Bend midwives face discipline

State licensing board brings two cases

By Sheila G. Miller / The Bulletin

Published Nov 29, 2012 at 04:00AM

Two Bend midwives face discipline from the state for keeping inadequate records, failing to disclose whether they had malpractice insurance and other alleged unprofessional acts.

Nicole Tucker, who owns and operates Motherwise Community Birth Center, may be sanctioned for two incidents, while Christyn King, a former midwife at the center, may be sanctioned for one incident. Calls to Motherwise were not returned.

The Oregon Health Licensing Agency’s Board of Direct Entry Midwifery in June notified Tucker and King of the impending discipline. The women may request hearings; if they don’t, the order will become final.

The board investigated Tucker alone on one complaint and the two together on another complaint.

In response to a complaint filed in March 2011, the board alleges Tucker failed to tell a client whether Motherwise carried malpractice insurance, and described her chart notes as deficient. The agency has proposed a $1,500 fine.

In December 2010, the woman’s water broke nearly 24 hours before Tucker decided the woman needed to go to a hospital because her labor wasn’t progressing. The woman asked and Tucker arranged for her to be taken to St. Charles Redmond, 18 miles away. But after arriving there, the baby was delivered by Caesarean section and then flown to St. Charles Bend’s neonatal intensive care unit with possible sepsis, according to the disciplinary notice.

In a second case, , the state received a complaint against Tucker and King in September 2010. According to the board investigation, the complaining client started receiving care from Motherwise in September 2009, with Tucker as her primary midwife. King assisted with the woman’s care.

Tucker was responsible for explaining the birth center’s policies and billing procedures. Tucker did not disclose whether she carried malpractice insurance, and admits her forms didn’t provide that disclosure until Jan. 1, 2011. She also did not provide the woman with an emergency transport plan.

In addition, the woman’s bill changed between September 2009 and January 2010, increasing by $400.

When the woman went into labor April 19, 2010, King was the only “non-apprentice midwife” on hand for the first 15 hours of the woman’s labor, until Tucker arrived around 7:30 p.m. The labor was difficult. By 10:15 a.m. the next day, King and Tucker decided to take the woman to St. Charles Bend. The baby was delivered around 1 p.m. by Caesarean section.

According to the investigation, “no detailed labor flow charts were created or provided” on the two days of labor, and were not provided to the mother until four months after her first request. The agency also found that some chart notes and forms were inaccurate or missing.

As penalty, the agency has proposed Tucker pay a $2,500 fine and be required to submit for review client disclosure forms and client records and charts for 10 mothers under Tucker’s care after the final order.

The agency proposes King pay a $1,750 fine, earn six continuing education credits at her own expense and submit for review five complete client charts.

Reached by phone in Vermont, King said she’s requested a hearing, which will take place in April. She also said the state has offered to erase the majority of fines against her and is in the process of rewording the “finding of facts” in the order.

The disciplinary action isn’t the first problem for Tucker, King and Motherwise.

In April, the parents of a child who suffered complications at birth sued Motherwise, King and Tucker, as well as the state, asking for more than $50 million and alleging medical negligence and fraud.

The lawsuit, filed by Kristine and Greg Andrews on behalf of their son, alleges that Motherwise, Tucker and King lacked malpractice insurance and did not alert the parents to that fact.

According to the lawsuit, when the child was born April 5, 2010, he did not breathe on his own. He was taken to St. Charles Bend; discharged 10 days later, he had signs of brain damage caused by oxygen starvation at birth. The child suffers from significant brain damage and cerebral palsy.

In May, the state denied it caused any injury to the boy or Kristine Andrews. In its answer, the state said it issued administrative rules to govern midwifery, but denies any culpability in the birth.

In July, Tucker admitted that she and Motherwise lacked malpractice insurance, but wrote that she didn’t have enough information to weigh in on the medical allegations of the lawsuit.

King also answered the lawsuit in July. She wrote she doesn’t know whether she or another employee told the Andrewses about the lack of malpractice insurance, and “did not intentionally hide any information and was unaware the Patient Disclosure form did not contain this information.”

She also wrote that to her recollection, Kristine Andrews’ blood pressure was “within the scope of the guidelines set by the licensing board” during labor.

The case is slated to go to trial in March 2013.