Saturday, 19 February 2011

Meeting @ Putrajaya

The meeting with the hospital management and the people involved went well yesterday. Below is the summary...

Date: 18th Feb 2011
Time: 3pm
Attendees: Staffs involved during the operation, deputy of the hospital, myself and my husband.

  1. Failed 'spinal' anaesthetic; no general anaesthetic (GA) given immediately as briefed to me before surgery starts.
  2. No info given to parents about baby whereabouts after the surgery.
  3. Wrong antibiotics given; with no alternative antibiotics.
  4. Confirmation on lab test results for chromosome check.
  1. My simple question to them was, why was I not briefed that the entonox gas will be given first (and see if I can bear the pain first) then only convert to GA? After a long explanation from the dept head (which some are irrelevant), she admitted that it was not done as briefed to me and that they will re-look at their SOP on briefing the correct procedure to patients in future.
  2. Head of O&G explained her investigation from the nurse in-charge for this. The nurse was also assigned to assist the doctor in-charge of the baby, in trying to save the baby (baby Amir Daniel was born 'flat line'). The delay of informing was due to this; the nurse couldn't find my husband after that but assumed that my husband knows what happened since she was told that he had already went to NICU to look for the baby. Wrong assumption by nurse.
  3. Explained what happened in the ward where the nurse advised me to just 'take it or leave it' (after I mentioned that I am allergic to the same group of antibiotics); and senior pharmacists also confirmed that I can take the antibiotics. Head of O&G admitted that this is a negligence by the staff. The nurse should have referred to the MO in-charge and I should be given an alternative antibiotics instead for my wounds. Plus, the nurse is NOT AUTHORIZE to give such advice to a patient. Even the senior pharmacist made a wrong decision! Because of this, I had rashes for days. This is a medical negligence and the hospital can be sued.
  4. Doctor from NICU confirmed that the chromosomes were sent to HKL instead of LPPKN since HKL normally do a detailed test, rather than LPPKN. This test results may take up to 6 months. Hhhmmm....
There are few other minor matters raised - pathway to the morgue issue, attitudes of the nurses, etc. which I do not mention here. The meeting was about an hour. Anyway, I have requested for them to re-reply my complaint letter; admitting their negligence and written apology...

Monday, 14 February 2011

The Misconduct of Procedure

After all the shock and trauma, I tried to give a lot of time for myself especially in heal the wounds from the c-section. This is a great challenge for me as this is my first cesarean and the wounds just won't heal easily even though it's already my fifth week (there's this just one very tiny dot that won't close completely). During the operation, there was a misconduct of procedure, on the anesthetics given to me. I am now waiting for the appointment with the management and people involve in the operation; waiting for them to explain why was I not treated accordingly. Below is the long report that I wrote to the Director of the hospital...

"I was admitted to ward immediately and was scheduled for an emergency operation, which I followed without any hesitancy. In the operation theatre, I was briefed that I will be given a half body anaesthetic (spinal) and they will wait if it works for me. If not, then it was mentioned to me that I will be given a general anaesthetic before starting the operation. I had given my consent after understood the whole procedure. The medical officer then had multiple attempts to insert the spinal catheter but it seemed that she could not really find the exact spot. I was quite disappointed with this; especially that it was my first time having an operation and I had great pain from these multiple injections. After trying several more times, I was asked to lie down and I thought that she had found the correct spot to inject the anaesthetic. I was asked by one of the nurses from time to time if I feel any numbness of my legs. However, each time I kept informing the staff nurse that I still can feel the normal sensation in my limbs. I was also asked to lift my legs and I could do so perfectly at that time. I believe this showed that I was not completely anaesthetised. Apart from all these, I was able to follow the instructions as I trusted the staffs were experienced enough and I saw that the surgeons have started preparing their tools for the surgery.

At first, I felt a pulling with pain sensation at my bikini line and I was asked if I felt pain; I immediately replied “YES” as I was able to feel the sensation. The pulling was repeated and I still tell them I can still feel the pain. To my surprise, the surgeon straight away did the same thing which I believe they have started the incisions and the operation, although I had mention to the staff that it was very painful when asked. The nurse who was all the time standing above my head had of course noticed that I was in great pain; she had also kept on asking if I still feel the pain and I still kept on telling her “YES”. I had to endure the great pain for a long time that I could not say anything anymore. I also felt the great pain of pulling, in and out of my stomach; and until I passed out. Before I passed out, I could only remember that someone asked to give me the entonox gas but even at that time I could still feel the great pain and the gas did not help at all.

Unfortunately, I was never informed of the above incident after I came out the operating theatre. Later, after being transferred to the ward, I was informed of my baby's poor health condition and needing NICU admission by my husband. Dr Marya, the on-call specialist that night obviously was not informed of the above incident by the medical officers involved.

I had informed this incident to my sister in law – Dr Hayati Yaakup from HUKM; and she had helped me to follow up with Dr Marya. Since Dr Marya is in Labuan, Dr Haslina has called me up regarding this issue on 15th January 2011. During my conversation with Dr Haslina, there were many discrepancies of what was written or reported on the operation note and what had happen to me. My sister in law had the chance to look at the operative note and had spoken the nursing staff assisting my baby who clearly remembers there was no word mentioning general anaesthesia. Therefore, Dr Haslina had advised me further that it's best to write to you on this matter.

I regard this as a traumatic experience; and I would appreciate you to investigate on this serious matter. I also seek your explanation on the below:

a. Why did the medical officer started the operation when I still inform them that I could still feel the pain?

b. Why didn't they give me general anaesthetic when they know the anaesthetic (spinal) did not work?

c. Dr Haslina informed me that, it was stated that I was given the general anaesthetic after the baby had been delivered. Why was I given the general anaesthetic only after I passed out and after the baby had been delivered? (Has someone altered the operative note after my sister in law had enquiry regarding this matter?)

d. After I had regained consciousness, why wasn't there any doctor confronting me to inform me what had happened to me and/or to my baby? No doctors inform my husband who was waiting outside the operation theatre any information and that my baby was already sent to NICU. Why is this so? Is this a normal practice?

e. There was no apology at all of what had happened in the operation theatre but the staffs knew that I had to endure great pain until I passed out. Why is this so?

I seek for your kind assistance to investigate this traumatic experience that I had briefly stated in this letter. I greatly appreciate an appointment with you for further clarification and you may also call me at the stated number below at any time. I am greatly disappointed of what had happened as I had put in a great trust to your surgeons and staffs."

Unfortunately, I receive a reply letter with no clear explanation of what happened and no apology at all.. We'll see what happens later after the appointment with them next week.

Sunday, 13 February 2011

Amir Daniel had chosen Heaven

5th Jan 2011:
NICU, Putrajaya Hospital

Baby Daniel was diagnosed with Congenital Diaphragmatic Hernia (CDH) with Unidentified Syndrome. Congenital diaphragmatic hernia (CDH) is a congenital malformation (birth defect) of the diaphragm. The cause is still unknown to the world and it is not hereditary. Baby Daniel had a hole at his right diaphragm which resulted to his intestine pushes into his chest; thereby impeding proper lung formation.

My heart was torn when I saw him lying helplessly and depending on machines to live. There were tubes everywhere in and out few parts of his body. He was a very beautiful baby, with full dark hair, long eye lashes, perfect brows and fair skin. After several complications, baby Daniel couldn't be saved during the last CPR given, after the doctors change the tubes around him. I was there waiting on the wheel chair alone nearby the section and I know he cannot be saved. Amir Daniel left us all at about 5.30pm. Inna lillahi wa inna ilahi rojiuun...

6th Jan 2011:
The funeral

I requested for an early discharge. I don't think I could stay at the hospital since everybody else around me were having their babies with them; and I was just all alone. Plus, I kept on waking up in the middle of the night suddenly and just felt so lonely.

My husband arranged for the funeral from the hospital. We were lucky that he had some contacts and neighbors to help assist for everything. After picking up baby Daniel's body from the mortuary, we went back home for a while for a change of clothes. My husband's family was all there to see the baby for the first, and the last time..

Baby Amir Daniel was buried at around 1pm.

Amir Daniel was born

31st Dec 2010:

It was my 38th week check up with my obstetrician, Dr Jamea at Klinik Jameaton. During the whole pregnancy, I never had any issues or problem. During this check up though, the doctor sense that my baby was small for date. Dr Jamea wrote a letter to Hospital Putrajaya for them to check me and for second opinion.

When I arrive at the labor room dept, the medical officer asked me to come back the week after as she didn't see that it was an emergency. She re-schedule me to come back on 4th Jan 2011.

4th Jan 2011:
Amir Daniel was brought into this world...

The queue was extremely long and dragging. I reached the hospital about 8.30am and was only called in around noon. Dr Normila is the first one to check me; she did find that my baby was quite small. She then asked the Dr Marya who was the consultant and Dr Marya had decided that I can be induced since I was already at 39 weeks. I was queued to get the CTG done to check on the baby's heart rate. Dr Marya mentioned that if the baby's heart rate was stable, they will induce me to deliver; if no, I'll have to go through the c-section.

Unfortunately, while doing the CTG, I had one contraction and during that time the baby's heart sounded that it was failing. Without doubt, Dr Marya decided that I should get a cesarean. I waited for more than 15 minutes as they had to find a bed for me in the ward (the ward was full at that time). I was straight away brought to the ward and changed to the hospital's gown. I was quite surprise that suddenly two nurses pushed in an operation bed and asked me to change to the operation gown. They mentioned that the surgeons have called for the next c-section. So, I quickly changed and the nurses did the necessary to prepare me to go to the operation theater. It was all done quite fast.

At the operation theater, the MOs, nurses and surgeons prepared all the necessary tools for the operation and I was given a spinal block to numb half my body (from waist down). The operation was done traumatically (I will write about this experience in another post) and Amir Daniel was born at about 4.25pm. Amir Daniel was a small baby (1.98kg) and he was sent straight to the NICU. I didn't know when they took him out from my tummy nor hear him cry since I passed out during the operation. I regained conciousness after few hours and was brought back to the ward to rest...