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‘Probe absentee doctors’

Sunday, March 9, 2014

The issue of absenteeism by University of the West Indies (UWI) consultants at the Eric Williams Medical Sciences Complex is being raised in the wake of the death of Quelly Ann Cottle’s baby boy and the suspension of a junior doctor from the Mt Hope Women’s Hospital. The questions being raised are: Who really is to blame? Why the Caeseran section was not done by the most senior doctor or consultant? The C-section performed on Cottle resulted in her baby boy’s head being sliced from ear to ear.   


The Sunday Guardian was reliably informed by a senior obstetrician, who does high-risk pregnancies, that a team of doctors should have been present to deliver the baby and that the team should have been headed by a consultant.



The Sunday Guardian understands that Cottle’s pregnancy was deemed to be a difficult one or high risk since she was hypertensive, had previous pregnancy losses, the baby was premature (she was 30 weeks pregnant), and Cottle had intrauterine growth restriction, which means the baby was small for the number of weeks. The surgery was deemed an emergency on the Thursday (February 27) and schedule for Carnival Saturday, a day traditionally know to be short staffed.


The obstetrician said a team comprising the most senior doctors headed by a consultant and including a registrar, senior house officer, interns, neonatologist, senior anaesthesiologist and nurses should have been there to deliver Cottle’s baby. The Sunday Guardian was told that the UWI consultant who should have been on-call to assist in the child’s delivery was absent. Issues relating to the consultant’s absenteeism had been raised before.


According to an October 24 letter sent to Prof Samuel Ramsewak, dean of UWI’s Faculty of Medical Sciences, from the chairman of the North Central Regional Health Authority’s (NCRHA), Dr Shehenaz Mohammed, complaints were made by the chairman about the UWI consultants’ absenteeism, treatment of junior doctors (who feared victimisation), and some doctors who wished to be paid more but provide only minimal services. 


The letter said of the consultant who should have been on-call during Cottle’s delivery, “The authority has received numerous complaints about (the consultant’s) absenteeism during working hours and while on-call. One such incident was reported by (another senior medical officer, name and position withheld) who was on-call for the Neonatal Intensive Care unit (NICU) while (the consultant) was on-call for obstetrics and gynaecology on May 26.”


The letter went on to state that a patient admitted was to deliver triplets but the other senior doctor was not informed of the patient by the said consultant until the next day, and when the said consultant was called, the other doctor was informed that the consultant was “en-route” to Piarco.  The triplets subsequently died and the NCRHA was medio-legally responsible for the deaths and might be the subject of litigation. 



The letter said, “The mere simple facts that on-call services are not provided by some UWI staff, that many do not engage in post-call ward rounds, that many are not regular and punctual for their teachings, has left two decades of young doctors misguided, unmonitored, and ill-prepared for their responsibility as interns and house officers in the public sector. In fact, the issues of absence of tutors, teaching and mentoring, and the poor examples set, have been raised by the majority of these young doctors.” 


Harris: We will meet in 48 hours
Asked about the matter, UWI’s vice chancellor Nigel Harris, in a phone interview yesterday, said he was scheduled to hold a meeting and have a “full discussion” with Ramsewak and UWI, St Augustine, principal Clement Sankat within the next 48 hours on the matter. He said the university has a commitment to the highest standard of service, and whenever there are any concerns about its ability to adhere to standards the matter will be properly looked into. 



Fuad: Culture of absenteeism among consultants
Asked if there was a high absenteeism rate among consultants at the public hospitals, Khan said he was trying to address this situation. “There has been a culture of absenteeism among all the consultants. This problem has been going on for 20 years. I have been trying my best to change the culture. It has become very difficult.” Khan said even chairman of the NCRHA Dr Shehenaz Mohammed has described the absenteeism problem as overbearing.


“She is upset with the absenteeism of doctors. We are going to look and see how best we could take action.” Mohammed said consultants and registrars don’t seem to understand their contractual obligation to the hospitals. She said “absenteeism is a breach of their contract.” Khan said Cottle and her baby’s father Emil Millington were within their right to take legal action against the hospital, while the ministry would have the right to defend itself and ensure it does not happen again.



Millington: Suspend consultant
Last night Millington called for the consultant, who should have been present during the surgery of his wife, to be suspended. He said his wife was a high-risk patient and needed to be properly looked after by the doctor in charge. Millington said tomorrow he would know if the NRCHA would pay for his baby’s funeral.


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