A state board has ordered Coleen and Jerusha Goodwin of The Baby Place to stop working in Idaho permanently, according to documents that contain new allegations of misconduct.
The midwives acted in “serious, unprofessional” ways and broke the rules of their profession, the Board of Midwifery said. It suspended the Goodwins in the spring, after claims that the women acted wrongly while overseeing births.
State investigators said the Goodwins delivered babies with dangerously low heartbeats, interfered with emergency hospital transfers, failed to send a woman to the hospital when she had persistent vomiting and diarrhea, and allowed a baby’s umbilical cord to hemorrhage blood.
Coleen Goodwin was ordered to pay a fine of $9,500 for four counts of violating several state laws, rules and practice standards. Jerusha, her daughter, was ordered to pay $5,000 for two counts. The board also ordered both women to cover the costs of investigating and prosecuting them. That amount is not yet available.
The board said the midwives did not respond to “numerous notifications” mailed to their addresses and to telephone messages left on their home, office and cellular phones, and they did not participate in a June 5 hearing on their case.
The board received witness testimony at the hearing from a state licensing investigator and three midwives, including a former midwife for The Baby Place. The board said the Goodwins offered no testimony or evidence, although they sent letters challenging their emergency suspension.
LOST BLOOD,NO HEARTBEAT
In one case, a baby’s heartbeat plummeted to half the normal rate after about 18 hours of labor, and the midwives delivered a “limp, motionless and pale” baby with no pulse. Its umbilical cord had been wrapped around its neck.
A student midwife then cut the baby’s umbilical cord without clamping it, causing the baby to lose a significant amount of blood, the board found.
The midwives called paramedics shortly after delivering the baby and trying to resuscitate it, according to board documents. The three paramedics who arrived at The Baby Place said the Goodwins didn’t mention anything about the umbilical cord problems and the blood loss.
The baby died about two weeks later at St. Luke’s Meridian Medical Center.
After the delivery, someone at The Baby Place called another midwife who worked at the birth center as a part-time unpaid assistant, asking whether she could help clean up. When that midwife arrived, she saw a trail of blood that flowed from the baby as it was carried to a post-delivery table, the board said.
The midwife said the “blood spatter was unlike any other birthing scene (she) had previously seen in terms of quantity and the spray pattern.” It looked like the blood spatter from a cut artery, according to the board.
The Goodwins were “unsure” or vague about the cord-cutting, investigators said. Their records didn’t say anything about blood loss or failure to clamp the cord.
LACK OF URGENCY
Two summers ago, an expectant mother who had Type 1 diabetes arrived at The Baby Place with vomiting and diarrhea. Jerusha Goodwin sent the woman home that night and told her to drink fluids, the board said. She returned that night with intense contractions, carrying a bucket with her because of the vomiting.
After several hours of vomiting, diarrhea, “excruciating pain” and crying, the woman was told to start pushing because the baby’s heart rate was “too low,” the board said. According to records from Dani Kennedy, a midwife who later left The Baby Place, the baby’s heartbeat had fallen to half the normal rate. Coleen Goodwin later called paramedics, who said they had to ask Goodwin for information “multiple times.”
Coleen Goodwin “denied the existence of any complications” and didn’t give paramedics any medical records or say why it was an emergency, the board said. She kept paramedics out of the woman’s room for four minutes, then asked the woman “what she wanted to wear” to the hospital, the board said.
The board found that Coleen Goodwin instructed paramedics to take the woman to St. Luke’s Boise Medical Center instead of two closer hospitals, against the woman’s wishes.
The baby died at the hospital. When a doctor confronted Goodwin about not taking the woman to the St. Luke’s in Meridian, she told the doctor that “he would have to talk directly with her lawyer,” the board said.
The Baby Place’s records said nothing about the woman getting sick, the low heart rate or the trip to the hospital.
The board said Coleen Goodwin should have seen and heeded warning signs and called paramedics sooner. Her decisions took precious minutes from the baby’s emergency birth, the board said.
FLAWED RECORDS
Kennedy, who had written down details of the woman’s labor — information that contradicted The Baby Place’s records — tried to give paramedics the woman’s medical records, the board found. “Coleen Goodwin grabbed the records out of Kennedy’s hand and left the room,” the board said.
Goodwin later told Kennedy to “destroy her notes,” the board said. A year after the summer 2010 incident, Goodwin asked Kennedy to “redo” the woman’s labor charts, the board said. Kennedy refused.
Goodwin inserted a one-page addendum into the charts, and all of her comments in that addition “portray (the patient) in a negative light,” the board said. Goodwin told investigators that the patient was uncooperative, “extremely demanding” and kept midwives from monitoring the baby adequately.
OTHER EVIDENCE
An investigation into a birth at the center last August turned up evidence that the midwives weren’t truthful about the seriousness of some medical problems.
In that case, a patient had greenish vaginal discharge and labored for about 48 hours. Jerusha Goodwin told the woman, “If we have to transport (you to the hospital), tell the paramedics that labor started at 3 p.m.,” the board said. The woman’s water actually broke at 1:30 a.m., and she had started pushing about 10 a.m.
That baby was delivered “limp, unresponsive and pale,” with a low heart rate.
When paramedics arrived, they noticed that the baby was placed on a table in a way that blocked his airway. Jerusha Goodwin was trying to breathe air into the baby but wasn’t doing it properly, the paramedics said.
A doctor at the hospital where the baby was taken “opined that Jerusha Goodwin did not accurately report” the baby’s condition.
She faxed medical records to the hospital at 4:32 p.m. on Aug. 12 — about an hour after the baby died.
SETTLEMENT AND POLICE INVESTIGATION
The Goodwins agreed to a $5 million settlement in April with a couple who sued after their baby suffered brain damage. But payment was in doubt because the Goodwins did not carry malpractice insurance.
Meridian police said in July that they forwarded their criminal investigation into one baby’s death to Ada County prosecutors.
A message left by the Statesman at The Baby Place — recently renamed New Beginnings Baby Place — during office hours Wednesday was not returned.
Both Goodwins can appeal the Board of Midwifery’s ban in District Court.
Audrey Dutton: 377-6448, Twitter: @IDS_Audrey
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