A FORMER midwife has been struck off the nursing register after committing a catalogue of mistakes while working at the Royal Surrey County Hospital.
Margarita Dobreva Avramova was moments away from giving a baby a potentially lethal injection before being stopped by a colleague, the Nursing and Midwifery Council (NMC) heard.
The Bulgarian intake demonstrated how she would perform an epidural top-up which could have had fatal consequences.
She failed to return a newly delivered baby to her mother and took no steps to increase another baby's slow heart rate when it was identified as beating too slowly.
The mistakes were among a long list of errors Avramova made while at the hospital from May 26, 2009 until she was dismissed from her employment on July 15 2010. Royal Surrey County Hospital then referred her to the NMC.
Avramova, who was found guily of misconduct by the NMC, was struck off the nursing register, and given an 18 months interim suspension order at the council's conduct and competence committee hearing on February 5 to 6.
It emerged her qualifications were not comparable to a UK qualified midwife and that she was unable to communicate sufficiently with patients.
The midwife told one woman in labour to "push, push" when it could have been detrimental to do so.
She intended to administer a Vitamin K injection to a baby with a syringe containing an air bolus and failed to check the correct amount of Vitamin K in the needle.
Avramova could not identify how to administer an epidural top-up, demonstrating a procedure which could have been fatal for the patient involved if carried out. She allowed another woman to have a shower while her epidural was still fitted, the Council was told. When confronted by staff over her mistakes, Avramova simply shrugged, the hearing heard.
Avramova was told: "The panel was in no doubt that your behaviour on the facts found proved fell significantly below the standards expected of a registered midwife.
"The panel considered that your deficient clinical care had put patients at serious risk of harm.
"It took into account that these matters occurred while you were on a preceptorship programme and latterly under supervision. However as a qualified midwife you are personally responsible for ensuring that your midwifery practice is safe at all times.
"In all of these circumstances, the panel concluded that your behaviour on the facts found proved goes beyond mere clinical incompetence and does constitute misconduct."
The Council ruled Avramova's fitness to practise was impaired by reason of her misconduct.
Jacqui Tingle, head of Midwifery at Royal Surrey, said: "The Royal Surrey County Hospital is guided by the NMC decision that Margarita Avramova's fitness to practice has been found to be impaired and sanctions are required.
"Our decision to refer Ms Avramova to the NMC in the first instance follows a strict supervision programme through which we ensured no mothers or babies were ever put at any risk. Our actions to proactively ensure only the best possible care for our patients demonstrates that the systems in place at the Royal Surrey are effective in maintaining the highest quality of clinical care.
"Midwives who are employed at The Royal Surrey County hospital are fully qualified and are subject to the utmost professional standards as set by the NMC and our ongoing internal quality checks and procedures. The public can be reassured that patient safety and quality of care are our highest priority and we will continue to take appropriate action if issues should arise that could compromise patient safety."Read the NMC's report into Margarita Avramova's conduct here:
http://www.nmcuk.org/Documents/FTPOutcomes/2013/Feb/Reasons%20AVRAMOVA%20CCCSH%2020130206.pdf
