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Lawyer speaks about medical negligence…

Malpractice lawsuits on the increase

Tuesday, March 29, 2011
Chrystal Boodoo-Ramsoomair …died after a Caesarean section at San Fernando General Hospital on March 4.

The death of 29-year-old Chrystal Boodoo-Ramsoomair has raised the obvious question of medical malpractice. The mother of three died hours after undergoing a Caesarean section at San Fernando General Hospital on March 4. For families plunged into disbelief and sorrow, what recourse does the Trinidad and Tobago law hold? According to attorney Martin George, there has been an “evolution” in the laws of T&T, as the number of medical malpractice cases keep increasing. George said given the vast nature of such cases, the law had adapted to suit. “What we have had in T&T is an evolution in the law as it regards medical negligence … The law has grown, it has evolved and it as increased,” he explained.

Checks with the library at the High Court showed that there were no available statistics on medical malpractice suits. A High Court Judge, however, said less than 20 judgments were handed down each year in medical malpractice lawsuits. According to George, in such lawsuits “the whole area of medical malpractice” must be taken into consideration. “You are looking at the whole spectrum of duties and responsibilities which flow from that,” George said. He cited the 1985 case of Grace Primer as the first which “broke ground” in T&T regarding medical malpractice. “Grace Primer versus the Attorney General changed the direction in which medical practice was handled in T&T,” he said.

“In that case, the plaintiff made allegations against the state and the staff of the Eric Williams Medical Sciences Complex, Mt Hope. “She indicated she was 26 and she made allegations of negligence against the doctors and nurses who attended to her.” Trial judge Justice Basdeo Maraj found that the nurses on duty at the ward were negligent in that they did not pay any due regard to the plaintiff’s case or previous medical history. “In other words there is a duty upon the institution to not only look at the circumstances as they are but also look at the case history, which is critical,” George said. He said since then there had been several other cases which had followed along that line. According to George, because of the Grace Primer case, doctors have been “willing” to come forward to give evidence against their colleagues.

“We have had scenarios where doctors are actually willing to go in court, go on the witness stand and give evidence against other doctors. “So the profession has become a lot more open minded towards this area of medical negligence and medical malpractice. “Whereas in the past doctors wouldn’t want to give evidence against a fellow doctor, that has changed,” he said. George also cited the 1998 case of Rana Ramlal versus a doctor assigned to the South West Regional Health Authority (SWRHA) which resulted in a “major scandal in the health institution.”  According to facts, in a Court of Appeal judgment delivered by Justice Allan Mendonca in 2003, Ramlal went to the Casualty Department of San Fernando General Hospital. She was approximately 18 to 20 weeks’ pregnant and experiencing severe lower abdominal pain and vaginal bleeding.


Ramlal was examined by the doctor who told her that she had suffered an incomplete abortion and the dead foetus needed to be expelled. The judgment went on to state that Deonarine used a sponge holding forceps to remove what appeared to be a placenta tissue. Ramlal, however, said that the doctor was “pulling at her insides” and insisted that her baby was alive as she was feeling movement.
Deonarine, via intravenous drips, also administered syntocinonto induce uterine activity to assist in expelling a foetus. After tests were conducted by other doctors it was found that Ramlal was in fact carrying a live baby. Some six weeks later, on December 21, 1998, Ramlal gave birth to a premature baby that died within 24 hours of birth.
The court found that the doctor had mistaken the products of conception for an endo-cervical polyp which is extremely rare in pregnant women. The doctor who has since left the country, was ordered to pay costs. “Arising out of this particular matter, which is still deemed to be a major medical scandal, the courts have been quite willing to act and promptly deal with areas of medical negligence,” George said.
He cited another case in 2008 where a Santa Cruz woman opted to have a home delivery. “The NWRHA sent a trainee midwife alone to conduct the delivery. There were no support services, including no ambulance. “This trainee midwife was on a cell phone trying to contact the hospital and to get instructions from someone to talk her through the procedure while she was struggling to do this delivery. As a result, the entire delivery was botched and the baby died,” George said. He said NWRHA “ended up settling and quite a considerable sum was paid out.”
Limitation period
A doctor may have operated on a patient and may have been negligent and the patient may not be aware.
It’s only when the patient is made aware of the negligence that the litigation period of four years starts, George said. “There may be many people out there who had issues of negligence and didn’t know it.
“So the four-year period runs from the time you know there
nature of medical claims
Medical claims can arise out of accident and emergency, anaesthetics, cancer treatment, cardiothoracic surgery, cardiology, gastroenterology, general practice, keyhole surgery, mental health, neurosurgery, obstetrics and gynaecology, oncology, ophthalmology, orthopaedics, paediatrics, plastic surgery, psychiatry, radiology, sterilisation, urology, vascular surgery and many more. Doctors have been found in breach of a duty of care for, among other things, failed or delayed diagnosis, failure to warn of risks in treatment, failure to obtain proper consent to treatment, medication errors, careless surgical procedures and delayed referral to specialists. Negligence can also arise out of system errors in the hospital where the treatment took place. Most cases concern registered medical practitioners (doctors and surgeons).
But similar principles apply to dentists, midwives, nurses, physiotherapists, psychologists and psychiatrists.
Extracted From : Trinidad Guardian Newspaper

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