Joshua Seemu­n­gal

Se­nior Mul­ti­me­dia Re­porter

joshua.seemu­n­gal@guardian.co.tt

Sev­er­al moth­ers who re­cent­ly lost ba­bies de­liv­ered at pub­lic hos­pi­tals are call­ing for the Pan-Amer­i­can Health Or­ga­ni­za­tion/World Health Or­ga­ni­za­tion and the Min­istry of Health’s in­ves­ti­ga­tions in­to neona­tal deaths at the Neona­tal In­ten­sive Care Unit (NICU) in the Port-of-Spain Gen­er­al Hos­pi­tal (PoS­GH)to be ex­pand­ed to in­clude oth­er pub­lic hos­pi­tals and cas­es fur­ther back than April. 

They said the cir­cum­stances sur­round­ing the deaths of sev­en ba­bies at the NICU be­tween April 4 and April 7 have en­cour­aged them to speak up about their hor­ri­ble or­deals of child loss. They said they are hop­ing to get hon­est an­swers about what hap­pened to their ba­bies be­cause they be­lieve they may have been lied to.

 If any­one can re­late to the pain felt by the 11 sets of par­ents who lost their ba­bies at PoS­GH and are now tak­ing le­gal ac­tion, it is Rashel East­man-Chotoo. The To­bag­on­ian lost two ba­by boys be­tween Sep­tem­ber 2022 and Au­gust 2023.

 “I saw this sto­ry with the sev­en ba­bies that died. I want to know if I put my sto­ry out there if I will get some an­swers. All I want is an­swers. They ex­pect me to take it and swal­low it. It is very hard to lose two chil­dren, two healthy chil­dren,” East­man-Chotoo said.

 Both of East­man-Chotoo’s ba­bies were de­liv­ered at Scar­bor­ough Hos­pi­tal but were trans­ferred to Port-of-Spain Gen­er­al Hos­pi­tal (PoS­GH).

The first ba­by

The first ba­by, Kadan Emanuel Smith, was born on Au­gust 10, 2022. At first, doc­tors told her every­thing went well and there was noth­ing to wor­ry about. 

 “I re­alised some­thing was wrong. I picked up the ba­by, and his hat fell off. I no­ticed this bright red bump on my ba­by’s head. When the mid­wife came back, I asked why my ba­by had this bump on his head. She said that was be­cause the ba­by squeezed through my cervix and that it would go down in a few days,” she said.

 Kadan was on the ward with East­man-Chotoo, and her con­cerns were, at first, put to rest when the doc­tor re­peat­ed that the bump would go down in a few days. But her gut was telling her some­thing was wrong. The ba­by kept cry­ing on the ward. The cry­ing con­tin­ued at home af­ter they were both giv­en med­ical clear­ance and dis­charged.

 “That night, the ba­by did not sleep. He just kept cry­ing—a pained cry. I took him to the hos­pi­tal, and they checked his blood glu­cose. All the doc­tors came rush­ing in­to the room. He went down to pae­di­atrics. He just kept get­ting worse by the day. They said they sus­pect he has an in­fec­tion—menin­gi­tis. They took blood and urine sam­ples, and I had to keep ask­ing for the re­sults,” she said.

 Three days lat­er, the ba­by went on a ven­ti­la­tor. The doc­tor in­formed her some­time af­ter that the ba­by was hav­ing seizures, so they took him down to the NICU (in Scar­bor­ough), and he was be­ing treat­ed for seizures and in­fec­tions for a week and a half.

 “A nurse came to me and asked, ‘Mom­my, why don’t you ask for a trans­fer for your ba­by?’ I said I don’t have fam­i­ly in Trinidad. She said, ‘Ask for a trans­fer for your ba­by.’ She said ‘What hap­pened last night hurt me.’

 “That night, when I got up to check on the ba­by, I saw the tube in the ba­by’s mouth bro­ken, com­plete­ly off, and my ba­by was just there ly­ing down. And I ran, and I called them, and they ran and taped it up. I thought to my­self, my ba­by is in a deep sleep; how can he break a tube? That is what the nurse was talk­ing about,” East­man-Chotoo said.

 The next day, she asked for a trans­fer to Port-of-Spain Gen­er­al Hos­pi­tal. But be­fore the ba­by could be sent to Trinidad, a CT scan had to be done. The doc­tors in­formed her that the left side of the ba­by’s brain was dam­aged. She tried to save her ba­by’s life by tak­ing him to the PoS­GH, but he died on Sep­tem­ber 14, 2022, at just one month old.

 On Kadan’s death cer­tifi­cate, it said the cause of death was hy­pox­ic is­chemic en­cephalopa­thy (HIE), a brain in­jury that oc­curs when a ba­by’s brain does not re­ceive enough oxy­gen dur­ing de­liv­ery; cere­bral oede­ma—swelling of the brain; and seizures. 

Heart­bro­ken and con­vinced some­thing was not right, she let it go three months lat­er when she dis­cov­ered she was preg­nant again.

The sec­ond ba­by

Doc­tors at the Scar­bor­ough Hos­pi­tal said that, giv­en what took place with her last preg­nan­cy, they want­ed to do a C-sec­tion this time as a pre­cau­tion. The ba­by was due on Au­gust 10 (the same day as her oth­er ba­by), 2023.

 “When I gave birth, they took him and told me they were go­ing to take him to the NICU be­cause he was a lit­tle cold. That night, I did not see him. When I went to the NICU, he was there, with no tubes, noth­ing. I took him out and got him dressed. I spent time with him. The doc­tor said they want­ed to send him to Trinidad be­cause they want­ed to run tests on him,” East­man-Chotoo said.

 Tests and checks at PoS­GH sug­gest­ed that every­thing was fine and the ba­by was in good con­di­tion. Doc­tors had men­tioned that they sus­pect­ed the first ba­by may have died be­cause of a ge­net­ic con­di­tion, so they want­ed to mon­i­tor the in­fant close­ly.

 “When I went to the NICU, I could tell some­thing was off. I told the doc­tor my ba­by looks like he is sick. The doc­tor said, ‘No, Mom­my, every­thing is ok.’ They said they did tests and an ul­tra­sound, and every­thing was al­right. I said my ba­by is sick. They in­sist­ed he was fine. I spent the day with him, and I went back to To­ba­go. They said they would send him home on Mon­day. They just said the ba­by had a heart mur­mur and would be dis­charged.

“The day af­ter I was get­ting my crib and stuff ready for him to come home, the doc­tor called me to tell me that my ba­by had a seizure. I rushed back to Trinidad,” she said.

 Doc­tors in­formed East­man-Chotoo that the ba­by had a blood in­fec­tion, menin­gi­tis, and like­ly a ge­net­ic con­di­tion. They told her they would send sam­ples to Mex­i­co to con­firm. Her sec­ond ba­by died two weeks lat­er, and the tests sent to Mex­i­co came back neg­a­tive.

 “I told them they could go ahead and do a bur­ial be­cause I could not go through that again, and I asked for an au­top­sy. I got the au­top­sy re­port three or four weeks ago, and the ba­by died in Au­gust (2023). They said the ba­by had sep­sis. I asked, How did my ba­by get that? They said it could have been that I passed it through my cervix.

 “It’s a cov­er-up. I had one who died in Sep­tem­ber 2022. I had a pro­longed labour, and that ba­by died from brain in­juries, and they cov­ered it up. I ac­cept­ed it and moved on. I got preg­nant soon af­ter, and I was hap­py. When my ba­by left To­ba­go, he was healthy, and he nev­er came back home. They just want me to swal­low this one and move on, but I can’t,” she said.

BOX/ run over

An­oth­er mom steps for­ward  

Ann-Marie, whose name was changed, gave birth to a ba­by girl on Jan­u­ary 11 at the Port-of-Spain Gen­er­al Hos­pi­tal. The preg­nan­cy was com­pli­ca­tion-free, and a healthy ba­by was de­liv­ered, she said. Be­fore she de­liv­ered, the pain was so in­tense that she begged the nurs­es to give her a C-sec­tion, but the nurs­es sought to as­sure her that it was not nec­es­sary. Lat­er on, she said, at some point they said they were go­ing to burst her wa­ter bag.

 “I kept ask­ing them for some­one to come and see me be­cause I said the pam­pers I was in were full. Af­ter one on Thurs­day, they said ‘You are six cm (in di­lata­tion) now, so we are go­ing to send you down­stairs.’ When I went down­stairs, I heard a mid­wife say, ‘I don’t know why they keep burst­ing peo­ple’s wa­ter bags when they are not ready yet.’ 

 “When the ba­by came out, she didn’t cry right away. The pae­di­atric doc­tor came, and af­ter about three min­utes, she start­ed cry­ing. They then took her out. They cleaned me up and put me in an­oth­er room with two oth­er moth­ers. I kept ask­ing them to see my ba­by, re­mem­ber­ing I didn’t know what’s hap­pen­ing with her be­cause they took her away one time. No­body was tak­ing me on. I was just ly­ing there. I start­ed to cry and break down,” she said.

 Even­tu­al­ly, she was car­ried to see the ba­by. There, she was in­formed that her new­born had con­gen­i­tal pneu­mo­nia and per­sis­tent pul­monary hy­per­ten­sion (a con­di­tion that may cause a ba­by to not get enough oxy­gen af­ter birth).

 “I was pret­ty dumb­found­ed. I had this per­fect­ly healthy ba­by. I was ask­ing, How did she get these things? And they were just giv­ing all these med­ical terms be­cause they weren’t break­ing it down for me.

“They were like the med­ica­tion that she needs, the hos­pi­tal doesn’t have it, so I have to go out­side of the hos­pi­tal and get it, and any phar­ma­cy pro­vides it. So I sent some­one to search for the med­i­cine, and they got it. It costs $500. So we wait­ed for the phar­ma­cy to make it, and then we got it. They said the ba­by has been re­spond­ing to the med­ica­tion, and they are go­ing to start to wean her off of the med­ica­tion. They said she was get­ting bet­ter,” she said.

 The ba­by did not get bet­ter. The woman said with­out any pre­vi­ous in­di­ca­tion that some­thing was se­ri­ous­ly wrong, things took a turn for the worse. 

 “They start­ed giv­ing her a blood trans­fu­sion, and I start­ed watch­ing them give her blood. A short while af­ter, I kept see­ing the doc­tor look­ing back at me. They gave her an ul­tra­sound, and then they start­ed to pump her body, say­ing ‘1, 2, and breathe.’ And I’m there, look­ing at this. I spent half an hour look­ing at this un­til I couldn’t take it any­more. I went out in­to the hall­way and start­ed break­ing down cry­ing.

 “The doc­tor came and said, ‘We got her back.’ He then said, ‘In my pro­fes­sion­al opin­ion, I don’t think she’s go­ing to make it.’ Af­ter I heard that, I ran straight out and broke down cry­ing again,” she said.

 Hav­ing heard about the sev­en ba­bies that died at the NICU in April, she said she could not help but won­der if a bac­te­r­i­al in­fec­tion was present be­fore and just got worse with time.

 “It’s very hard to know you had a per­fect preg­nan­cy straight up un­til the ba­by pushed out for them to come and tell you it’s pneu­mo­nia. It al­so rais­es ques­tions about the com­pe­ten­cy of the staff, be­cause you’re burst­ing peo­ple’s wa­ter bags and you are leav­ing them there in fae­ces, know­ing this is the birth canal where the ba­by has to pass.

 “I will nev­er tell any­body to go to Port-of-Spain. I will tell peo­ple to lie about their ad­dress. Go pri­vate or some­thing,” she added.

 Last week, the NWRHA is­sued a me­dia re­lease con­firm­ing that three or­gan­isms, Ser­ra­tia marcescens, ES­BL Kleb­siel­la pneu­mo­ni­ae, and Kleb­siel­la aero­genes, which all pose sig­nif­i­cant risks to neonates, were present in the unit by lab­o­ra­to­ry in­ves­ti­ga­tions.

 It said that up­on recog­nis­ing the sever­i­ty of the sit­u­a­tion, the med­ical team ini­ti­at­ed in­fec­tious dis­eases and con­trol pro­to­cols for the treat­ment of late-on­set neona­tal sep­sis. Send­ing con­do­lences to the af­fect­ed fam­i­lies, it said no new in­fec­tions were de­tect­ed af­ter April 7.

 On Thurs­day, the NWRHA’s head of its In­fec­tion Pre­ven­tion Con­trol Unit was sent on leave while in­ves­ti­ga­tions are on­go­ing.