I am concluding the thoughts on tolerance but, until improved, it will remain an outstanding issue so I will be getting back to it.
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Mom cheated by system—AG
Quelly Ann Cottle, the mother of baby Simeon Cottle, is now officially calling for the doctor involved in the botch C-section to be jailed or at least for the Medical Board to revoke his license. She made the call yesterday after receiving the official report on the child’s death from Attorney General Anand Ramlogan, who also announced he had forwarded the report to Director of Public Prosecutions (DPP) Roger Gaspard and acting Police Commissioner Stephen Williams for an investigation which will determine whether or not criminal charges should be laid. Cottle, who cried during a press conference hosted by the AG, said when baby Simeon died she also questioned where was God at that time. “It was really difficult. To be honest I would like to see the doctor have his license revoked or hopefully go to jail, but who knows. “As far as everything goes right about now I am happy thus far. It is hard, it took so long it come around,” Cottle said.
On whether she intended to sue the hospital, she said he would have to discuss the issue with her lawyer. Ramlogan said the report was also sent to the Medical Board of T&T to establish whether there is need for disciplinary action against any doctor who was involved in the case. On the specific outcome from the DPP, acting top cop or the medical board, the AG said he prefered not to speculate. “The report is clear. It veers towards a finding of negligence on the part of the institution and the doctors that managed this particular patient,” Ramlogan said.
“It’s a tragic, sad, frustrating and depressing situation and reading the report leaves you with a sense of lingering disappointment. “It is fair to say that Quelly has been cheated by the system. Her loss is one that no mother, no father should ever have to go through.”
Baby Simeon’s head was slashed from ear to ear as his mother Quelly Ann Cottle underwent a C-section in March. The surgery was done at the Eric Williams Medical Sciences Complex, Mt Hope, on Carnival Saturday (March 1). The doctor who did the operation remains on suspension pending the outcome of the investigations. Saying yesterday that the case also raised the issue of adequate supervision of junior doctors, Ramlogan said the issue would not be thoroughly probed. “There is a clear and urgent need for us to ensure that senior doctors effectively supervise and monitor the junior doctors who perform these operations. A C-section by itself is considered to be a fairly routine procedure, but be that as it may the C-section in this particular case may very well have clearly warranted the presence of a senior doctor. “Whether it is a pregnancy that is high-risk or one that would give way to complications, the senior support staff must be there,” Ramlogan added.
He said Prime Minister Kamla Persad-Bissessar has instructed that the recommendations contained in the report be implemented and has instructed Health Minister Dr Fuad Khan to ensure this is swiftly done. He said the field of obstetrics and gynecology has been a “soft, vulnerable point” in the country’s medical health care system for quite sometime. Saying there was nothing which could compensate for the loss of a child, Ramlogan said he met with Cottle for an hour yesterday. “It has been a very heart rendering experience. The anguish of her loss is one that is very fresh. The emotional wound is very raw. “In speaking to Quelly the one thing that she wants is to prevent this from happening to another or another child,” Ramlogan said.
Recommendations for Implementation
1. That the consultant on call be involved in all cases involving mortality or serious morbidity. Following a serious event the consultant should see the patient or parents involved and should provide an immediate support team.
2. Laboratory services are required round-the-clock. The availability of a blood transfusion is a necessity sometimes and must remain an utmost priority.
3. All health care workers must have a clear understanding of risk assessment and management and seek to improve the quality of care for mothers and babies. Develop an effective multi-disciplinary team comprising midwifes, nurses, obstetricians, paediatricians and other support staff so that in cases of planned deliveries, fetal indications and planned pre-termed deliveries can be arranged in consultation.
4. There is need for a dedicated obstetrics theatre.
5. There should be a full handing over on the wards.
Ramlogan said in his experience there was “a lot that is lost in translation” during a handing over. “Upon the handing over it would appear that people are sometimes eager to obviously leave shifts and go home, but during that time it is vital...a life and death matter...that nurses and doctors who are handing over to the incoming shift as part of the established protocol must spend time to meet with the incoming doctors and nurses to have a proper transfer of relevant patient information and up to date as it concerns the patient. “If we do not have that then the data would be lost in translation and things would fall into a grey area,” Ramlogan said.
On March 17, Ramlogan named the team to do the investigation which was headed retired Justice of Appeal Mustapha Ibrahim. It also included consultant obstetrician and gynaecologist at the University College London Hospitals Dr Melanie Clare Davies and neonatologist and former head of the neo-natal unit at the Port-of-Spain General Hospital Dr Petronella Manning-Alleyne.
An autopsy found that the baby died from a laceration to the head which caused massive blood loss and hypovolaemic shock.