Until, I read of the demise of the young mother and her baby in her attempt to give birth last month, I was beginning to ease my long held apprehension about the attitudes to work by some of the health ‘professionals’ at the institution. Members of the Shepherd family are contending that medical negligence caused the tragedy in their family and they have initiated legal proceedings against the Tobago Regional Health Authority. Interestingly, Brindley Sheppard’s lawyers have also written to President Carmona urging him to launch a Commission of Enquiry into healthcare on the ‘crown jewel’ of the Caribbean.
It was exactly 20 years ago that a great outcry from residents forced the Denoon Administration to mount an investigation into unnecessary deaths at the Scarborough Hospital. On that occasion, Dr. Elizabeth Quamina, a nationally acclaimed medical doctor, was contracted to investigate three deaths, including two from botched surgeries associated with appendicitis complaints. The compassion, that was absent then among health workers, was also absent a year later when my own father was left to die in a vehicle in front of Casualty mere days before Christmas. I am still pained to write that a lack of oxygen at the hospital to treat his respiratory disorder cut short his life. The point to be emphasised is that it’s far too common that medical procedures, which are not life threatening, have brought grief and bewilderment to scores of families in Tobago. Sadly, the culprits in most instances are exonerated or at worst the authorities terminate their employment (presumably on expiration of their contract).
What did the Health Secretary, Claudia Groome-Duke imply when she said that it was 20 years since the last time a mother died giving birth? Suppose that both deaths were avoidable, what would be the position she would advance on this issue?  Frankly, I thought a new culture of care would have infused the hospital personnel in the spanking new medical institution, with an unswerving commitment to preserve life and limb of all in need of medical assistance. But the revelation of 20 plus childbirth related deaths has jolted me such that my apprehension is undeniable.
The Tobago revelation prompted me to source international statistics on stillbirths. Trinidad and Tobago in 2009 had a rate of 8.61 stillbirths per 1,000, which is much higher than the leading nations, Finland, Denmark and Norway, which all record rates lower than 3 per 1,000. Most of our Caribbean neighbours have slightly higher rates of stillbirth than this country. Pakistan and Nigeria have an appalling record of more than 40 per 1,000. (Data extracted from the World Health Organisation Still Births Rate 2009). Obstetrics and gynaecology in the worst performing countries can hardly give comfort, but it would not be surprising to learn that those high rates are attributable to all kinds of factors, except incompetence of the medical practitioner. Although disaggregated figures for Tobago could not be sourced, it would hardly be surprising to learn that little difference exists with local stillbirth rates before the new hospital commenced operation.
Where litigation has been pursued by former hospital patients or their relatives, it has not yielded much success. Notably, earlier this month, a High Court judge made a decision that went against an aggrieved person. Justice Frank Seepersad made a significant finding which the TRHA board should give proper attention. Seepersad’s judgment was delivered via video conferencing at the Hall of Justice in Port-of-Spain. The patient and her lawyers, as well as those representing the TRHA, were at the High Court in Tobago, listening on as he gave his oral ruling. He said he was perturbed by matters which developed during the case, as the patient had a difficult task in retrieving her medical records. “Citizens must not be given the runaround to retrieve their medical records,” he said, adding that there has been a frequency of this in medical negligence claims.
Seepersad said that he has seen an unexplainable resistance by the RHAs to disclose medical records to patients who often have to apply for them through the Freedom of Information Act (FOIA) at some cost to themselves. “This situation is unacceptable, and must be addressed,” he said. “It cannot be that the RHAs are using the FOIA to justify their non-disclosure of medical records. The purpose of the Act is not to absolve RHAs from giving medical records,” he said.
Attorney Martin George has been in the forefront of filing lawsuits for some of these aggrieved individuals. The Mary Patterson case was one of the earliest. In 2008, the High Court ruled against the award of a medical negligence claim. It is alleged that the doctor performed a surgical procedure on Patterson at the hospital in November 2002 after she was admitted with abdominal pains and cramps.
The procedure was said to have been unsuccessful and instead made her condition worse, resulting in further complications and continued post-operative pain for several months.
Patterson subsequently underwent corrective surgery by a specialist surgeon who reportedly discovered a large cyst overlying the mesh and membrane of her previous surgical repair which had to be partly excised and inflammation drained.
Following further examination, the specialist surgeon informed Patterson on March 25, 2004, that the surgical procedure conducted by the other doctor was responsible for her pains and medical complications. However, subsequent attempts by Patterson to discuss the matter with the doctor and the TRHA gained no response, forcing her to seek legal action.
On December 15, 2012, the Secretary of Health and Social Services, Claudia Groome-Duke said she was very pleased with “Operation Nightingale” during which 57 in-patients were moved two miles in an ambulance convoy, with blaring sirens and police escort, from the old Scarborough Regional Hospital at Fort King George to the new $750 million institution overlooking the Atlantic Ocean. Surely, many of us were hopeful that it would mark a period when quality healthcare would be the rule rather than the exception. Can the Shepherd tragedy precipitate the change for good in healthcare in Tobago.