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SmokeyGTi wrote:Its obvious that a mistake was made here, one that resulted in death. The question is what kind of disciplinary action should be taken? Should a doctor lose their job for this?
Is a doctor expected to have a flawless record simply because lives are at stake?
And can that argument be extended to other professionals such as firemen, life guards and the police?
fokhan_96 wrote:Surely all yuh men does do all yuh job perfect. The fact is EVERYONE makes mistakes, no one is perfect. Such is life. Is unfortunate what happened. Clearly you all know nothing about the law with respect to medical negligence. The fact is things go wrong all the time. You cant get it right all the time. If all doctors were fired after something went wrong with a patient, guess what, there would be NO doctors working. You simply cannot fire a medical professional based solely on the outcome of a particular incident. The fact of the matter is that the working on a living person is very unpredictable and anything can happen anytime. But is shocking to hear people taking about this person as if he is a criminal and he did it on purpose. Is unfortunate and sad what took place, but it has already happened and is time to move on. The most that would come out of this is that the family would be compensated and the doctor suspended for a reasonable period with mandatory psychological counselling. The fact of the matter is, the next time this said doctor would be performing a C-section, he would be extra careful and double check and triple check everything before hand and to be honest, if he uses this as a learning experience he would be an even better surgeon than before.
crazychinee wrote:The doctor cant simply be disciplined because in the court of public opinion he is deemed to be negligent. Negligence has to be proved , or in this case at least an internal hearing on whether they want to settle this sooner rather than later. There are enough consultants @ the RHA to advise them.
On a later note...What value of life you think a court places on a child in that particular family setting? Given the occupation of the parents ,it probably isn't going to be much.
They might be better off taking a quick settlement and forgetting about it.
And on a side note, informed consent doesn't indemnify a medical doctor against negligent acts, it simply acknowledges that the patient was well aware of all of her options, and possible complications.
Firing the doctor or taking rash actions will probably open up the RHA to a bigger law suit. Anyone read about how much money a nurse got after a wrongful termination re: hot water bottle burning a baby?
Nurse Richardson was unable to work for 6 yeas during the trial was awarded $75,000 and reinstated into the position from which she was dismissed or one similar to it. Richardson, the mother of two, from Fyzabad, was then an Enrolled Nursing Assistant (ENA) when she was dismissed by the NCRHA. [/quoteThe other nurse, Janice Charles, who was a nursing assistant when she was dismissed, was awarded $350,000 in compensation. Charles, from Sangre Grande, was re-employed in January 2011, four years after her dismissal, with the Eastern Regional Health Authority. She did not seek reinstatement at her former job at the Mt Hope Women’s Hospital. “The nurse who instructed the ENA to put the waterbag next to the baby without proper protection obviously was negligent,”PSA case in the industrial court after they were fired without due process
crazychinee wrote:The doctor cant simply be disciplined because in the court of public opinion he is deemed to be negligent. Negligence has to be proved , or in this case at least an internal hearing on whether they want to settle this sooner rather than later. There are enough consultants @ the RHA to advise them.
On a later note...What value of life you think a court places on a child in that particular family setting? Given the occupation of the parents ,it probably isn't going to be much.
They might be better off taking a quick settlement and forgetting about it.
And on a side note, informed consent doesn't indemnify a medical doctor against negligent acts, it simply acknowledges that the patient was well aware of all of her options, and possible complications.
Firing the doctor or taking rash actions will probably open up the RHA to a bigger law suit. Anyone read about how much money a nurse got after a wrongful termination re: hot water bottle burning a baby?
you asking answerDe Dragon wrote:crazychinee wrote:The doctor cant simply be disciplined because in the court of public opinion he is deemed to be negligent. Negligence has to be proved , or in this case at least an internal hearing on whether they want to settle this sooner rather than later. There are enough consultants @ the RHA to advise them.
On a later note...What value of life you think a court places on a child in that particular family setting? Given the occupation of the parents ,it probably isn't going to be much.
They might be better off taking a quick settlement and forgetting about it.
And on a side note, informed consent doesn't indemnify a medical doctor against negligent acts, it simply acknowledges that the patient was well aware of all of her options, and possible complications.
Firing the doctor or taking rash actions will probably open up the RHA to a bigger law suit. Anyone read about how much money a nurse got after a wrongful termination re: hot water bottle burning a baby?
So by your logic if it was a resident of Westmoorings with her first child a different outcome would be in order
Doctor that performed the C-section was in 'high spirits' as he had just come from a fete.
fokhan_96 wrote:Surely all yuh men does do all yuh job perfect. The fact is EVERYONE makes mistakes, no one is perfect. Such is life. Is unfortunate what happened. Clearly you all know nothing about the law with respect to medical negligence. The fact is things go wrong all the time. You cant get it right all the time. If all doctors were fired after something went wrong with a patient, guess what, there would be NO doctors working. You simply cannot fire a medical professional based solely on the outcome of a particular incident. The fact of the matter is that the working on a living person is very unpredictable and anything can happen anytime. But is shocking to hear people taking about this person as if he is a criminal and he did it on purpose. Is unfortunate and sad what took place, but it has already happened and is time to move on. The most that would come out of this is that the family would be compensated and the doctor suspended for a reasonable period with mandatory psychological counselling. The fact of the matter is, the next time this said doctor would be performing a C-section, he would be extra careful and double check and triple check everything before hand and to be honest, if he uses this as a learning experience he would be an even better surgeon than before.
88sins wrote:
The laws also need to be amended to allow for victims of medical negligence to be able to sue for punitive damages as well, since a lot of slip ups often result in patients suffering from physicians mistakes for decades, long after whatever little small change award they receive is gone.
http://www.newsday.co.tt/news/0,163916.html
Medical negligence
By JADA LOUTOO Friday, July 27 2012
A HIGH COURT judge has found gynaecologist Dr Kong Sheik Achong Low guilty of medical negligence in his treating of a pregnant woman who later bled to death shortly after giving birth to a stillborn baby.
Karen Lezama, 41, died on April 6, 2003 at Stanley’s Nursing Home in St Clair after giving birth to her stillborn son which was given the name Ryan.
In a 67-page judgment, Justice Ricky Rahim yesterday ruled in favour of Brian Lezama, husband and administrator of his wife’s estate, who brought a medical negligence lawsuit under the Supreme Court of Judicature Act and the Compensation for Injuries Act. According to the judge’s finding, Achong Low who operates out of Good Health Medical Centre at Fitzblackman Drive, Woodbrook, failed to exercise “all due care and diligence” in the treatment of Lezama.
“Management (of a patient) often involves literal life and death decisions with no time for leisurely reflection. Be that as it may, it is the responsibility entrusted to them by the public at large, in whose collective and singular interest, they must at all times act by adhering to the accepted practice in their area of speciality even under the most dire circumstances,” Rahim said in his judgment.
According to Brian Lezama, his wife — who was a mother of three — was a gestational diabetic and “known bleeder”. On April 2, 2003 at about 7 pm, a full-term Lezama was admitted to Stanley’s Clinic where bed rest was ordered and at about 9.30 am, the next day, she was discharged.
On April 6, Lezama was again admitted and drips administered to induce labour.
Achong Low visited his patient at about 11 am and left instructions to be called when Lezama was close to full dilation. He got the call five and a half hours later.
At about 4.53 pm, Lezama had a normal spontaneous vaginal delivery of a stillborn baby boy and almost immediately, began bleeding profusely with no clotting taking place. Achong Low was said to have directed that she be given more units of syntocinon (medicine for haemorrhaging) and intravenous fluids for what he assessed to be, coagulation problems.
Some 40 minutes later, Lezama went into shock, suffered an amniotic fluid embolism and died at 10.10 pm. The lawsuit alleged that Achong Low failed to heed that his patient was a “known bleeder” and request or consult her medical records.
The doctor was accused of failing to have done any blood investigations or ensuring there was sufficient blood on hand if transfusions were needed as well as failing to administer sufficient medication to stop the bleeding. In his defence, Achong Low who had delivered Lezama’s third child, denied knowing that she was a “known bleeder” and that he was guilty of negligence. He insisted he obtained the necessary amount of blood required for the patient and administered such while also taking all steps necessary as accepted in the field of Gynaecology and Obstetrics.
Lezama’s lawyers Stanley Marcus SC and Patricia Dindial called several medical practitioners as expert witnesses including Dr Mary Bhola-Singh, Dr Harold Chang, Professor of Pathology Dr Hubert Daisley, Dr Petronella Manning-Alleyne and Dr Waveney Charles. Achong Low’s attorneys’ Stuart Young and Michael Bullock called Achong Low, Dr Rawle Jibodh and Dr Hemant Persad in his (Dr Achong Low) defence.
Manning-Alleyne testified that she was present at the time of delivery and immediately informed Achong Low, when he entered the delivery room, that Lezama had experienced port-partum haemorrhage with her three previous deliveries.
She said that when Achong Low removed the stillborn baby, there was an abundance of blood while Lezama’s husband later testified that he was told by Achong Low that his wife was torn during delivery and he (Achong Low) could not see properly to do the stitching because of the profuse bleeding.
Achong Low instructed nurses to rub Lezama’s stomach to stop the bleeding. Lezama, in his testimony, said that at this time his wife began complaining that she was not feeling her legs and Achong Low suggested he (Lezama) rub his wife’s stomach for three to four hours and, “everything would normalise.”
At this point, Manning-Alleyne drew blood to run some tests. Lezama also testified that Achong Low refused the help of Dr Ajit Kuruvilla and noted he would have to send for blood. Lezama said at this time his wife became unresponsive and this was articulated to Achong Low, who appeared unaware of his patient’s condition.
At 7 pm, Lezama was asked to leave the room and a short time later when he wandered back into the delivery room, he observed Manning-Alleyne rubbing his wife’s chest while Achong Low was still rubbing her stomach.
Lezama said he saw Chang insert a needle in his wife’s body but he (Chang) said he could not find any workable vein because the veins had collapsed. By this time, Lezama’s condition had deteriorated and Achong Low advised she be taken to St Clair Medical.
When he returned to the delivery room, after being asked to wait in a waiting room with relatives, Lezama said his wife had gone into cardiac arrest at about 9.40 pm. Attempts were made to stabilise the patient and paddles were used in an attempt to shock her, but Lezama said there was a flat-line on the monitor. Achong Low walked out of the delivery room at 10.10 pm after attempts to resuscitate Lezama failed.
Lezama said that later in the month, he was unable to get his wife’s file and visited Achong Low’s office where he was that the doctor believed an amniotic embolism had killed Lezama but as there was no conclusive evidence to prove this, he (Achong Low) wrote, “post-partum haemorrhage” on the death certificate.
Achong Low also said since no autopsy was performed, he was unsure of the diagnosis and that was the reason he wrote haemorrhage and DIC (Disseminated Intra-vascular Coagulopathy).
Pathologist Daisley who was asked to provide his expert opinion on the possible cause of Lezama’s death, opined that she died from hypovolaemic shock (loss of large volumes of blood) following post-partum haemorrhage. He also stated that she delivered a macerated stillborn baby and was a gestational diabetic. The baby was said to be macerated because it had died in the womb three days prior to delivery.
Admitting there was no witness who could definitively say that Lezama would have survived had Achong Low called for help, administered more medication or gotten and administered blood at an earlier stage, the judge said that based on evidence of all the medical practitioners, the earlier the patient was given blood and blood products the more likely she was to survive an onset of post-partum haemorrhage.
“It therefore follows that it is more likely than not that the omission to administer more blood and blood products in a timely fashion resulted in the death of the deceased from post-partum haemorrhage,” Rahim said in his ruling. Damages are to be assessed and costs quantified by a Master of the Court.
C-section doctor’s full statement
Story Created: Mar 15, 2014 at 9:59 PM ECT
Story Updated: Mar 15, 2014 at 11:27 PM ECT
Following is the full statement by Dr Javed Chinnia to the NCRHA outlining his activities from 8 a.m. on March 1, 2014 to 8 a.m. on March 2, 2014:
“I arrived at the hospital at 8.15 a.m. that morning and proceeded to the antenatal ward for rounds. At about 8.45 a.m. Dr Mitchell called me to discuss a patient who was in the birth department for whom I recommended for a Caesarean Section.
Dr Mitchell joined me and we completed the ward round, seeing both our unit patients as well as others who’s units were not on duty. We identified two patients in need of urgent Caesarean Section, one of whom was Quelly Ann Cottle.
I then went to the birth department where I saw an admission who needed an emergency Caesarean Section and I informed Dr Bissoon who was already in the operating theatre. This was about 11 a.m.
At this time I had also discussed with Dr Bissoon the patients seen on the gynaecology ward as she had done the rounds there.
I was informed that the patients were all stable and did not require my review. I went to the emergency department where I saw the patients who were waiting there until I was called back to the birth department to review a patient in labour. This patient also required an emergency Caesarean Section.
By 2 p.m. I had joined Dr Bissoon in the operating theatre to offer her a break after having done three emergency Caesarean Sections for the day already. We then proceeded with the first urgent Caesarean Section from the antenatal ward which was Ms Cottle. While performing the operation an injury to the fetal scalp was found at delivery and the Paediatrician was informed. The mother was also immediately informed as she was under spinal anaesthesia. The rest of the procedure was routine and a tubal ligation was also done as requested by the patient. I remained in the operating theatre until the baby was transferred to the Intensive Care Unit. At 5 p.m. I left the compound to have some lunch. At about 5.45 p.m. I was informed that the neonate’s condition had worsened and the prognosis was poor. I then returned to the hospital at 6 p.m. The rest of the evening was spent counselling the patient and keeping a close watch on her blood pressure as she had a hypertensive disorder if pregnancy. Once she was stable I left at 9.15 p.m. to have a shower and I returned for a rounds in the birth department at 11 p.m. and then went to rest.
I then started ward rounds on my unit patients at about 5.30 a.m. on March 2, 2013 until 8 a.m. when we finished on the natal ward.”
SURGICAL ERROR
C-section report handed to Health Minister states:
By BY Anika Gumbs CCN Senior Multimedia Investigative Journalist
Story Created: Mar 15, 2014 at 10:06 PM ECT
Story Updated: Mar 15, 2014 at 11:27 PM ECT
The report into the death of a newborn baby whose head was cut during a Caesarean Section has stated that Dr Javed Chinnia, the surgeon who performed the surgery on mother Quelly Ann Cottle, listed the incident as a “surgical event/surgical error”.
The March 9 document sent to Health Minister Dr Fuad Khan is titled “Report into the death of infant of Quelly Ann Cottle” and was submitted by acting quality coordinator of the Mt Hope Women’s Hospital Laldaye Jadoonanan.
Page four of the report which was obtained exclusively by the Sunday Express states that following the March 1 surgery on Cottle, an “adverse event” incident form was completed by Dr Chinnia who highlighted the incident during Cottle’s C-section.
Her baby, named Simeon, sustained a cut to the head during the C-section and died hours later.
The report states: “Dr Chinnia listed the nature of the event as a surgical event/surgical error resulting in the death of the patient.”
The report quotes his description of the event as: “A Caesarean Section was being performed for delivery as there was severe intrauterine growth restriction. Routine procedure was followed. The lower uterine segment was first incised using the scalpel. The incision was opened with blunt dissection using a small artery clip. On delivery of the fetus a laceration about 3-4cm was observed across the scalp. The Paediatrician present was informed immediately as to was the patient.”
But in his statement to the North Central Regional Health Authority (NCRHA) board (under which the Mt Hope Women’s Hospital falls) on the surgery, Dr Chinnia notes that he spent about three hours after the C-Section “counselling” Cottle and monitoring her blood pressure after he was informed that the baby Simeon’s condition had worsened and the prognosis was poor.
His statement says that he observed there was an “injury” to the baby’s scalp. The surgery was performed on March 1 at 2.34 p.m.
However, in Chinnia’s statement also obtained by the Sunday Express he does not list the baby’s head being cut as a surgical error.
His stated: “While performing the operation an injury to the fetal scalp was found at delivery and the Paediatrician was informed. The mother was also immediately informed as she was under spinal anaesthesia. The rest of the procedure was routine and a tubal ligation was also done as requested by the patient.”
Chinnia’s statement read: “I remained in the operating theatre until the baby was transferred to the Intensive Care Unit.At 5 p.m. I left the compound to have some lunch. At about 5.45 p.m. I was informed that the neonate’s condition had worsened and the prognosis was poor. I then returned to the hospital at 6 p.m. The rest of the evening was spent counselling the patient and keeping a close watch on her blood pressure as she had a hypertensive disorder of pregnancy. Once she was stable I left at 9.15 p.m. to have a shower and I returned for rounds in the birth department at 11 p.m. and then went to rest.
I then started ward rounds on my unit patients at about 5.30 a.m. on March 2, 2013 until 8 a.m. when we finished on the natal ward.”
The quality report also noted information listed in Chinnia’s statement and that of midwife Selima Mohammed.
Section Three of the report said: “The Caesarean Section was performed by Dr Javed Chinnia when it was noted that the infant sustained a three to four centimetre scalp laceration likely as a result of the small artery clip used for blunt dissection of lower segment. However, the midwife’s report indicates the surgeon made a small smiley face incision and asked for a six-inch artery forceps which he used to extend the incision as per usual. There appears to be some conflicting information between the surgeon and the midwife’s report.”
And while questions were asked by the Dr Shehenaz Mohammed-led board as to why University of the West Indies (UWI) consultants Dr Bharat Bassaw and Dr Mary Singh-Bhola were not present during the surgery, the quality report did not list the reasons for the doctors being absent.
The UWI in a release last Wednesday indicated the it was not necessary for consultants to be present during the surgery.
The release stated that one of the consultants was on leave while the other consultant remained on call.
The quality report said Bassaw and Singh-Bhola are consultants attached to Unit A of the hospital.
However, nowhere in the quality report does it state that Bassaw was to proceed on a leave of absence with effect from March 1 to 3.
The hospital roster obtained by the Sunday Express listed both Bassaw and Singh-Bhola as scheduled for duty on March 1, 2014.
However, a note stating Bassaw’s leave of absence is listed below the roster.
Meanwhile, Singh-Bhola, who was asked to submit a report on her whereabouts during the surgery wrote: “Unit A was on duty on March 1, 2014. I arrived at the hospital- Mt Hope Maternity Hospital at 10.30 a.m. By that time ward rounds were completed. I was advised by the registrar of the various patients on the labour ward and the proposed management plans. I was also informed of the planned Caesarean Section scheduled to be performed later that day as was previously agreed upon on the patient Quelly Ann Cottle due to severe hypertension with associated fetal growth restriction. I left the hospital at midday but was available for on-call (advice, assistance as needed).”
Singh-Bhola said in the report that she was informed of baby Simeon’s injury.
“I was informed by the registrar of the injury which was sustained at the time of the Caesarean Section. At that time, the neonate was being managed by the paediatricians and no obstetric intervention was needed hence the reason for not coming. I was again called later that night to inform me of the subsequent demise of the neonate. I was called a few times later that night for advice regarding the management of other patients.”
The Sunday Express learned that Singh-Bola was not required to be at the hospital during the surgery.
A senior medical source yesterday told the Sunday Express that either a registrar or consultant is required for a Caesarean Section with assistance from a junior officer and a scrub nurse.
Anaesthetic consultant Dr Ruth Ramkissoon was also cited in the report.
According to the quality report, Ramkissoon learnt of baby Simeon’s death via a newspaper article five days after the incident.
“Dr Ramkissoon indicated in her report that she was the anesthetic consultant on call for the day but was not informed of the incident since it was not an anaesthetic-related matter. She further stated that her first knowledge of the incident was on March 6, 2014 when she read the newspaper article,” the quality report said.
The quality report also noted that the laboratory was not informed that a high risk patient was being taken to the theatre for a Caesarean Section.
Listed also in the report is a summary of statements from members of staff who were on duty and on call on the day of the surgery.
In its conclusion the report stated: “In the absence of a root cause analysis and clinical review no conclusion can be determined on the clinical aspect of the adverse event.”
The report also noted a need to closer examine compliance with the Ministry of Health Obstetrics and Midwifery Standard Operating Manual and on call coverage of the hospital by all consultants and registrars.
It was also recommended that an independent investigation be launched into the matter.
Medical staff on duty
Medical reports show that staff in attendance on the day were:
Surgeons: Dr Chinnia and Dr Meera Bissoon
Anaesthetist: Dr Viswaswara Rao Kurapati and Dr Angela Ofomata
Paediatrician: Dr Cara Ranghell
Scrub nurse: Judith Edwards
Circulating Nurse: Crystal Henry
Midwife: Selima Mohammed
Rec room nurse: Sister Fareeda Khan.
saxman642 wrote:http://www.trinidadexpress.com/news/C-section-doctors-full-statement-250487231.html
http://www.trinidadexpress.com/news/Doc ... 87751.htmlSURGICAL ERROR
C-section report handed to Health Minister states:
By BY Anika Gumbs CCN Senior Multimedia Investigative Journalist
Story Created: Mar 15, 2014 at 10:06 PM ECT
Story Updated: Mar 15, 2014 at 11:27 PM ECT
The report into the death of a newborn baby whose head was cut during a Caesarean Section has stated that Dr Javed Chinnia, the surgeon who performed the surgery on mother Quelly Ann Cottle, listed the incident as a “surgical event/surgical error”.
The March 9 document sent to Health Minister Dr Fuad Khan is titled “Report into the death of infant of Quelly Ann Cottle” and was submitted by acting quality coordinator of the Mt Hope Women’s Hospital Laldaye Jadoonanan.
Page four of the report which was obtained exclusively by the Sunday Express states that following the March 1 surgery on Cottle, an “adverse event” incident form was completed by Dr Chinnia who highlighted the incident during Cottle’s C-section.
Her baby, named Simeon, sustained a cut to the head during the C-section and died hours later.
The report states: “Dr Chinnia listed the nature of the event as a surgical event/surgical error resulting in the death of the patient.”
The report quotes his description of the event as: “A Caesarean Section was being performed for delivery as there was severe intrauterine growth restriction. Routine procedure was followed. The lower uterine segment was first incised using the scalpel. The incision was opened with blunt dissection using a small artery clip. On delivery of the fetus a laceration about 3-4cm was observed across the scalp. The Paediatrician present was informed immediately as to was the patient.”
But in his statement to the North Central Regional Health Authority (NCRHA) board (under which the Mt Hope Women’s Hospital falls) on the surgery, Dr Chinnia notes that he spent about three hours after the C-Section “counselling” Cottle and monitoring her blood pressure after he was informed that the baby Simeon’s condition had worsened and the prognosis was poor.
His statement says that he observed there was an “injury” to the baby’s scalp. The surgery was performed on March 1 at 2.34 p.m.
However, in Chinnia’s statement also obtained by the Sunday Express he does not list the baby’s head being cut as a surgical error.
His stated: “While performing the operation an injury to the fetal scalp was found at delivery and the Paediatrician was informed. The mother was also immediately informed as she was under spinal anaesthesia. The rest of the procedure was routine and a tubal ligation was also done as requested by the patient.”
Chinnia’s statement read: “I remained in the operating theatre until the baby was transferred to the Intensive Care Unit.At 5 p.m. I left the compound to have some lunch. At about 5.45 p.m. I was informed that the neonate’s condition had worsened and the prognosis was poor. I then returned to the hospital at 6 p.m. The rest of the evening was spent counselling the patient and keeping a close watch on her blood pressure as she had a hypertensive disorder of pregnancy. Once she was stable I left at 9.15 p.m. to have a shower and I returned for rounds in the birth department at 11 p.m. and then went to rest.
I then started ward rounds on my unit patients at about 5.30 a.m. on March 2, 2013 until 8 a.m. when we finished on the natal ward.”
The quality report also noted information listed in Chinnia’s statement and that of midwife Selima Mohammed.
Section Three of the report said: “The Caesarean Section was performed by Dr Javed Chinnia when it was noted that the infant sustained a three to four centimetre scalp laceration likely as a result of the small artery clip used for blunt dissection of lower segment. However, the midwife’s report indicates the surgeon made a small smiley face incision and asked for a six-inch artery forceps which he used to extend the incision as per usual. There appears to be some conflicting information between the surgeon and the midwife’s report.”
And while questions were asked by the Dr Shehenaz Mohammed-led board as to why University of the West Indies (UWI) consultants Dr Bharat Bassaw and Dr Mary Singh-Bhola were not present during the surgery, the quality report did not list the reasons for the doctors being absent.
The UWI in a release last Wednesday indicated the it was not necessary for consultants to be present during the surgery.
The release stated that one of the consultants was on leave while the other consultant remained on call.
The quality report said Bassaw and Singh-Bhola are consultants attached to Unit A of the hospital.
However, nowhere in the quality report does it state that Bassaw was to proceed on a leave of absence with effect from March 1 to 3.
The hospital roster obtained by the Sunday Express listed both Bassaw and Singh-Bhola as scheduled for duty on March 1, 2014.
However, a note stating Bassaw’s leave of absence is listed below the roster.
Meanwhile, Singh-Bhola, who was asked to submit a report on her whereabouts during the surgery wrote: “Unit A was on duty on March 1, 2014. I arrived at the hospital- Mt Hope Maternity Hospital at 10.30 a.m. By that time ward rounds were completed. I was advised by the registrar of the various patients on the labour ward and the proposed management plans. I was also informed of the planned Caesarean Section scheduled to be performed later that day as was previously agreed upon on the patient Quelly Ann Cottle due to severe hypertension with associated fetal growth restriction. I left the hospital at midday but was available for on-call (advice, assistance as needed).”
Singh-Bhola said in the report that she was informed of baby Simeon’s injury.
“I was informed by the registrar of the injury which was sustained at the time of the Caesarean Section. At that time, the neonate was being managed by the paediatricians and no obstetric intervention was needed hence the reason for not coming. I was again called later that night to inform me of the subsequent demise of the neonate. I was called a few times later that night for advice regarding the management of other patients.”
The Sunday Express learned that Singh-Bola was not required to be at the hospital during the surgery.
A senior medical source yesterday told the Sunday Express that either a registrar or consultant is required for a Caesarean Section with assistance from a junior officer and a scrub nurse.
Anaesthetic consultant Dr Ruth Ramkissoon was also cited in the report.
According to the quality report, Ramkissoon learnt of baby Simeon’s death via a newspaper article five days after the incident.
“Dr Ramkissoon indicated in her report that she was the anesthetic consultant on call for the day but was not informed of the incident since it was not an anaesthetic-related matter. She further stated that her first knowledge of the incident was on March 6, 2014 when she read the newspaper article,” the quality report said.
The quality report also noted that the laboratory was not informed that a high risk patient was being taken to the theatre for a Caesarean Section.
Listed also in the report is a summary of statements from members of staff who were on duty and on call on the day of the surgery.
In its conclusion the report stated: “In the absence of a root cause analysis and clinical review no conclusion can be determined on the clinical aspect of the adverse event.”
The report also noted a need to closer examine compliance with the Ministry of Health Obstetrics and Midwifery Standard Operating Manual and on call coverage of the hospital by all consultants and registrars.
It was also recommended that an independent investigation be launched into the matter.
Medical staff on duty
Medical reports show that staff in attendance on the day were:
Surgeons: Dr Chinnia and Dr Meera Bissoon
Anaesthetist: Dr Viswaswara Rao Kurapati and Dr Angela Ofomata
Paediatrician: Dr Cara Ranghell
Scrub nurse: Judith Edwards
Circulating Nurse: Crystal Henry
Midwife: Selima Mohammed
Rec room nurse: Sister Fareeda Khan.
88sins wrote:saxman642 wrote:http://www.trinidadexpress.com/news/C-section-doctors-full-statement-250487231.html
http://www.trinidadexpress.com/news/Doc ... 87751.htmlSURGICAL ERROR
C-section report handed to Health Minister states:
By BY Anika Gumbs CCN Senior Multimedia Investigative Journalist
Story Created: Mar 15, 2014 at 10:06 PM ECT
Story Updated: Mar 15, 2014 at 11:27 PM ECT
The report into the death of a newborn baby whose head was cut during a Caesarean Section has stated that Dr Javed Chinnia, the surgeon who performed the surgery on mother Quelly Ann Cottle, listed the incident as a “surgical event/surgical error”.
The March 9 document sent to Health Minister Dr Fuad Khan is titled “Report into the death of infant of Quelly Ann Cottle” and was submitted by acting quality coordinator of the Mt Hope Women’s Hospital Laldaye Jadoonanan.
Page four of the report which was obtained exclusively by the Sunday Express states that following the March 1 surgery on Cottle, an “adverse event” incident form was completed by Dr Chinnia who highlighted the incident during Cottle’s C-section.
Her baby, named Simeon, sustained a cut to the head during the C-section and died hours later.
The report states: “Dr Chinnia listed the nature of the event as a surgical event/surgical error resulting in the death of the patient.”
The report quotes his description of the event as: “A Caesarean Section was being performed for delivery as there was severe intrauterine growth restriction. Routine procedure was followed. The lower uterine segment was first incised using the scalpel. The incision was opened with blunt dissection using a small artery clip. On delivery of the fetus a laceration about 3-4cm was observed across the scalp. The Paediatrician present was informed immediately as to was the patient.”
But in his statement to the North Central Regional Health Authority (NCRHA) board (under which the Mt Hope Women’s Hospital falls) on the surgery, Dr Chinnia notes that he spent about three hours after the C-Section “counselling” Cottle and monitoring her blood pressure after he was informed that the baby Simeon’s condition had worsened and the prognosis was poor.
His statement says that he observed there was an “injury” to the baby’s scalp. The surgery was performed on March 1 at 2.34 p.m.
However, in Chinnia’s statement also obtained by the Sunday Express he does not list the baby’s head being cut as a surgical error.
His stated: “While performing the operation an injury to the fetal scalp was found at delivery and the Paediatrician was informed. The mother was also immediately informed as she was under spinal anaesthesia. The rest of the procedure was routine and a tubal ligation was also done as requested by the patient.”
Chinnia’s statement read: “I remained in the operating theatre until the baby was transferred to the Intensive Care Unit.At 5 p.m. I left the compound to have some lunch. At about 5.45 p.m. I was informed that the neonate’s condition had worsened and the prognosis was poor. I then returned to the hospital at 6 p.m. The rest of the evening was spent counselling the patient and keeping a close watch on her blood pressure as she had a hypertensive disorder of pregnancy. Once she was stable I left at 9.15 p.m. to have a shower and I returned for rounds in the birth department at 11 p.m. and then went to rest.
I then started ward rounds on my unit patients at about 5.30 a.m. on March 2, 2013 until 8 a.m. when we finished on the natal ward.”
The quality report also noted information listed in Chinnia’s statement and that of midwife Selima Mohammed.
Section Three of the report said: “The Caesarean Section was performed by Dr Javed Chinnia when it was noted that the infant sustained a three to four centimetre scalp laceration likely as a result of the small artery clip used for blunt dissection of lower segment. However, the midwife’s report indicates the surgeon made a small smiley face incision and asked for a six-inch artery forceps which he used to extend the incision as per usual. There appears to be some conflicting information between the surgeon and the midwife’s report.”
And while questions were asked by the Dr Shehenaz Mohammed-led board as to why University of the West Indies (UWI) consultants Dr Bharat Bassaw and Dr Mary Singh-Bhola were not present during the surgery, the quality report did not list the reasons for the doctors being absent.
The UWI in a release last Wednesday indicated the it was not necessary for consultants to be present during the surgery.
The release stated that one of the consultants was on leave while the other consultant remained on call.
The quality report said Bassaw and Singh-Bhola are consultants attached to Unit A of the hospital.
However, nowhere in the quality report does it state that Bassaw was to proceed on a leave of absence with effect from March 1 to 3.
The hospital roster obtained by the Sunday Express listed both Bassaw and Singh-Bhola as scheduled for duty on March 1, 2014.
However, a note stating Bassaw’s leave of absence is listed below the roster.
Meanwhile, Singh-Bhola, who was asked to submit a report on her whereabouts during the surgery wrote: “Unit A was on duty on March 1, 2014. I arrived at the hospital- Mt Hope Maternity Hospital at 10.30 a.m. By that time ward rounds were completed. I was advised by the registrar of the various patients on the labour ward and the proposed management plans. I was also informed of the planned Caesarean Section scheduled to be performed later that day as was previously agreed upon on the patient Quelly Ann Cottle due to severe hypertension with associated fetal growth restriction. I left the hospital at midday but was available for on-call (advice, assistance as needed).”
Singh-Bhola said in the report that she was informed of baby Simeon’s injury.
“I was informed by the registrar of the injury which was sustained at the time of the Caesarean Section. At that time, the neonate was being managed by the paediatricians and no obstetric intervention was needed hence the reason for not coming. I was again called later that night to inform me of the subsequent demise of the neonate. I was called a few times later that night for advice regarding the management of other patients.”
The Sunday Express learned that Singh-Bola was not required to be at the hospital during the surgery.
A senior medical source yesterday told the Sunday Express that either a registrar or consultant is required for a Caesarean Section with assistance from a junior officer and a scrub nurse.
Anaesthetic consultant Dr Ruth Ramkissoon was also cited in the report.
According to the quality report, Ramkissoon learnt of baby Simeon’s death via a newspaper article five days after the incident.
“Dr Ramkissoon indicated in her report that she was the anesthetic consultant on call for the day but was not informed of the incident since it was not an anaesthetic-related matter. She further stated that her first knowledge of the incident was on March 6, 2014 when she read the newspaper article,” the quality report said.
The quality report also noted that the laboratory was not informed that a high risk patient was being taken to the theatre for a Caesarean Section.
Listed also in the report is a summary of statements from members of staff who were on duty and on call on the day of the surgery.
In its conclusion the report stated: “In the absence of a root cause analysis and clinical review no conclusion can be determined on the clinical aspect of the adverse event.”
The report also noted a need to closer examine compliance with the Ministry of Health Obstetrics and Midwifery Standard Operating Manual and on call coverage of the hospital by all consultants and registrars.
It was also recommended that an independent investigation be launched into the matter.
Medical staff on duty
Medical reports show that staff in attendance on the day were:
Surgeons: Dr Chinnia and Dr Meera Bissoon
Anaesthetist: Dr Viswaswara Rao Kurapati and Dr Angela Ofomata
Paediatrician: Dr Cara Ranghell
Scrub nurse: Judith Edwards
Circulating Nurse: Crystal Henry
Midwife: Selima Mohammed
Rec room nurse: Sister Fareeda Khan.
Xplode wrote:Sounds like they trying to say they found the injury to the fetus & didn't cause it.
So the mother maybe had a #10 scalpel in the womb prior to them performing a C-Section?[/quot] That doc is a quack, the baby was cut close to the birth canal inside the mother and when the C- Section was over and the baby came out they saw what happen . They admit to negligence and in that case compensation will be paid .
The State will end up paying that.
Are you also forgetting that they attempted to cermate the fetus to hide the evidence why hide if it was a mistake??,they also tried to say it was the mother's fault cause she was uncooperative, which is nonsense because the cesarean section procedure begins with a routine IV during labor and anesthesia usually an epidural or spinal block, so the lower half of your body will be numb, but you'll remain awake.lastly the abdominal wall is very thin the cut on the fetus head was deep, deep enough to cut brain tissue to me this shows inexperience and if he did over "ONE HUNDRED SUCCESSFUL" c sections that is negligencenovastar1 wrote:What about the hundreds of c sections that he did and was successful?
Nobody taking that into account?
Saved hundreds of lives....then for error? As in a less than 1% complications
According to the uwi statement...the doc is a specialist
More importantly...who will do the c sections if this doctor is fired? Wouldn't removing him impact negatively on the rest if the women who are waiting for surgery?
As far as I know there are risks with any surgery. And you have to sign a consent form beforehand.
This whole situation is sad however you look at it
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