Baby's head `crushed' by forceps birth

AN OBSTETRICIAN who left the country after allegedly crushing a baby's head during a forceps delivery may be extradited to Britain to face a manslaughter charge.

Helmi Nour, a former locum senior registrar at Queen Charlotte's hospital, west London, is said to have used "grossly excessive" force in trying to deliver the baby, Amos Tutt, who died an hour after birth on 16 August 1997.

He should have been a healthy 8lb boy but he was born with a four-inch skull fracture and haemorrhaging. The pathologist who performed the post mortem examination said he had never before seen such extensive injuries.

Mr Nour, who is now practising in Saudi Arabia, is accused of serious professional misconduct by the General Medical Council which opened its hearing into the case yesterday in his absence.

The obstetrician is alleged to have made repeated attempts to deliver the child, "yanking and jerking" the forceps before discovering that he had misdiagnosed the baby's position in the womb. He continued his attempts, despite protests from the child's father, Andrew Tutt, a cancer specialist at the Royal Marsden Hospital, London, and requests from colleagues that he seek a second opinion.

Rosalind Foster, counsel for the GMC, said one witness had seen Mr Nour put his feet up on the bed to get a better purchase. The "very severe" skull fracture "can only have been produced by injudicious excessive force at the time of the delivery", she told the hearing.

The baby's mother, Anne Tutt, 35, a barrister, said despite having had an epidural she immediately felt a "dramatic difference" in the force used by Dr Nour compared with the earlier, gentle tugs by his junior colleague who had first tried to deliver the baby.

Mrs Tutt said: "I hadn't felt anything up to that point. I felt myself bracing myself on the bed. After a bit, there was more yanking, tugging, strong forward pulling with a jerk, pulling downwards. I slipped down the bed." She said she realised something was very wrong when she saw the worried faces of other members of staff standing at the end of her bed.

Dr Tutt told the hearing how Mr Nour appeared to be pulling his wife "in several directions, continually applying force". He added: "He was continuing to pull. It didn't seem to be an obstetrics emergency that required the sort of force he was using. Dr Tutt quickly realised the delivery was "not being performed correctly".

Then the baby's heartbeat started to fall. "I realised something terrible had happened. He said he had to turn the baby and did it."

Afterwards, Mr Nour, who had worked in Britain for more than six years, is alleged to have made a false entry about his role in the delivery in the medical records.

Miss Foster earlier said that Mr Nour had repeatedly failed to comply with the council's requests about the proceedings for over a year and attempts were now being made to extradite him back to Britain.