Death of mom after childbirth…Stricter measures to be put in place from antenatal level

Mar 23, 2018 News

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– Linden Hospital CEO

By Enid Joaquin

“We don’t want to be surprised we want to know the patient’s history beforehand!”
That was the assertion of Dr. Farouk Riyastat, CEO of the Linden Hospital Complex (LHC), as he reflected on the death of Amelia’s Ward resident Jennifer Gill, a 41-year-old mother who succumbed at the health facility, one day after giving birth to a healthy baby boy.
Dr. Riyastat, in alluding to certain measures that would be put in place, to prevent possible recurrences, emphasised that there would be stricter monitoring of patients from the antenatal level.
“We want to make sure that we see every single patient that is pregnant. We will have them come to the Hospital, and if they can’t come to the hospital we will go to them – for patients in Kwakwani, we will go to Kwakwani to ensure that within the antenatal period they have at least one visit, so that we can see them beforehand.
We also want closer collaboration with doctors who are working at the health centres with the doctors who are working with the Obstetrics/gynecology team at the Hospital for communication purposes and referral of patients.
Dr. Riyastat said that this would allow for early identification of any risk factors in order to relate same to the hospital, indicating the issues at hand. He suggested that the Clinic doctors themselves could bring in these high risk patients. He said that this would allow for patients to be seen early enough.
“We want to know and identify these patients early enough, so that when they come to the maternity ward, we don’t have to say, that we didn’t know.

We need also for the doctors at the health centres to send patients early enough for elective caesarean section – patients who have had surgeries before and you know that they might need to have another surgery, for many reasons, for instance some may have had twins or might have some medical condition.
We want to know – we don’t want to be surprised when they come to us….when they land at the maternity ward then we learn that they have xyz and then we don’t know how to manage them at that point in time, because different cases would need different resources.”
Dr. Riyastat was at the time speaking with media operatives during a press conference to shed some light on the tragedy.
The CEO said that the patient had a coagulation disorder that even if she had had a C-Section she would have still succumbed, because of the propensity to bleed with this disorder. Gill’s death was as a result of kidney failure due to haemorrhaging, an internal investigation by the hospital has revealed.
According to Dr. Riyastat, the haemorrhaging was caused by dyscrasia, which is a condition where the blood does not clot fast enough.
“She was bleeding faster than the blood was clotting. What you found is that the blood got thinner and when the kidneys sensed that there was not much oxygen flowing through in the blood, they started shutting down. When she came out and was sent to the ICU, she wasn’t passing any urine. Until the next day she wasn’t passing any urine and, as a result of the kidney failing and the loss of blood, she died,” Dr. Riyastat disclosed.
He pointed out that had the patient’s history been known, the hospital would have been prepared to manage her accordingly.
Gill had started haemorrhaging after giving birth on Sunday evening. A hysterectomy was subsequently decided upon, after she continued to bleed despite efforts to stop the haemorrhaging. However she experienced a hypovolemic shock during the surgery.
Hypovolemic shock occurs when more than 20 percent of the body’s blood or fluid supply is lost, rendering the heart incapable of pumping a sufficient amount of blood throughout the body. Organ failure can result as a consequence.
Dr. Riyastat, in alluding to the claims made by relatives that Gill was scheduled for a C-section, said that that was never the case. He also disputed claims that no doctor was available to perform the procedure.
DISCLOSURE
According to Medical Superintendent of the LHC, Dr. Remeeza McDonald the patient only made the disclosure that she had a blood disorder on her way to surgery.
McDonald said that Gill related that she had haemorrhaged during a delivery 20 years ago.
The Linden Hospital Complex in a press release yesterday expressed its sadness and regrets that after nine years, the institution recorded a maternal death on Monday.
It noted that there is a lot of information being peddled regarding the incident, hence, the reason for calling the press conference was to disclose the facts about the case.
Further, it was pointed out that this was done only after an official investigation was launched and a report was produced.
According to the release, Pathologists travelled from Georgetown to Linden (Wednesday) to perform a Post Mortem on the body of Gill, but no family member showed up, despite communication with them multiple times. The Post mortem was subsequently postponed. It was indicated that the body would have to be sent to Georgetown for the procedure when the relatives are ready.
The release further detailed that on first assessment by the doctor, the patient was in active labour (6 cm dilated). Further assessment by the consultant, showed that the patient had no criteria for Caesarian and that she gave birth to a healthy baby.
Throughout the process the patient received all the necessary drugs and blood, it was stated.
After the patient was observed haemorrhaging, she was prepared and taken to the operating theatre to have a hysterectomy. The patient went into hypovolemic shock while in the operating theatre, the release said
She was subsequently transferred to the ICU and continued receiving blood and medications as needed. However at 19:48 pm on Monday, the patient went into cardiorespiratory arrest after which resuscitation was done but proved futile. The patient subsequently died at 20:30 hrs.
It further stated that Ms Gill was treated by expert doctors from the time she entered the Hospital to the very end and that her immediate family was updated on her condition throughout.
The Linden Hospital Complex holds firm that the institution is equipped with competent and aid compassionate doctors who aim to deliver the best quality care to the community.
Relatives of Gill are holding out for further investigations into her death.

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