GPHC debunks couple’s claims

Apr 08, 2011 News

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Director of Medical Services Dr Madan Rambarran has categorically dismissed claims by a young couple that negligence of the Georgetown Public Hospital Corporation (GPHC) caused the death of their baby on April 1, last.
Tiffanie Leacock and her husband Sherwin Williams told this publication that if the doctors had followed a referral letter which stated that a caesarian section should have been performed, instead of a normal delivery, her baby would have been alive.
But Dr Rambarran yesterday told Kaieteur News that he will not be commenting on the issue of the ultrasound, since it was done independently.
“It was not done at the GPHC, and because of that fact I would not be commenting!” Rambarran stated emphatically.
Further Rambarran said that Leacock was at the district centre – CC Nicholson Hospital at Nabaclis, East Coast Demerara – and was referred to the GPHC. He said that the officials at the CC Nicholson Hospital did not find a heartbeat and when Leacock arrived at the GPHC this was also confirmed.
According to Rambarran, the fetus was already in uterine death. He said that upon delivery of the baby, it was noted that the infant’s abdominal area was not developed. Rambarran said that the bottom line is that the child had already died.
However, sources at the CC Nicholson Hospital yesterday said that when Leacock was examined the baby had a heartbeat. It was explained that if the baby was dead, a note would have been made on the referral letter.
The source said that the referral letter only specified that Leacock needed a caesarian section.
Yesterday when this newspaper told Leacock about the issues surrounding the issue of the heartbeat, the woman explained that it was the nurses at the GPHC who reassured her that the baby’s heartbeat was good.
Leacock said that the nurses explained to her that when the baby is in a breech position, they would have to check above her navel.
Leacock explained to this newspaper that she went into labour on Friday last and was taken to the CC Nicholson Hospital. While there, Leacock said that the “on duty” doctor informed her that her baby was in a breech position.
The young mother said that she was given a referral letter from that institution to the Georgetown Hospital, informing that Leacock needed a Caesarian Section, instead of vaginal delivery.
Upon arrival at the GPHC, Leacock said that she was taken to the labour room for observation.
Kaieteur News was told that the on duty doctor who looked after Leacock was a “relatively young Cuban-trained” doctor, who confirmed that the baby was in a breech position and that Leacock was in the advanced stages of labour.
The woman said that the doctor examined her and told her that the baby was coming by the foot.
She insists that the referral letter was totally disregarded and that the doctor said that she would be delivering the baby vaginally.
Leacock estimated that she spent almost an hour pushing intensely after which she eventually delivered a girl. She claimed that after the delivery, the doctor quickly called the on duty nurses and whispered something to them.
Even though the woman believed she heard her baby cry, the doctor along with the nurses told her that the baby was a “stillborn.”
Leacock said that the doctor and nurses told her that the baby was born with her small intestines protruding and there was no way she could have survived.
The woman said that she told officials that she had taken an ultrasound and nothing was detected. The ultrasound was taken on March 29 by Dr Nainiappan Daniel.
“I took the ultrasound at a private institution….and nothing wrong was detected and if something of that nature indeed happened before delivery I’m sure it would have been detected,” Leacock said.
Further, the woman said that the doctors at the GPHC had claimed that the doctor who did the ultrasound was not certified.
In an invited comment Dr Nainiappan Daniel sought to clarify reports about how the incident could have happened.
Dr. Daniel has been practising in Guyana for the past 20 years and has been at the Mercy Hospital for the past 10 years. He produced his certification from the American Society of Diagnostic Medical Center which deals primarily with ultrasound training. Daniel said that he regularly updates his qualifications.
The doctor explained that the day he did Leacock’s ultrasound there were no abnormalities in the fetus. He said that the parents were given the privilege of hearing the baby’s heartbeat. Dr. Daniel made it clear that if anything was wrong the ultrasound, he would have picked it up.
Further he stated that the baby suffered from a congenital defect. He explained that could possibly be responsible for the protruding intestines.
Firstly, the doctor explained, a baby’s abdominal walls are very weak. If pressure is put on it, it can open.
He added that the uterus, which would be contracting during birth, can cause double pressure that presses the already weak abdominal wall and in most cases it would burst. And thirdly, the doctor said, the baby’s umbilical cord can open at birth and become enlarged placing pressure on the weak abdominal wall and forcing the stomach contents to protrude. This, he said, is called viscera, which would be fatal.
The doctor went on to explain that in cases when the baby is in the breech position it is very risky to do a vaginal delivery.
“The doctors should have done a Caesarian section instead,” Dr Daniel explained.
Meanwhile the GPHC in a statement yesterday said that parts of the couple’s story were not factual.
It was indicated that following the hospital’s investigation, it was revealed that a medical personnel from the referring hospital, advised that a C-section may be the better option based on the confirmation of an ultra sound (to be done at GPHC), which was to determine whether the baby was still alive or not.
This, it was noted, was so advised because the attending midwife at the referring hospital could not detect a fetal heartbeat and this was explained to the patient and documented on the referral note.
“At no time did the patient inform GPHC staff that she had an ultra sound done privately.
Upon physical examination by the doctor at GPHC and based on the information documented on the referral form, it was confirmed by a Pinnard Foetoscope examination (the most effective conventional method of examination) that no fetal heartbeat was heard and it was not advisable to have the mother undergo a c-section – to avoid unnecessary risks. Additionally, the doctor observed that the Liquoir (amniotic fluid) was clear to yellow – clinically this signifies that the baby would have been dead for some time in the uterus. As such, the patient had no criteria for a c-section.”

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