On March 1st this year in Trinidad, a baby, Simeon Cottle died at the Mount Hope Women’s Hospital after a horrific mistake during a routine caesarean operation. The doctor performing the c-section carelessly cut open the head of the baby who later died after profuse bleeding.
Naturally there was an outcry from the family of the child, the community and the media over this case and a demand for action. Responding to the outrage over the case, the Trinidadian Prime Minister Kamla Persad-Bissessar instructed her Attorney General Anand Ramlogan to have the matter investigated. A committee comprising retired Appeal Court judge Mustapha Ibrahim, neonatologist, Dr Petronella Manning–Alleyne and consultant obstetrician/gynaecologist Dr Melanie Clare Davis was empanelled to investigate.
By June 6th, 2014, just over three months later and after interviewing 27 witnesses including the mother of the child, Quelly Ann Cottle, the panel submitted a report to the Attorney General. The Prime Minister then set up a ministerial task force to address the findings of the report. This task force consisted of Attorney General Ramlogan; the Health Minister, Dr Fuad Khan; Education Minister, Dr Tim Gopeesingh; Justice Minister, Emmanuel George; Gender Minister, Clifton De Cocteau and Housing Minister Dr Roodal Moonilal. This committee has since submitted a series of recommendations based on the report’s findings and has met with the North Central Regional Health Authority on the matter.
The March 9th quality report submitted after the tragic death and the report of the panel will now form the basis for a settlement/civil litigation between the family of the child on one hand and the regional health authority, hospital and doctor on the other. At the professional level the conduct of the culpable doctor will be referred to the Trinidad Medical Council though questions have been raised about the independence of action of this body. It has also been posited in the Trinidadian media that an inquest should be convened to gauge the depth of the negligence involved in the death of this child.
If there is any solace to be drawn from this case it is the seriousness and speed with which the relevant authorities addressed it. The involvement of the Prime Minister, the composing of the panel, the delivery of its report in a matter of weeks and the addressing of its recommendations bespeak a recognition of the urgency to act in the public interest even if that in itself would limit the damage to the government. One member of the panel, Dr Manning-Alleyne lamented that the same recommendations have to be made ad nauseam. The point is however that real action was taken by the Trinidadian authorities and the investigation established culpability and identified a number of other individuals who dropped the ball.
By contrast, if one was to consider the travails of Nathalie Caseley whose healthy son died tragically at the Georgetown Public Hospital in December last year, one could easily conclude that the intention of the authorities here is to delay the process, frustrate the bereaved and prevent the sanctioning of those who were negligent in the death of her child.
There is no medical comparison between the two cases except that both ended tragically for the boys and two families have been irreparably rent. What is however remarkable was the expeditious handling of the matter in Trinidad encompassing the head of government, the delivery of a report by an expert panel and action on its findings. In three months, the mother of the Trinidadian child could be satisfied that substantial action had been taken towards justice. Seven months later here, a frustrated Ms Caseley is now preparing to sue the hospital.
The death of Ms Caseley’s healthy four-year-old son Jaden Mars after treatment for a cut tongue should be cause for grave concern in the health sector. The disclosure that an incorrect dosage of a drug caused fatal cardiac trauma for Jaden warranted a full and transparent investigation with the public fully clued in. Unfortunately, not even Ms Caseley knows definitively what has transpired in this investigation. She has been told various things by the hospital and Health Ministry, has read of other developments in the press and has literally had to chase down Health Ministry officials for a clear understanding of the investigation that was pursued and the disciplinary steps that should have been taken. She has been from pillar to post and this is most unconscionable considering the grievous loss she and her family sustained.
The Georgetown Public Hospital Corporation and the Ministry of Health must forthwith release to Ms Caseley and the public the findings of the report that was done into Jaden’s death, the recommendations that were made and what steps have been taken to discipline the culpable. Like in Trinidad, there have been longstanding questions about the manner in which the Medical Council of Guyana acts in relation to cases brought against doctors. This one here is no different. It is unacceptable that over six months after the death of Jaden the public has not been notified of action taken against the professionals involved.
This case is by no means an exception as the Ministry of Health has been challenged frequently over final reports in maternity deaths and other cases to no avail. Families have just given up in frustration. Ms Caseley is determined to pursue the case of her son and we applaud her fortitude and determination.
There is no doubt that the GPHC as the premier public health institution in the country is performing a critical role in offering medical care to thousands each year and saving many lives. That truth cannot however mitigate the need for families like Ms Caseley’s to be told exactly what transpired in the deaths of their loved ones and for the culpable to be held to account. In this respect, the GPHC and the Ministry of Health can take a leaf out of the book of the Trinidadians.
