said forceps will not damage the baby and she said, ‘You can go ahead with the delivery’.
“Once it was apparent that delivery could not be facilitated solely by the use of ventouse, I discussed further with Patient A the use of forceps and the need for an episiotomy.
“Patient A said she did not want a forceps delivery but only when, in my clinical judgment, it was too late to safely change to a Caesarean section.”
She maintained that a C-section at that stage would have been riskier than using forceps:
“Patient A’s clinical condition and the position of the baby’s head meant the use of forceps was the most reasonable option in Patient A’s and the baby’s best interests.”
Addressing the tribunal, Dr Thampi said: “I appreciate the effects that a traumatic birth can have on a mother and baby.
“I am very sorry that Patient A had the birthing experience that she did and I have reflected on this deeply.”
She denied ever saying she could have gone home at 6 pm, explaining she was contractually obliged to work until 7 pm. The tribunal accepted this but upheld other allegations.
Dr Thampi was cleared of misconduct in relation to two other patients.
MPTS chair Mrs Tehniat Watson said: “Whilst the conduct involved one patient a significant number of years ago, the failure to obtain informed consent, Patient A being pressurised into agreeing to a forceps delivery, and inappropriate communication were serious matters and action is needed to mark the seriousness to uphold the wider public interest.”
Dr Thampi’s three-week suspension is effective immediately.
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