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Fuad defends absent doctors

Final report on C-section death today
Monday, March 10, 2014
Health Minister Dr Fuad Khan

A final report on the death of a baby boy during a C-section is expected to be sent to Health Minister Dr Fuad Khan this morning. An autopsy revealed the baby’s head was cut so deeply that it penetrated the brain and damaged the tissue during the surgery performed at the Mt Hope Women’s Hospital on Carnival Saturday. The C-section was performed on Quelly Ann Cottle, 38, who along with her husband, Emil Millington, are now demanding answers as to why their son died. The baby was to be named Simeon.


Chairman of the North-Central Regional Health Authority (NCRHA) Dr Shehenaz Mohammed told the T&T Guardian yesterday that the report was prepared by the hospital’s quality co-ordinator and would be forwarded to the NCRHA’s chief executive officer Dr Kumar Boodram. Mohammed said she would get a copy of the final report today and then pass it on to Khan.


The final report, Mohammed added, was separate and apart from a preliminary investigation which led to the suspension of the doctor who performed the surgery. The doctor has been suspended with basic pay. A senior obstetrician told the T&T Guardian that such an operation should have been performed by someone with at least ten years’ experience. It was reported that the operating doctor had recently graduated as a specialist obstetrician.


In outlining some of the details of the final report, Mohammed said, “This report would deal specifically with the processes and procedures and how these were adversely affected. “It would take into consideration the details of the statements taken from all the medical personnel who attended to the patient from the time of being warded to being discharged.


“It would also take into account a time and motion analysis, meaning it would look at accountability...whether those who were supposed to be there did in fact fulfil their contractual obligations to the best of their ability. “It would also seek to determine whether the different levels of staff responded appropriately.” Depending of these findings, she said, if it is determined there was guilt involved immediate action would be taken.


A senior hospital administrator yesterday expressed concern that the process could be stymied, however, as two of the consultants involved in the case do not fall under the NCRHA’s purview. Instead, they are assigned to the Faculty of Medical Sciences at the University of the West Indies, St Augustine. Dean of the faculty is Dr Samuel Ramsewak. 



The administrator also expressed displeasure by the reported attitude of the consultants not directly assigned to the NCRHA, saying: “They would tell you in your face flat, ‘I don’t work for you (the NCRHA).’” A letter was sent from the NCRHA to Ramsewak on Friday requesting that the consultants fully co-operate in the matter. Mohammed also said it was important that a clinical investigation be done as soon as possible to bring closure to the matter.



Consultants did no wrong-Fuad
Although questions have been raised regarding the absence of two consultants during the surgery, the Health Minister said there was no need to pursue them as they did nothing wrong. Describing the surgery as routine, Khan added: “It was a normal C-Section surgery. There was nothing untoward about it. The fact is the consultants were available and just a phone call away. There was no need for them to be around at the hospital at that time.”


On the fact that one of them was in Tobago, Khan said: “So what? Tobago is part of Trinidad. And even so the other consultant was in Trinidad and was readily available be called at a moment’s notice. “There was no trouble so the consultants were not called. They were only notified after the C-section was done.” Khan said the matter must be looked at objectively, not emotionally. The focus of the probe, he added, would be what technique was employed by the doctor during the operation.


“That is the main issue we must examine. Exactly what method did he use to do the surgery,” Khan said. Asked about the doctor’s lack of experience, Khan said that was not a matter of concern as he was qualified as a specialist. “The doctor who did the surgery is one who is considered a specialist and a professional in his own right to operate. If he was not given the specialist status then that could have been a matter of concern,” he said.


“If it was a junior doctor then a consultant would have been required to be present and if the consultant was not around that consultant would be held accountable, but that is not the case in this matter.” He said an independent team of investigators was expected to be put in place this week, but such members would first have to give their consent to be part of the team. “We could chose people who we feel would be best qualified to be on the team, but at the end of the day it is up to them to say they want to serve,” Khan said.


Reports have surfaced that the father of the doctor who performed the surgery is a senior member of the United National Congress. Asked about this, Khan acknowledged knowing the doctor’s father, but did not confirm or deny the man’s UNC’s membership. “I know (name called) him very well. The fact is the buck stops with me. It makes no difference who you are at the end of the day, whether a member of the UNC or PNM,” Khan added.


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