Once again, the Mt Hope Maternity Hospital is in the news—and
not in a positive light. Hospital administrator Dr Esau Joseph
confirmed that the autoclave sterilising equipment broke down
and they were trying to repair it.
Dr Tim Gopeesingh has been quoted as saying that this was
inexcusable for any hospital.
Health Minister John Rahael, who has been making a fantastic
effort to improve health care standards, was understandably
appalled that the hospital’s administrators did not have
sufficient working equipment.
We are far too wealthy and developed a nation for this backward,
Fourth World state of affairs to still exist at our nation’s
health institutions.
If these mistakes and problems persist, then citizens will
have no alternative but to turn to the law for redress and
legal recourse.
High-risk area
There are always so many complications and problems that can
occur with pregnancy and delivery, that it is small wonder
that this area is the branch of medicine which traditionally
sees the highest rate of medical negligence lawsuits.
And if the folks at Mt Hope don’t get it right pretty
soon, they may be facing another slew of legal actions over
this issue.
Although the area of medical negligence is being developed
slowly in Trinidad and Tobago, the courts have shown in the
past that they are willing to listen and to make findings
of medical negligence, especially in the areas of obstetrics
and gynaecology, and especially in matters concerning the
maternity wards of our hospitals.
Internationally, too, it is also one of the areas of medical
practice that carries the highest risk, and medical malpractice
insurance in some states in the USA carries astronomical premiums.
Some insurers don’t offer it at all, because they all
recognise the grave dangers and risks of this particular area
of medical practice.
More and more it is becoming the case that medical practitioners
in Trinidad and Tobago are no longer afraid to step forth
and give cogent, compelling and credible evidence in support
of claims brought by members of the public for medical negligence.
These claims for medical negligence are not limited to the
negligent actions of doctors, but can also include negligent
treatment by nurses and other hospital staff and administrators.
It can, therefore, affect an entire institution, such as the
Mt Hope hospital.
In the 1985 case of Grace Prima-v-Attorney General, the plaintiff
took the State to task over what was alleged to be “the
negligent medical treatment of the plaintiff on December 13,
1984, by the servants and/or agents of the State at the Mount
Hope Maternity Hospital.”
The plaintiff was 26 years old at the time, and gave a history
of having been treated and attended to throughout the term
of her pregnancy at Mt Hope Maternity Hospital.
She alleged that on entering the hospital for delivery of
the baby, she was treated or attended to so unskillfully and/or
negligently, that she suffered a rupture of her uterus, her
baby died, her uterus was then removed by the hospital staff,
and she also suffered post-operative sepsis.
Serious health consequences
Gopeesingh is this weekend warning that, “The health
consequences for the patients are very serious.”
He said patients can contract septicaemia and peritonitis
septicaemia, which could lead to hysterectomies, or death
in the occasional case.
In the Grace Prima case, the State for its part tried to defend
the Mt Hope Hospital and its staff, saying that the plaintiff
was attended to at all times by a qualified midwife and passed
through the first stage of labour successfully.
They went on to say, however, that during the second stage,
the plaintiff complained that something had burst inside her
and the doctor in attendance diagnosed a ruptured uterus.
A caesarian section was then performed, and the body of a
male child was then delivered stillborn, with the umbilical
cord wrapped three times tightly around its neck.
A hysterectomy was then performed, because of the severity
of damage to the plaintiff’s uterus, and the State denied
any negligence on the part of its hospital and staff at Mt
Hope.
The learned trial judge, Justice Basdeo Persad Maharaj, rejected
this argument, and found that the nurses on duty were negligent
and that the labour ward staff were careless.
The judge awarded the plaintiff damages in the sum of $130,000,
plus interest, special damages in the sum of $1,690 and legal
costs.
Negligent treatment
In the 1998 case of Rana Ramlal v South-West Regional Health
Authority, Dr Patricia Deonarine and Attorney General, the
plaintiff was a 19-year-old who at 18 weeks’ pregnant,
attended San Fernando General Hospital with complaints of
abdominal pains and bleeding.
She alleged that she was treated negligently when a cervical
polyp was mistaken for products of conception, and she was
treated for an incomplete abortion.
Three doctors testified on behalf of the plaintiff and four
for the defendant.
The trial judge found that:
• On a balance of possibilities, Dr Deonarine used the
sponge-holding forceps to pull on what was later identified
as the cervical polyp, which she apparently mistook for the
products of conception.
• This tugging on the cervical polyp caused the plaintiff
severe pain and she had been screaming.
• The court accepted the evidence of the plaintiff that
she asked for tests to verify that the foetus had died, and
that Dr Deonarine had said that it was not necessary.
• The plaintiff by this time had not only lost confidence
in the hospital staff, but had become afraid of the possibility
of a repeat of the tugging with the forceps and discharged
herself from San Fernando General Hospital. Within 48 hours,
she was reassessed by other doctors and found to be carrying
a live baby and was diagnosed and treated for an endo-cervical
polyp.
• The court went on to make a finding of negligence and
granted judgment for the plaintiff in the matter.
Our hospitals can’t continue to play fast and loose with
people’s health like this, and members of the public
are awakening to the fact that they can do something when
their health and their lives are put at risk, through the
carelessness and negligence of hospitals, doctors, nurses
and administrators.
