19 Mar 2011

Medical accountability and chaos–on a rock near to you.

[The following are from media reports. I do not assert that what is reported here are the facts.]

Chrystal Boodoo-Ramsoomair, 29, a mother of three, died hours after giving birth to a baby girl by Caesarean section at the San Fernando General Hospital on 4th March 2011.

Pathologist Dr Hubert Daisley, pathologist, found that the cause of death was bleeding. Relatives were reportedly told that two arteries which were cut during surgery were not discovered until the autopsy. [2011-03-17 TT Express]

Five doctors and four nurses were suspended on 13th March 2011 to allow a full investigation to take place. And Paula Chester-Cumberbatch, the CEO of SGH, was sacked, supposedly for delay in issuing letters of suspension to the doctors. [2011-03-17 TT Express]. It appeared that a decision was made on 11th March for letters of suspension to be issued on Monday 13th March but they were only issues on the Wednesday 13th March. On the Monday (11th) The Minister of Health  Therese Baptiste-Cornelis made announcement of the suspensions on Monday. A change of strategic direction is reported as the reason for Chester-Cumberbatch being given the kick, according to Dr Lackram Bodoe. Dr Chattergoon then gets the hump (as he expected) [Guardian 2011-03-19].

Anand Chattergoon, Medical Director, at SGH was in support of Paula Chester-Cumberbatch delaying on issuing suspension notices. He reportedly said, “The CEO and I discussed it, and we agreed that we would follow the law of the land. We had to do things properly and follow procedure..” [2011-03-17 TT Express]. On 2011-03-17 MPATT reportedly asserted that suspension of the 5 doctors was unlawful.

Amazingly PSA and MPATT (formerly not the best of ‘friends’) have now joined forces to do battle with those who have effected this unprecedented action against doctors. [Guardian 2011-03-19]. And now both the TTMA and MPATT have joined forces to condemn the suspensions [2011-03-19 Guardian].

The Government – now championing the cause of the people – have accepted liability for damages in relation to an unrelated similar case of Nekeisha Caine at POSGH [2011-03-19 Guardian].

I have no problem – at all with any government holding medical/nursing professionals to account. [Read that again]. However, the Cap smells something very strange going on in the suspensions. The degree of precision and the power with which the sword of State power is wielded seems quite unusual. I think – from memory – that the Rock has never seen anything like this before. Dr Chattergoon – a man who was previously seen by many as siding with a former government – has now broken ranks, it would seem. Chattergoon may not be popular but he is bright.

The government has opened up a can of worms. Not just opened it – they smashed it open. The overspill isn’t going to be pretty – the Cap predicts. The combined power of the intellect of some of the brightest doctors in the country and their lawyers, is set against that of politicians and their lawyers. That is where the battle will be played out.

The Cap can say from direct knowledge, that the area of law related to medical practice and employment – is a minefield. You don’t just go in and suspend so many without really good evidence and reason. And contrary to what plebs may think, suspending doctors because someone died of haemorrhage is not a routine way to do business. If as Chattergoon and Chester-Cumberbatch indicate, this has not been done according to due process of law, the backlash will quite serious.

The way the acceptance of liability for Nekeisha Caine’s death is played into this most recent crisis, suggests to me that the Government is out to play political mind-games. If that is the case, they picked on the wrong group to play those games with.

Dr Daisley’s autopsy report of Boodoo-Ramsoomair dying presumably from haemorrhage post-caesarian section – does not mean negligence. Calm dong! Negligence is not (in law) what you might think it is. I’ll leave Jumbie to educate you lot on dat – because I not in dee business of teaching (aka spoonfeeding) jackasses.

The Cap will be watching this space very carefully.