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A routine blood transfusion at Sangre Grande County Hospital for a three-year-old boy with sickle cell disease has resulted in a mother’s worst nightmare, as the child has contracted the HIV/Aids virus after receiving infected blood. The Eastern Regional Health Authority is facing a $4.5 million lawsuit for medical and clinical negligence.

The suit charges that as a result of negligence and a blood transfusion with infected blood, Kevon (not his real name), faces a loss of expectation of life, endures constant pain, discomfort and suffering. He has problems attending school, and his family has mounting medical bills. Kevon, who doctors concluded would not live past his fifth birthday, is now 16, and attends secondary school. His parents have never told him what is wrong with him.

Asked why, his mother, “Jane,” replied: “It is already so hard on me. I just cannot bring myself to tell him this kind of news. I simply cannot do it. I tried to protect him all these years as best as I could but I know I can’t do it forever.” She believes, however, that her son is silently aware of what is wrong with him.

“Every time we go to the clinic he would observe and pick up on things and remain very silent and become very sad,” she said. “I believe he knows about his condition, but he has never come out and said anything to me. “Now sometimes he tells me he does not want to take his medication…that he is going to die anyway. “It is very hard on him.”

Not knowing much about the disease, Jane too has battled demons. “Every time he got sick I thought he was dying,” she said. “I cannot put into words how emotionally hard it is one me. “I do not sleep in the night…I check all the time to see if my child is still breathing. “When he wakes up in the morning, it is a miracle for me.” Jane clings to the hope that he will live to celebrate his birthday in August.

Kevon recently had gallbladder surgery. Jane said her son does not have full-blown Aids, and attributed this to early medical intervention. “From the time his condition was detected at Mt Hope hospital, he started getting drugs.” Fed up of having the door shut in her face by the ERHA for nearly 12 years, and the matter dragging on in the hands of Legal Aid lawyers, Jane has now retained attorney Theodore Guerra, SC.

“I have been up and down trying to get my son’s documents, trying to see somebody, anybody, at the hospital,” she said. “It is very unfair, because my child did not ask for this. “They took his life from him because he was innocent and he got HIV from the hospital and the hospital does not want to accept any blame.”

She added she also appealed for help from then health minister John Rahael but none was forthcoming. The suit was filed in the Civil Court of the Port-of-Spain High Court on March 16, 2012. It cites the Sangre Grande County Hospital, which fell under the purview of the ERHA, as the second defendant. A leading consulting paediatrician was named as the first defendant.

Guerra has served a pre-action protocol letter on the ERHA’s chief executive officer. A copy of the proceedings, Guerra said yesterday, has been forwarded to Health Minister Dr Fuad Khan in an effort to settle the matter out of court. He said it was only after threats to obtain the documents under the Freedom of Information Act that the hospital began co-operating.

The letter says Kevon was born “normal” in August 1995 at the Sangre Grande County Hospital. About three months later, he fell ill and was taken back to the hospital, where he was diagnosed with sickle-cell disease. In May 1997, the letter said, Kevon received a blood transfusion at the hospital. He subsequently became seriously ill and was taken back for another transfusion.

“On or around April or May, 1998, our client developed a gland/swelling at the back of his right ear and became very ill,” the letter said. When his mother took him back to the hospital, Jane was told the swelling could have been an ear infection and medication was prescribed. But the problem persisted.

In August 1998, a doctor at the hospital took blood samples from the boy and sent them to the Eric Williams Medical Sciences Complex, Mt Hope, for testing. But it was only a year later that his mother discovered Kevon was HIV-positive. Jane said hospital authorities kept giving her the runaround, and refused to give her answers.

But finally, says the lawyer’s letter, “In the month of July 1999 or thereabouts, one Dr Murphy of the institution confided to our client’s mother…that the blood samples that were taken from our client tested positive for HIV.” Jane and Kevon’s father also submitted blood samples, which came back negative.

When the family tried to get his records from the EWRHA and the Sangre Grande hospital, they were fobbed off with excuses: there had been a fire, then a flood, and then that the file had been destroyed. Eventually, his mother was given “a bundle of papers purporting to be his file,” the letter stated.

It was only in June 2000 that Kevon was recommended for HIV treatment. In May 2006, he became very ill and suffered a near-death crisis at home, after which he was taken back to the hospital. Because of his low blood count, Kevon’s school attendance has been poor, as he is sometimes in hospital for weeks on end.

“He gets up with so many pains…foot pain, back pain…It is unbearable that you can’t help your child how you want to help him,” said his mother. “And this situation is getting out of control. It real hard, emotionally, financially. Anyhow you put it, it real hard. Every day I wonder if today will be the day for him.”

Jane has four other children, who are all HIV-negative.

Bartholomew’s findings

Consulted in support of the lawsuit, Prof Courtenay Bartholomew indicated that the child contracted the disease from a blood transfusion. In a letter, dated June 8, 2010, he said the child’s mother “was and is still is HIV-negative. And so this suggests that he got his HIV infection from a blood transfusion.”

He added that all blood donations were supposed to be screened for HIV by the Blood Bank. Bartholomew noted that in many instances, people donated blood during the incubation or seroconversion period, when the HIV antibody test would be negative. False HIV negative results are not uncommon if blood is tested during this “window period.”

It averages ten-14 days, but in some cases can be three or four weeks or more, Bartholomew stated. As a result, he said, all donated blood is tested in the United States for the viral-load content and does not depend only on the HIV antibody test. “One therefore needs to know whether the blood donated to the child was also viral-load tested,” he said.

“What I am saying is that you can have a negative antibody test, but the viral load will be positive. “In either event, this appears to be a valid case for legal action.”

Matter in legal hands

Health Minister Dr Fuad Khan confirmed last week that he was aware of the matter, and that he had received a copy of the pre-action protocol letter and other documents on the case. Khan said legal officers assigned to his ministry were handling the issue, and he could not comment on the details.

He said this was the first time that such a matter had been brought to his attention, but also noted that he took office only six months ago. Questioned whether in fact there was the possibility of someone contracting the HIV virus via a blood transfusion at a public hospital, Khan said: “I know now that the screening process at the Blood Bank is ironclad.

“This incident occurred quite a while ago, and back then I do not know what the screening processing at the Blood Bank was like.” Contacted last week, an official at the Blood Bank maintained that stringent measures were used to screen blood.

About sickle-cell

Sickle-cell disease, or sickle-cell anaemia, is an inherited blood disorder, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This “sickling” decreases the cells’ flexibility and results in a risk of various complications. The illness reduces life expectancy, and sickle-cell patients often need blood transfusion.

Extracted From: Trinidad Guardian Newspaper

Monday, March 26, 2012

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