Asha Javeed

Lead Ed­i­tor In­ves­ti­ga­tions

asha.javeed@guardian.co.tt

Sev­en fam­i­lies whose ba­bies died of neona­tal sep­sis over four days at the Neona­tal In­ten­sive Care Unit (NICU) of the Port-of-Spain Gen­er­al Hos­pi­tal (P0SGH) have joined to­geth­er to file a class ac­tion law­suit for med­ical neg­li­gence against the hos­pi­tal.

The par­ents, Shaniya Ray­mond-Adams, Natasha Samuel, Shaquille Har­ry, Danyelle Sama­roo, Tinelle Saun­ders, Jodie Moli­no, and Shirese Moore-Beck­les, are be­ing rep­re­sent­ed by for­mer at­tor­ney gen­er­al Anand Ram­lo­gan, SC.

Ram­lo­gan is­sued a nine-page let­ter to the chief ex­ec­u­tive of­fi­cer of the North West Re­gion­al Health Au­thor­i­ty (NWRHA) yes­ter­day out­lin­ing his pro­posed in­tent “to file an un­prece­dent­ed class ac­tion claim for med­ical neg­li­gence based on the mass death of sev­en in­no­cent ba­bies.”

He said the fam­i­lies were con­tact­ed over the week­end to at­tend a meet­ing with top-lev­el of­fi­cials in the NWRHA yes­ter­day but raised con­cerns about the pur­pose of the meet­ing, who would be in at­ten­dance, and whether the fam­i­lies were al­lowed le­gal rep­re­sen­ta­tives.

“While sev­en deaths have been ex­posed by the me­dia, we wish to make it clear that we are still in the process of as­sess­ing the true im­pact and scale of this tragedy, as sev­er­al oth­er par­ents have since con­tact­ed us with sim­i­lar hor­ror sto­ries re­gard­ing their ex­pe­ri­ence at the PoS­GH and the neg­li­gent death of their ba­bies.

“We are there­fore in the process of tak­ing the nec­es­sary in­struc­tions and ex­press­ly re­serve the right to add fur­ther claimants to this class ac­tion claim for med­ical neg­li­gence. In the mean­time, we seek full, frank dis­clo­sure re­gard­ing the num­ber of ba­bies that have died at the PoS­GH since Jan­u­ary 1, 2024, to present,” the let­ter said.

Ram­lo­gan said the fam­i­lies have ex­pressed grave con­cern about the in­tegri­ty of the med­ical notes and records for the moth­ers and their ba­bies. De­spite re­quest­ing these doc­u­ments mul­ti­ple times, they have yet to re­ceive them.

“They are trou­bled by the bu­reau­crat­ic stonewalling and con­tin­u­ing fail­ure and/or re­fusal to pro­vide these crit­i­cal doc­u­ments. They are wor­ried that the med­ical notes and records could be changed and al­tered to fab­ri­cate a de­fence or mit­i­gate the neg­li­gent con­duct of the med­ical staff at the PoS­GH,” the let­ter stat­ed.

“We ap­pre­ci­ate and un­der­stand our client’s fears and anx­i­eties on this is­sue be­cause we are in­volved in med­ical neg­li­gence cas­es in which we have rea­son to be­lieve that the med­ical notes and records were doc­tored and changed. In oth­er cas­es, the en­tire file con­tain­ing the pa­tient’s med­ical notes and records mys­te­ri­ous­ly van­ished. We there­fore see these con­cerns as le­git­i­mate and rea­son­able and there­fore urge you to dis­close our client’s med­ical records,” the let­ter said.

The let­ter said that a ba­by who was “suf­fer­ing from a se­ri­ous vi­ral in­fec­tion was trans­ferred from the St Clair Med­ical Cen­tre to the NICU in cir­cum­stances where the risk of trans­mis­sion and ex­po­sure to in­fec­tion was rea­son­ably fore­see­able.”

It said that no at­tempt was made to prop­er­ly iso­late our clients’ ba­bies to pre­vent in­fec­tion.

“In the cir­cum­stances, we in­tend to seek an or­der for dis­clo­sure re­gard­ing the trans­fer of this ba­by, which clear­ly placed our clients’ ba­bies at se­ri­ous risk and at com­pro­mise to their health with fa­tal con­se­quences,” it said.

Ram­lo­gan said he fur­ther in­tend­ed to seek ag­gra­vat­ed and ex­em­plary dam­ages “for the ar­bi­trary and op­pres­sive con­duct of the staff at the PoS­GH giv­en the reck­less, in­com­pe­tent, un­pro­fes­sion­al, and ir­re­spon­si­ble man­ner in which our clients and the ba­bies were treat­ed.”

He said, “To know­ing­ly ex­pose in­no­cent ba­bies to such a clear risk of fore­see­able harm with­out im­ple­ment­ing ap­pro­pri­ate pre­ven­ta­tive mea­sures to man­age the risk of ex­po­sure and pre­vent trans­mis­sion is cru­el and in­hu­man and could jus­ti­fy a crim­i­nal in­ves­ti­ga­tion to de­ter­mine whether charges for manslaugh­ter and mis­be­hav­iour in pub­lic of­fice oc­curred.

“The fact that these deaths were hid­den from the pub­lic with no time­ly state­ment by the Min­istry of Health (which is quick to boast about the ex­cel­lent lev­el of health care in our pub­lic hos­pi­tals), speaks vol­umes. The “hush-hush” pol­i­cy of the NWRHA il­lus­trates that they were pre­pared to bury their heads in the sand in the hope that these deaths would be sim­ply for­got­ten over time.”

He ar­gued that the NWRHA had a du­ty to dis­close the fact that six oth­er ba­bies had died at the NICU and in close prox­im­i­ty to each oth­er.

“The NWRHA breached this du­ty to make full and frank dis­clo­sure and is there­fore guilty of the worst form of hypocrisy and de­cep­tion. It is clear that the plan of ac­tion was to deal with each fam­i­ly sep­a­rate­ly and in­di­vid­u­al­ly in the hope that it could paci­fy them and sim­ply let them walk away on the un­der­stand­ing that the pain and suf­fer­ing over their loss would ease over time. Our clients will nev­er, how­ev­er, be able to over­come their loss, far less for­get about the man­ner in which their ba­bies were treat­ed,” he said.

The brief life of Kae’ Jhene Ker­ni­ah Charles

Kae’ Jhene Ker­ni­ah Charles had a brief life.

Ac­cord­ing to the let­ter, her mom, Shaniya Ray­mond-Adams, 27, of Pole 51 So­ri­ah Trace, Brazil Vil­lage, Ari­ma, be­gan hav­ing pains on March 31.

She was 32 weeks preg­nant.

She was tak­en to the PoS­GH by rel­a­tives. She ar­rived at the hos­pi­tal at around 12.30 am, was ex­am­ined, and was moved to the ma­ter­ni­ty ward at the PoS­GH.

On April 1, 2024, at 4.22 am, Ba­by Kae’Jhene was born via cae­sare­an sec­tion (C-sec­tion), weigh­ing 1.141kg, with AP­GAR scores of eight at one minute and nine at five min­utes. The let­ter said this meant that al­though the ba­by was pre­ma­ture, she was born in good, healthy con­di­tion. In ac­cor­dance with the usu­al prac­tice, the ba­by was placed in the Neona­tal In­ten­sive Care Unit (NICU).

Ac­cord­ing to Ram­lo­gan’s let­ter, the ba­by was strong and healthy, mov­ing her arms and legs, and do­ing quite well.

“Her progress was not­ed to be ‘ex­cel­lent’, and hence she was even­tu­al­ly tak­en off the ven­ti­la­tor on Tues­day, April 2, 2024. Our client in­quired whether this was safe, and the doc­tor as­sured her that there was no need for con­cern as the ba­by was suf­fi­cient­ly strong and healthy and could man­age on her own,” the let­ter said.

On April 3, 2024, ba­by Kae’ Jhene ap­peared to be cop­ing well with­out the ven­ti­la­tor. How­ev­er, af­ter be­ing fed some milk, she vom­it­ed and dis­played signs of dis­com­fort.

Charles re­quest­ed to see her ba­by but was told that every­thing was fine.

“Our client begged the nurse to sum­mon a doc­tor to ex­am­ine her child; how­ev­er, de­spite our client’s per­sis­tence, the nurse sim­ply re­it­er­at­ed that the ba­by was fine,” the let­ter said.

On April 4, 2024, the par­ents vis­it­ed the NICU to see their child.

“They ob­served the ba­by vom­it­ing again, and the med­ical staff in­di­cat­ed that they were ad­min­is­ter­ing an­tibi­otics and that there was noth­ing to wor­ry about. They per­sist­ed and said they want­ed to know what was wrong with their ba­by, and they were even­tu­al­ly told that the ba­by had de­vel­oped a blood in­fec­tion. The at­ti­tude of the staff was very ca­su­al, in­dif­fer­ent, and se­cre­tive, as they ap­peared re­luc­tant to dis­close any in­for­ma­tion about our client’s ba­by,” the let­ter said.

On April 5, 2024, Ray­mond-Adams was sud­den­ly ad­vised that her ba­by’s platelet count and blood lev­els were low and that a blood trans­fu­sion was nec­es­sary.

“This sud­den de­vel­op­ment left them feel­ing con­fused and fright­ened for their ba­by’s well­be­ing. Lat­er that evening, our client was dis­charged from the hos­pi­tal, re­luc­tant­ly leav­ing her ba­by in the NICU. They at­tempt­ed to ob­tain up­dates by phone, call­ing the hos­pi­tal at 7:56 pm where she was in­formed by a nurse that the blood trans­fu­sion had been suc­cess­ful and the ba­by had not ex­pe­ri­enced any ad­verse re­ac­tions. She was told that ‘all was well’ and that she should stop call­ing,” the let­ter said.

On April 6, 2024, around 5:30 am, Ray­mond-Adams re­ceived a dis­tress­ing call from the hos­pi­tal, urg­ing her to come down im­me­di­ate­ly as the ba­by’s lungs were fill­ing with blood and her heart rate was de­clin­ing.

The cou­ple (Ray­mond-Adams and her hus­band, Ker­ron Charles) rushed to the hos­pi­tal.

“Up­on ar­rival, the doc­tor in­formed them that the ba­by had al­ready been re­sus­ci­tat­ed twice, and de­spite med­ica­tion to stop the bleed­ing in the lungs, it re­curred short­ly af­ter. Re­gret­tably, the doc­tors then con­veyed to our clients that they would cease re­sus­ci­ta­tion ef­forts.

“Our clients begged the doc­tor to con­tin­ue ef­forts to save their ba­by to no avail. Trag­i­cal­ly, their ba­by passed away at 10:21 am on April 6, 2024.

“Dev­as­tat­ed, our clients were es­pe­cial­ly dis­tressed by the sud­den turn of events, as their ba­by was healthy and live­ly at birth, on­ly to be pro­nounced dead five days lat­er,” the let­ter said.

Ram­lo­gan’s case against the NWRHA–Med­ical neg­li­gence

The staff and/or agents of the NWRHA were neg­li­gent in that they:

a. Per­mit­ted an­oth­er ba­by with a se­ri­ous in­fec­tion to be ad­mit­ted with­out tak­ing the nec­es­sary pre­cau­tions to man­age and min­imise the risk of in­fec­tion and trans­mis­sion to oth­er ba­bies in the NICU.

b. Failed to pro­vide a clean, safe, and sani­tised en­vi­ron­ment in the NICU.

c. Failed to take the nec­es­sary steps to en­sure that the NICU was bac­te­ria-free, know­ing that on­ly high-risk ba­bies are ad­mit­ted there.

d. Failed to prop­er­ly ad­here to and main­tain in­dus­try stan­dards for a NICU unit.