CARELESSNESS,NEGLIGENCE IN HEALTH

Once again, the Mt Hope Maternity Hospital is in the news—and not in a positive light. Hospital administrator Dr Esau Joseph confirmed that the autoclave sterilising equipment broke down and they were trying to repair it.

Dr Tim Gopeesingh has been quoted as saying that this was inexcusable for any hospital.

Health Minister John Rahael, who has been making a fantastic effort to improve health care standards, was understandably appalled that the hospital’s administrators did not have sufficient working equipment.

We are far too wealthy and developed a nation for this backward, Fourth World state of affairs to still exist at our nation’s health institutions.

If these mistakes and problems persist, then citizens will have no alternative but to turn to the law for redress and legal recourse.

High-risk area

There are always so many complications and problems that can occur with pregnancy and delivery, that it is small wonder that this area is the branch of medicine which traditionally sees the highest rate of medical negligence lawsuits.

And if the folks at Mt Hope don’t get it right pretty soon, they may be facing another slew of legal actions over this issue.

Although the area of medical negligence is being developed slowly in Trinidad and Tobago, the courts have shown in the past that they are willing to listen and to make findings of medical negligence, especially in the areas of obstetrics and gynaecology, and especially in matters concerning the maternity wards of our hospitals.

Internationally, too, it is also one of the areas of medical practice that carries the highest risk, and medical malpractice insurance in some states in the USA carries astronomical premiums.

Some insurers don’t offer it at all, because they all recognise the grave dangers and risks of this particular area of medical practice.

More and more it is becoming the case that medical practitioners in Trinidad and Tobago are no longer afraid to step forth and give cogent, compelling and credible evidence in support of claims brought by members of the public for medical negligence.

These claims for medical negligence are not limited to the negligent actions of doctors, but can also include negligent treatment by nurses and other hospital staff and administrators.

It can, therefore, affect an entire institution, such as the Mt Hope hospital.

In the 1985 case of Grace Prima-v-Attorney General, the plaintiff took the State to task over what was alleged to be “the negligent medical treatment of the plaintiff on December 13, 1984, by the servants and/or agents of the State at the Mount Hope Maternity Hospital.”

The plaintiff was 26 years old at the time, and gave a history of having been treated and attended to throughout the term of her pregnancy at Mt Hope Maternity Hospital.

She alleged that on entering the hospital for delivery of the baby, she was treated or attended to so unskillfully and/or negligently, that she suffered a rupture of her uterus, her baby died, her uterus was then removed by the hospital staff, and she also suffered post-operative sepsis.

Serious health consequences

Gopeesingh is this weekend warning that, “The health consequences for the patients are very serious.”

He said patients can contract septicaemia and peritonitis septicaemia, which could lead to hysterectomies, or death in the occasional case.

In the Grace Prima case, the State for its part tried to defend the Mt Hope Hospital and its staff, saying that the plaintiff was attended to at all times by a qualified midwife and passed through the first stage of labour successfully.

They went on to say, however, that during the second stage, the plaintiff complained that something had burst inside her and the doctor in attendance diagnosed a ruptured uterus.

A caesarian section was then performed, and the body of a male child was then delivered stillborn, with the umbilical cord wrapped three times tightly around its neck.

A hysterectomy was then performed, because of the severity of damage to the plaintiff’s uterus, and the State denied any negligence on the part of its hospital and staff at Mt Hope.

The learned trial judge, Justice Basdeo Persad Maharaj, rejected this argument, and found that the nurses on duty were negligent and that the labour ward staff were careless.

The judge awarded the plaintiff damages in the sum of $130,000, plus interest, special damages in the sum of $1,690 and legal costs.

Negligent treatment

In the 1998 case of Rana Ramlal v South-West Regional Health Authority, Dr Patricia Deonarine and Attorney General, the plaintiff was a 19-year-old who at 18 weeks’ pregnant, attended San Fernando General Hospital with complaints of abdominal pains and bleeding.

She alleged that she was treated negligently when a cervical polyp was mistaken for products of conception, and she was treated for an incomplete abortion.

Three doctors testified on behalf of the plaintiff and four for the defendant.

The trial judge found that:

  • On a balance of possibilities, Dr Deonarine used the sponge-holding forceps to pull on what was later identified as the cervical polyp, which she apparently mistook for the products of conception.
  • This tugging on the cervical polyp caused the plaintiff severe pain and she had been screaming.
  • The court accepted the evidence of the plaintiff that she asked for tests to verify that the foetus had died, and that Dr Deonarine had said that it was not necessary.
  • The plaintiff by this time had not only lost confidence in the hospital staff, but had become afraid of the possibility of a repeat of the tugging with the forceps and discharged herself from San Fernando General Hospital. Within 48 hours, she was reassessed by other doctors and found to be carrying a live baby and was diagnosed and treated for an endo-cervical polyp.
  • The court went on to make a finding of negligence and granted judgment for the plaintiff in the matter.

Our hospitals can’t continue to play fast and loose with people’s health like this, and members of the public are awakening to the fact that they can do something when their health and their lives are put at risk, through the carelessness and negligence of hospitals, doctors, nurses and administrators.

©2004-2005 Trinidad Publishing Company Limited

 

Extracted From: Trinidad Guardian

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