Ontario couple want ‘justice’ for newborn baby who died in hospital from childbirth-related head trauma
Swati Patel can’t stop thinking about the assumptions surrounding the birth and death of her baby boy last summer.
What if a scalp clip wasn’t used to monitor her baby’s heart rate? What if the doctor had not performed a suction-assisted delivery? What if the cut on her newborn’s head from the scalp clip and her blood loss were discovered sooner?
The Brampton, Ont. mom may never stop wondering, but what she says could help her family heal is to get an apology and accountability for what happened to his son.
« I know that by doing all these things, I won’t get the baby back, » Patel told CBC News. « But I need justice for my baby. I need answers for my baby. »
Patel’s son Anant died two days after birth at Brampton Civic Hospital in August 2021. His death was caused by complications from a birth-related blunt head injury, a review has determined. post mortem. This head injury included a scalp laceration, significant bleeding between the baby’s scalp and skull, and bleeding outside of his brain.
“Throughout my pregnancy he was completely healthy,” Patel said. « We do our best to meet the doctor who gave birth, to ask the questions, but that never happened. »
Instead, Patel and her husband, Manish, met with management at Brampton Civic Hospital six months after their son’s death to review a quality of care committee review conducted by the health system. But the report did not mention the birth doctor and largely focused on potential issues with their baby’s post-natal care.
The meeting and review fell short of the accountability and apology the couple said they were seeking – which a patient advocate says are often hard to come by in Canada given fears of legal ramifications.
« It really shouldn’t be as hard as getting an apology, » said Kathleen Finlay, CEO of Toronto-based advocacy group Center for Patient Protection. « That’s all most people want. They’re not looking to make a lot of money out of a huge settlement. »
The hospital offers its « sincere condolences »
William Osler Health System, which operates Brampton Civic Hospital, told CBC News in a statement that it could not provide specific details or comment due to its policies and to protect the family’s privacy and confidentiality. .
« William Osler Health System expresses our sincere condolences to the family for their loss, » spokeswoman Emma Murphy wrote.
“We have a robust quality of care review process in place to assess patient care. This process includes engaging with family throughout the comprehensive review and offering support continues to the family. »
Two days after their baby died, a hospital social worker called the Patels and offered condolences and emotional support.
The quality of care report, reviewed by CBC News, says the vacuum-assisted delivery ‘may have contributed to a subgaleal hemorrhage/subdural hematoma’ – the only time a potential problem with the baby’s birth is mentioned. A vacuum-assisted birth occurs when a doctor places a small vacuum on top of a baby’s head to use suction to help remove the newborn when the birth is not progressing.
The Patels filed a complaint against the obstetrician with the College of Physicians and Surgeons of Ontario (CPSO) in January. Their complaint will go to a committee later this month to determine whether disciplinary action against the doctor is warranted.
CBC News is not naming the doctor as no malpractice allegations have been brought against them by the college at this time.
A couple say they were not consulted
In their complaint to the CPSO, the couple allege that the doctor caused a scalp injury to their baby during labor and failed to notify the neonatal intensive care unit (NICU) of the injury and loss. of blood ; has not obtained informed consent for vacuum delivery; failed to properly perform the vacuum delivery that caused the baby’s injury; and did not meet with the family to discuss what had happened despite requests to do so.
Hospital records reviewed by CBC News include doctor’s notes and reports. In these records, the doctor says the risks and benefits of vacuum assisted birth were explained to the couple and Swati Patel agreed to do so.
The doctor’s notes also state that « there was bleeding observed at the time of aspirator application after the clip was removed from the scalp – it is unclear if there was a detachment or if the blood was from vagina » and that the doctor « was careful not to pull hard » because of difficulty maintaining suction with the aspirator.
The Patels claim they were never consulted about the use of the vacuum cleaner and requested that Brampton Civic Hospital make corrections to doctor’s notes in their medical records – a request which was denied.
« The doctor took the clip out of the scalp and [the doctor] put the vacuum cleaner on and I was trying to vacuum with the vacuum cleaner, at which point I saw a lot of blood, » Manish Patel said.
« Later, when I describe to Sick Kids Hospital what I saw, the doctors at Sick Kids say that this blood was actually baby blood. »
The Patels say their baby was very pale when he was born at 3:18 a.m. ET on August 29, 2021, and according to records had « low respiratory effort », so he was taken to the NICU.
The William Osler Health System regional transport team was unable to ‘fast’ transport the baby to the Hospital for Sick Children in Toronto, so the NICU team tried to figure out what was wrong. was wrong with the newborn while receiving directions over the phone from Sick Kids until the transport team arrived, according to the Quality Care Review.
The report goes on to state that early identification of a possible head bleed (later determined to be from the scalp clip in the post-mortem report) was also delayed because a protocol for measuring head circumference was not available. was not followed because the staff prioritized the baby’s breathing.
Going forward, the quality of care committee recommended reinforcing the protocol with frontline staff and monthly audits to monitor compliance.
Undiscovered blood loss for hours, parents say
The couple say their baby’s care team didn’t determine their son needed blood until several hours after he was born, when the specialist transport team arrived, took charge of the care and ordered a blood transfusion.
“As soon as they transplanted the blood to where the scalp clip was put in, the blood started coming out of that wound, and then they know the baby is hurt,” Swati Patel told CBC. News.
The autopsy report confirms that « during transfer, a subgaleal hemorrhage was noted as well as bleeding from the scalp laceration, the latter resulting in the soaking of several absorbent pads ».
Tests and scans at Sick Kids after the transfer of the Patels’ son Anant revealed the extent of the little boy’s irreversible brain damage and the severity of the blood loss meaning his heart was unable to pump enough blood to other parts of the body, causing its organs to fail.
Anant was taken off a ventilator and died Aug. 31 at Sick Kids. Her mother said she is still haunted by what happened and hopes that by speaking out she can prevent the same from happening to others.
« I can’t sleep at night, » she said. « I dream that I am in the hospital looking for the baby. »
No more « healing solutions » needed
Finlay, of the Center for Patient Protection, said an apology can be a powerful healing tool for patients and their families — one that doesn’t necessarily put Canadian hospitals and doctors in legal jeopardy.
“In Ontario, for example, we have had apology legislation for over 10 years, which ensures that an apology cannot be used in legal proceedings,” Finlay told CBC News.
« It’s never considered an admission of guilt, but rather an admission of regret and grief. »
Most other provinces and territories have similar laws.
The center has also advocated for hospitals to appoint compassionate leaders to ensure patients are listened to and treated in a way that takes their trauma into account.
“We really need to find much better, faster, simpler and more effective healing solutions so that families can move on,” Finlay said. « It’s really important. »
For their part, the Patels are awaiting the outcome of their complaint against the CPSO.
“I will do my best to do everything until justice is done,” Swati Patel said.
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