Negligence cited as cause for maternal death at West Dem hospital

Dec 31, 2009 News

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“She playing tricks. She only behaving so when she see y’all,” were the alleged comments made by a midwife of the West Demerara Regional Hospital whose responsibility it was to attend to a pregnant patient some hours before she died.
Salima Ram, 32, of 19 Vive-La-Force, West Bank Demerara, was pronounced dead by doctors on Tuesday after she collapsed in the maternity ward of the hospital.
Reports are that the woman, overwhelmed with pain, was attempting to find nurses manning the ward to inform them that her baby was ready to be delivered. She collapsed before reaching them.
This newspaper understands that although it was quite a task for the woman to get medical attention, despite her many cries of intense pain, she received medical help in abundance after she collapsed; help that came a little too late, according to members of her family.
Ram, according to her sister, Roxanne Alli, was admitted to the hospital some time after 12:00 hours Monday with pains that she described as “severe labour pains.” During the woman’s stay at the hospital, Ram was in constant pain and was even passing blood, her sister said. However, she noted that nurses advised that Ram was not ready to be delivered.
It was during the midday visiting hour the following day that Chanwattie Ram, the dead woman’s mother, observed that Ram’s state had worsened.
“We see she was in great pain and they was not doing anything to help she. So we go and ask a doctor…they were calling him Dr Williams— if he can give we she fuh carry home. He and the other nurses start saying that they can’t send she out because they know we want tek she to another hospital,” Alli said
According to the sister, she and her mother were informed that should the woman be taken out of the hospital and something goes wrong they (hospital staff) should not be held responsible. Nonetheless, the pregnant woman’s family were denied a discharge request.
“The nurse tell we that she (Ram) gon deliver at the right time and dat we just got to wait,” a distraught Alli lamented.
Taking some solace in the fact that Ram had three previous successful deliveries, Alli said that she and her mother decided to leave when urged by nurses. But Ram was in such terrible pain, Alli recounted.
“When we leaving she just start crying and beg for somebody to stay with she. I come out and I tell mommy to stay with she. She just hold on pun mommy and cry…She was saying, ‘Ow mommy, stay with me nah’.”
According to Alli her sister was in such pain that as she clung to her mother she was bent double due to the unbearable pain. The woman said that it was a few minutes after leaving the ward that her mother followed claiming that the nurses told her that she couldn’t stay.

It was shortly after they left, Alli said, that they were later informed that Ram developed a bout of hysteria which was characterised by her screaming for help and crying out in pain. Alli said that during the 16:00 hours visiting time she and her mother were told that Ram suffered incredibility hours before her death but yet no medical assistance was forthcoming. “We hear that even in the pain she try to walk and go tell them that the baby coming…We didn’t know and we been just outside this whole time waiting for the afternoon visiting time.”
The woman said that when she and her mother blazed into the ward they were told that Ram was at the back. They however, were not informed that she was already dead. “I asked the nurses about Salima’s condition and them nah tell me nothing. They said to sit down and wait. After about 15 minutes later I see another doctor named Dr Ravi come out and pass we and he nah say nothing.”
When he passed back I ask he how is Salima’s condition and he said hold on. He passed about three more times and he still nah say nothing. So I ask he again when he pass back.”
Eventually, Alli related that Dr Ravi Persaud, Medical Superintendent of the hospital, invited herself and mother into a room where he informed them of Ram’s behaviour after they left earlier that day.
She said too that the doctor explained that Ram was only 37 weeks pregnant but should have in fact been 40 weeks. But even as he divulged the information about the pregnancy, Alli said that nothing was shared about the state of Ram and her baby.
“He talk and talk and I ain’t hearing nothing bout the baby nor she so I asked he what is them condition and he still nah answer.”
Dr Persaud, she said, subsequently related that Ram had no heart beat when she was examined some time after 13:00 hours on Tuesday. Neither the mother nor child had survived.
Chanwattie Ram is of the belief that had closer attention been paid to her daughter she could have still been alive. She said that at least efforts could have been made to save either her daughter or grandchild if saving both was not possible.
The woman disclosed that she had informed the midwife on duty that her daughter was hypertensive. According to her the midwife had even dismissed her daughter’s cries of pain as “playing tricks.”
Chanwattie Ram said that the midwife insisted that it was only when family members were around that Ram had a less than acceptable behaviour.
The distraught mother even recounted how her daughter’s request to visit the washroom to defecate was ruled out as ‘playing tricks’ by the midwife.
“They didn’t render any assistance to her. They were not caring enough. If they were just little bit caring my daughter could still be alive,” the heart-broken woman related. The woman said that she is hoping that the relevant authorities would look into the matter so that justice could be served.
Medical Superintendent, Dr Persaud, in an invited comment yesterday said that a post mortem has been planned for today to determine the cause of Ram’s death. According to him an investigation into the death commenced since Tuesday and will be continued with even more clarity when the result of the post mortem is known.
He declined to comment further on the matter.
It was just last Sunday that another maternal death was recorded at the Linden Hospital Complex. That death was attributed to poor medical response and a non-functioning operating theatre at the spanking new hospital.
Reports are that Tricia Winth, a 35-year-old mother of three, and her unborn baby died at the recently commissioned medical facility shortly before 14:00 hours on Sunday, six hours after she was admitted for the delivery.
Her husband, Eusibo Winth, told this newspaper that his wife went to the hospital around 07:30 hours the same day in severe pain. According to the man, his wife who was hypertensive, could hardly walk and was suffering spells of headache when she arrived at the hospital. Upon arrival there, she was examined by nurses who reportedly told her that she was not ready to deliver after examining her. This was despite the woman producing evidence of a complicated pregnancy, evidence obtained from an ultrasound performed on her on Christmas Eve Day.
Eusibo Winth related that while in hospital, his wife’s blood pressure kept fluctuating and nobody took the time to summon a doctor. The doctor was eventually summoned some four hours later, but by that time, Tricia Winth began suffering from seizures.
This newspaper was told that the doctor who turned up informed that although he was not officially on call, he would have made himself available if he was contacted earlier.  By then a normal delivery was ruled out even as medical personnel battled to control the woman’s blood pressure.
It was also too late to transfer the woman to the Georgetown Public Hospital. To compound matters the operating theatre at the billion-dollar hospital was inoperable, putting an end to any plans to perform Caesarian section to deliver the baby.
In the end Tricia Winth perished with her baby inside her. An investigation into that death has also since ensued.

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