Baby suffers fractured skull during birth

–mother wants deep probe, compensation

By Svetlana Marshall
A NOW one-month-old baby is suffering from a fractured skull after he literally dropped out of his mother’s womb when nurses at the Georgetown Hospital allegedly ignored her early pleas to be taken to the delivery room.

Public Health Minister, Dr. George Norton

This case comes amid deep concerns over pre and post-natal care in the public health system here. On August 21, Nyesha Hamilton of Paradise Housing Scheme, East Coast Demerara, arrived at the Georgetown Hospital at approximately 22:00h with the expectation of having a normal delivery, only to have her hopes dashed.

In an exclusive interview with the Guyana Chronicle, the mother of two said upon her arrival at the Maternity Ward, she was examined by two doctors. “Two doctors examined me. One of them said I was 4cm; the other one said I was 5cm, so they took me in the pre-natal room,” the young mother said.

Minutes after the doctors left, she said, the labour pains intensified, and she began to bleed and vomit simultaneously. “I called one of the midwives and told her

GNA Executive Director, Ms Grace Bond

that I was bleeding, and she turn and tell me there isn’t anything she could do now, because they usually do the examination every four hours,” Hamilton recalled.

IN FULL LABOUR
Then, approximately 10 minutes after, the 21-year-old reportedly sought the help of one of the nurses, after realising that she was going into labour.
“I tell her that the baby head is already coming down. There wasn’t any wheelchair in the room, so she said let us start walking to the delivery room, while another nurse get the wheelchair,” Hamilton said.
According to the young mother, she repeatedly told the nurse that she couldn’t go any further; that she was in labour, but all she was told in response was to continue walking.
“As soon as we reach the second door where the washroom is, I actually stoop down to catch the baby, but it was too late; the baby fall out. I didn’t want it fall with me standing, because I know the injuries would have been worse, so I stoop to save him,” she explained. That was around 10:20hrs.
On seeing this, Hamilton said, the nurse who was accompanying her panicked. So, too, did her colleague who had joined them on the way to the labour room.

The Maternity Ward of the Georgetown Public Hospital where the incident occurred

“They didn’t want to pick him up; they were afraid,” Hamilton said, adding that it was only after the baby was born that the promised wheelchair arrived.
“You know what is the sad part? After my baby fall, they didn’t do no check-up nothing; they pretended as though it was a normal delivery and send me to the Maternity Ward with my baby,” she said.
It was not until 13:30h the following day (Monday, August 22) that the baby was sent to have a CAT (computerized tomography)-scan done to determine the magnitude of the injuries it sustained.

UNUSUAL SWELLING
Said the mother, “The swelling started on the Monday, but is till in the afternoon when the doctor came and saw the swelling that the CAT-scan was done.”
She would later be told that her son had suffered a fractured skull from the fall, and that he was bleeding internally. “They said it was the internal bleeding that caused the swelling,” Hamilton said.
Next he started to vomit. After this had gone on for three days, the baby, who was by now named Ricardo, was removed from the care of his mother in the Maternity Ward and taken to the Nursery where he remained for 13 days before being discharged.
Now, little Ricardo is required to see a neuro-surgeon regularly at the GPHC. His mother is not happy with this, and is calling on the hospital’s administration and the Ministry of Public Health to launch an investigation into the incident. She’s also hoping to have all related health expenses for her baby paid in full by the hospital.
When this newspaper contacted the Matron’s Office for a comment, we were told that the Matron is currently on leave. The person who took the call declined to disclose his identity and wanted to know why, after one month had passed, the matter was only now being reported.

NO COVER-UP
Public Health Minister, Dr. George Norton, when contacted, said, “Nobody is denying that it happened,” but refuted claims that the hospital is trying to cover up the incident. According to him, reports from the nurse on duty, the nurse in charge of the ward at the time the incident occurred, the pediatrician and the neurosurgeon were submitted to the hospital’s administration.
He further said that based on his discussion with the nurses on duty, Hamilton’s amniotic sac, commonly called the ‘water bag’, was still intact, and it is common practice to have the pregnant woman walk as a form of exercise.
“It was not mismanagement; we do have wheelchairs in the ward; it was in the passageway, but by the time one of the nurses got one, she had already delivered,” Dr Norton said.
The matter was also raised with Executive Director of the Guyana Nurses Association (GNA), Ms Grace Bond, who said such an occurrence should have never happened.

She said that while she is aware that medical protocol stipulates that a Vaginal Examination (VE) or a Pelvic Examination should be done every four hours to prevent infection upon admission, the nurses, upon realising that Hamilton was in labour, should have done the delivery within the pre-natal ward, given the circumstances.
“If the mother complains that the baby is coming, certainly something has to be done, instead of having her walk to the labour room,” Bond said.

WASN’T THINKING
“The option was to have a chair; there was no chair. Instead of having her walk, she could have had the delivery in the prenatal room; the nurse wasn’t thinking,” she added.
In her opinion, the required instruments could have been taken to the pre-natal room, where a safe delivery could have been conducted.
Bond said while the Midwives Association is known for conducting workshops to enhance the skills of midwives, what happened to Hamilton was not a matter of skill, but of attitude.
“To me, it is more about attitude and not the skill of the midwife that is in question here. The whole attitude of nurses is unbecoming,” she contended.
Bond said nurses and midwives must do more for their clients. “Many times when I go to the classroom and I speak with nurses and even here at the GNA, I would always remind them that they must put themselves in the client’s place. If they are a patient, what they would want for the nurse to say or do for them? How would they like to be treated?”
The GNA Executive Director is also of the opinion that stern action should be taken against nurses who fail to execute their mandates in keeping with the Nightingale Pledge.
Last November, a baby fell off the cot on which he was placed within an hour of bi