Hospital learns lesson after probe

Thursday, 19th March 2015

Lack of effective communication lead to parents claim of undue pressure under which they were placed to have their sick child transferred to an overseas hospital.


Hospital learns lesson after probe

in All News, Health / By: bvi news online on 03/18/2015 at 10:29 AM /

 By Nedburn Thaffe, BVI News Online Staff

The management of Peebles Hospital has decided not to collect just over $8,000 from two parents who had requested that the Complaints Commission investigate the ‘undue pressure’ under which they were placed in having their sick child transferred to an overseas hospital.

The parents sought to have Peebles Hospital reimburse half of the $16,000 spent on air ambulance service to eventually have the child flown to Barbados.

Their ordeal is contained in the Complaints Commissioner’s latest report, which was tabled in the House of Assembly this month. Though the incident dates back to 2013, the investigation was completed last year.

According to the report, the mother took her one-year-old daughter to a private medical facility where she was treated for reactive airway obstruction. The child reportedly became ill after eating a yogurt.

She was taken to Peebles Hospital and, under admission, her condition worsened. She was admitted to the Emergency Care Unit after being urgently intubated due to symptoms that indicated the probability of imminent respiratory failure.

Dr. Emmanuel Ogunde, who heads the hospital’s Pediatrics Unit, informed the mother that the child would have to be transferred to HIMA Hospital in Puerto Rico, because Peebles did not have the resources to provide the necessary care, said the Complaints Commissioner.

The following day, the child reportedly showed signs of improvement, but arrangements continued in earnest to have her sent overseas.

Those arrangements however hit a snag when it was realized that HIMA was only willing to accept $60,000 from the parents, because they did not have insurance.

A decision was then taken to instead transfer the child to a hospital in Barbados. The deposit in this instance was $25,000 although the air ambulance cost rose from $5000 for the earlier proposed Puerto Rico trip to $16,000 for the flight to Barbados.

While steps were being taken to execute the transfer, the child’s condition reportedly improved, and the parents became unconvinced about the need to have her transferred. However Dr. Ogunde persuaded them to have the transfer done, said the Complaints Commissioner.

The transfer from Peebles Hospital to Barbados was executed. But, en route to Barbados, the child suffered a left lung collapse which was healed when she was admitted for over 16 days to the hospital in Barbados.

The medical bill for treatment in Barbados was some $46,185, in addition to $4,700 for ground transportation and other expenses relating to the transfer. There is also a $3,600 bill for the care administered at Peebles hospital.

Mother files report

On April 5, 2013 the child’s mother made a report to the Office of the Complaints Commission headed by Elton Georges, stating that she and the child’s father had been ‘unduly pressured to agree to the evacuation’ of the baby.

The mother described the transfer as unnecessary at the time it was done, and said it took place ‘at great personal sacrifice that could have been avoided if the hospital authorities had shown more consideration and exercised more patience’.

The parents, in the Complaint Commission’s report, also claimed that they spoke with Dr. Kedrick Pickering who reportedly said they could not have been forced to transfer the child. Dr. Pickering, it is said, admitted to speaking with the parents, adding that he understood the reasoning behind the transfer and did not involve himself any further.

Best interest of the child

Few months later, the Complaints Commission received a written response from the Chief Executive Officer (CEO) of Peebles Hospital, Darlene Carty Baptiste, regarding the incident.

The CEO stated that the transfer was done in the best interest of the child, and considering the challenges and constraints at Peebles.

She said: “It is my view that the agencies in the hospital acted with due diligence to ensure optimal care was delivered, optimal support was provided [including financial] to the family, and every effort was reasonably made to ensure the family’s concerns were addressed appropriately.”

Following investigation, the Complaints Commission, in its findings, concluded that the hospital had reasonable grounds to have ordered the transfer of the child.

It however concluded that the hospital’s manner of communicating with the parents made the situation worse.

“In this situation, the hospital needed to have given all relevant information, set out the case for transfer, and discussed the risk of the transfer and those of delaying a move for a day or two, informed the parents of their rights, and involved them in being part of the decision,” said the Complaints Commission. “Instead, information seems to have been delivered piece meal, was incomplete, and meetings were dominated by Dr. O’s insistence that the move was imperative with no option.”

The Complaints Commission further stated that the parents’ complaint that they were placed under ‘undue pressure’ was sustained, and was largely owing to the failure in communication.

It recommended – among other things – that the hospital should write a letter of apology to the parents, admitting the failure that occurred and the ‘injustice that resulted’.

The Complaints Commission also advised the hospital to implement a system that will ensure persons are informed from the outset about – among other things – their rights and obligations.

Peebles Hospital, in response, identified the main lessons learnt and – as a form of generous gesture to the parents – offered to ‘forgive’ an outstanding $8,185 loan that was given to the parents to assist with the medical evacuation.

Dr. Ogunde stopped working with Peebles Hospital on June 1, 2014. The reasons are not clear.