Yet another maternal death

Dec 17, 2010 News

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– raises serious questions about “State-of-the-art” operating theatre at Linden

By Latoya Giles

Even as the Ministry of Health is trying to address the problem of maternal deaths, which has reached troubling proportions, its effort was dealt another blow after a 23-year-old mother of one, from Linden, succumbed hours after delivering a stillborn at the Georgetown Public Hospital Corporation (GPHC).
According to reports, the young woman, Inga Nieuenkirk, died around 20:00hrs on Wednesday in the Intensive Care Unit of the GPHC.
The woman’s death raised several serious questions, one being if the Linden Hospital Theatre was indeed functioning why wasn’t the surgery conducted there, instead of bringing the woman to Georgetown.
Speaking with Kaieteur News yesterday, Kurwyn Greene, the woman’s reputed husband, explained that Nieuenkirk began experiencing labour pains on Tuesday around 23:00hrs.
He assisted in taking her to the Linden Hospital Complex.
Minutes after his wife’s admission, Greene said nurses told him that they failed to receive any signs that the baby was alright.
“They (nurses) told me they weren’t getting heartbeat…so they have to transfer her to the Georgetown Hospital,” Greene explained. He claims that it was the nurses who were doing everything, and a doctor only came after 45 minutes to the hospital – only after being summoned by the same nurses.
The man further told this publication that Nieuenkirk left the Linden Hospital Complex sometime around 03:45hrs on Wednesday.
Upon her arrival at GPHC she was immediately rushed to the operating theatre.
“She was bleeding….but she was still talking to me,” Greene recounted.
Greene said he was told by the nurses that he should go home and return at midday since the woman would be in the theatre for some time.
He said he returned at lunchtime and his wife was out of the theatre but was in the Intensive Care Unit (ICU), which created some confusion for him. The man said he could not understand what could have gone so wrong within that short space of time.
Greene said that when he visited his wife in the Intensive Care Unit she was vomiting and streaks of blood were evident. He said after spending some time at the ICU, he left. Around 20:00hrs on Wednesday, Greene said he received a telephone call from the hospital saying that Nieuenkirk had died.
Efforts yesterday to contact the relevant medical officials proved futile.
For the past month or so the health ministry has been plagued with an alarming upsurge in maternal deaths.
Reports into such deaths at the New Amsterdam and Skeldon Hospitals have shown a number of discrepancies.
“Although she was a high-risk maternal patient, no ultrasound was ordered for acting headmistress Esther Dwarka-Bowlin, no blood was available for her when she needed a transfusion, and no doctor was present when she was ready to deliver.”
This was one of the many findings in the report.
Dwarka-Bowlin died on October 16, last, at the Skeldon Hospital.
A report was done also for Nadira Sammy, a 15-year-old from Number 69 Village, Corentyne, who died on September 16; Rebekah Seegobin (also called Rebekha Chinamootoo), 27, of Number 36 Village, Corentyne, who also died in September; and Heerawattie Bisham, 21, (also called Yogeeta Bisham), who died on October 20.
The report raised several questions about the quality of treatment that the women received.
Among the observations made in the report was that high-risk patients were left in the hands of junior doctors, who were unable to handle emergency maternal cases. The report further stated that the patients were left unattended.
A similar observation was made during the Guyana Medical Council investigations earlier last year into the deaths of high-risk maternal patients Tricia Winth and Salima Ram at the Linden Hospital and the West Demerara Regional Hospital, respectively. No staffers were disciplined, although investigations revealed that negligence contributed to their demise.
At the Georgetown Hospital, Nurse Charlene Amsterdam, who dedicated 15 years of service to GPHC, succumbed two days after undergoing a Caesarean section.
Unconfirmed reports had stated that Amsterdam had an ovarian cyst. A source said that during the Caesarian section, the doctor nicked one of the blood supplies to the cyst (either arterial or venal) and sparked excessive bleeding.
The source added that some time later, when the nurses noted the bleeding, they called the doctor who was hesitant to take the woman back into the theatre for corrective surgery.
However Head of Medical Services for the GPHC, Dr Madan Rambarran in an interview with this newspaper said that no negligence has been cited for Amsterdam’s death.
Meanwhile reports into the investigations surrounding the deaths of maternal patients Monica Carmichael and Miriam Bristol, are expected to be completed by weekend. This was disclosed by a senior official in the Ministry of Health on Tuesday.
The two women died hours apart at the GPHC last month.
Carmichael, who delivered
a stillborn, died one day after undergoing a caesarian section while Bristol died minutes after delivering a healthy baby girl.
A post mortem examination conducted on Carmichael revealed that she died from hypovolemic shock (caused by massive loss of blood and other fluids).
The examination also showed that the woman suffered from pulmonary embolism (a blockage of the pulmonary artery or a branch of it leading to the lung)
Bristol’s post mortem showed that she died from hypovolemic shock and cervical laceration.
According to Carmichael’s relatives, the woman was transferred from the New Amsterdam Hospital, because medical staff realised that all was not right with the baby.
One relative had said that the baby had died inside of the woman and an emergency surgery had to be done.
An aunt further opined that the nurses should have kept monitoring her niece since she was considered to be a high-risk patient.
In Bristol’s case, her relatives refuted claims by the hospital which stated that the woman died because she had done multiple c-sections.
The hospital in a release had stated that Bristol had a previous caesarian section, and it was a case which posed an increase risk of bleeding.
Relatives further said that Bristol spent almost one week at the Linden Hospital Complex.
According to them, doctors at the hospital had suggested that Bristol undergo emergency surgery, but the operating theatre was not functional, so she was transferred to GPHC.
Some medical sources believe that the lack of experienced staff at the institution and the absence of an obstetrician, are contributing factors to the spate of maternal deaths.
The sources believe that there will be more maternity deaths if the situation is not rectified as soon as possible.

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