Thursday, October 27, 2011

Health director defends handling of Penan child’s birth ~ C Section Adhesions

Health director defends handling of Penan child’s birth

MIRI: The State Health Department yesterday said standard care and management were provided to a Penan mother Seri Yung and her baby by its staff in Limbang and Miri hospitals but apologised for not waiving the charges.
In a statement, its state director Dr Zulkifli Jantan said complications due to lack of oxygen supply (hypoxic ischaemic encephalopathy) was the cause of the infant’s death. It was brought about by the extra long time needed in the ceasarian operation due to massive adhesions present.

“The department would like to state that all reasonable care and management have been duly provided to both Seri Yung and her infant while in Limbang and Miri hospitals,” he said.

The statement was in response to a letter highlighted through Batu Lintang assemblyman See Chee How that a Penan couple from Limbang was requesting an inquest into the death of their infant and case management.

The couple also alleged that they were verbally abused, and were forced to borrow money to pay the RM180 hospital charges.

The department apologised over the flap (on hospital charges), saying it was due to miscommunication. The patient had described herself as a Rela staff and not as a Penan, and therefore was charged accordingly.

“If she had presented herself as a Penan who could not afford the charges, the fee exemption could have been activated on the spot. For this (misunderstanding), we would like to tender our sincere apologies,” Dr Zulkifli said.

He said Seri had a previous Ceasarian operation to deliver her first baby in 2006, and in the recent case, an emergency operation was needed due to the prolonged labour.

She came to Limbang hospital at the early stage of her labour, diagnosed as a high risk patient and was sent by an ambulance to Miri Hospital on Oct 15 as her condition warranted it.

Labour commenced spontaneously in Miri Hospital and normal delivery trial was planned as previous Ceasarian operation did not contraindicate such, and the condition of mother and infant were monitored accordingly throughout.

“However, progress was slow and the infant began showing signs of distress, and a Ceasarian section was carried out but it was 30 minutes longer than normal due to extensive adhesions affecting the uterus and abdominal wall as a result of previous Ceasarian operation, “ he added.

The patient recovered from the operation without complications, and doctors at the Miri Hospital explained to her and her husband the whole incident, including about the infant.

The infant showed poor oxygenation upon birth at 4/10 in the first minute assessment and improved to 5/10 in five minutes. Emergency and intensive care was provided from birth until the infant girl passed away on Oct 17 caused by lack of oxygen due to longer than expected operation.

“The situation could not have been dealt with in a different way. Although it is common to have some adhesions from a previous Ceasarian operation, it is not common to have the extensive adhesions that this unfortunate patient had,” he added.

Dr Zulkifli said that the care and management of the mother and infant from Limbang to Miri hospitals were correct and appropriate.

The date mentioned by See (Chee How) contradicted with the department’s chronology of event. The infant was reported to have died on Oct 15 after Seri Yung was transferred to Miri hospital on Oct 13.

The Batu Lintang assemblyman said nothing short of a public apology from Miri Hospital would suffice as the couple was hurt and disappointed for losing their baby girl and also subject to needless criticism and humiliations for their financial hardships.

Meanwhile, on the imposition of RM180 hospital charges, the Miri Hospital director Dr Jack Wong said a breakdown in communication could be the cause.

He said the hospital could not ascertain at that point of time, the status of the patients (Seri and daughter) – whether they were entitled to a waiver of the hospital charges.

“However, we are prepared to waive the charges and to meet Seri and her husband, Roy Dumani. We will work out a mechanism to help solve the problems,” said Dr Wong.

On allegations of verbal abuse by the hospital staff, Dr Wong said investigation was being carried out.

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