Fol­low­ing the threat of a law­suit for neg­li­gence in di­ag­nos­ing three-year-old Jay­don Gilbert, who suf­fers from Hirschsprung’s dis­ease, the South West Re­gion­al Health Au­thor­i­ty (SWRHA) is of­fer­ing to have him un­der­go cor­rec­tive surgery at the Jack­son Memo­r­i­al Chil­dren’s Hos­pi­tal in the Unit­ed States.

Last No­vem­ber, Jay­don’s moth­er Shirleen Gilbert, through her at­tor­ney Al­li­son Roberts, stat­ed that in spite of the var­i­ous tests and di­ag­noses, the San Fer­nan­do Gen­er­al Hos­pi­tal is yet to pro­vide a sat­is­fac­to­ry di­ag­no­sis of Jay­don’s prob­lem.

Roberts claimed that af­ter wast­ing time and deny­ing Gilbert’s re­quest for a sec­ond opin­ion on Jay­don’s prob­lem, hos­pi­tal staff had now re­quest­ed that she get a sec­ond opin­ion from the Na­tion­wide Chil­dren’s Hos­pi­tal in the Unit­ed States.

Gilbert had de­mand­ed more than TT$400,000, in­clu­sive of US$65,000 for in­pa­tient surgery four weeks be­fore ar­rival, and if the an­tic­i­pat­ed vis­it lasts more than sev­en days, the fam­i­ly would be re­spon­si­ble for an ad­di­tion­al US$3,500 per day. This does not in­clude the prepa­ra­tion cost of get­ting to the US and ac­com­mo­da­tion for Gilbert.

The stip­u­lat­ed 28-day pe­ri­od for the SWRHA’s com­pli­ance had passed, but in a let­ter dat­ed Jan­u­ary 18, SWRHA le­gal of­fi­cer Car­la Sci­pio wrote to Roberts ask­ing for an ex­ten­sion to pro­vide a com­pre­hen­sive re­sponse. Last Fri­day, Sci­pio re­spond­ed and said that she was in­struct­ed that con­tact was made with the Hope of a Mir­a­cle Foun­da­tion, a non-gov­ern­men­tal or­gan­i­sa­tion, which has agreed to fund Jay­don’s vis­it to the Mi­a­mi-based hos­pi­tal with one par­ent. How­ev­er, Sci­pio said hav­ing re­viewed Jay­don’s med­ical records, it was re­vealed that two months af­ter Jay­don’s birth in 2016, Gilbert was told of his clin­i­cal di­ag­no­sis of con­gen­i­tal Hirschsprung’s dis­ease. Hirschsprung’s dis­ease is a con­di­tion that af­fects the large in­testines, caus­ing prob­lems with pass­ing stool. It is caused by the ab­sence of gan­glion cells in the colon.

SWRHA’s let­ter al­so stat­ed that colonic and rec­tal biop­sies in May and June 2017 showed the pres­ence of gan­glion cells. It said Gilbert was “ad­vised clin­i­cal­ly that the child had Hirschsprung dis­ease, but there was no his­to­log­i­cal con­fir­ma­tion” as it would re­quire fur­ther biop­sies. Sci­pio said the hos­pi­tal, at the time, did not have the equip­ment to per­form the pro­ce­dure.

“In this re­gard, your client’s al­le­ga­tion that ‘the hos­pi­tal and its staff have been un­able to pro­vide . . . a sat­is­fac­to­ry di­ag­no­sis of her son’s prob­lem’ is un­for­tu­nate and un­found­ed. While it is not de­nied that the op­tion of Jay­don ob­tain­ing treat­ment abroad was dis­cussed with your client, the aver­ment that the au­thor­i­ty had re­quest­ed a sec­ond opin­ion abroad is de­nied.

“I am in­struct­ed that at each stage of treat­ment, your client was coun­selled by Jay­don’s med­ical team, which in­cludes se­nior med­ical of­fi­cers and the rel­e­vant con­sent forms were signed,” Sci­pio wrote.

How­ev­er, Gilbert said it was not un­til 2018, when Jay­don un­der­went a “pull-through pro­ce­dure” at the South­ern Med­ical Cen­tre, that she was in­formed of the di­ag­no­sis.

A May 2017 sur­gi­cal pathol­o­gy re­port pro­vid­ed by Gilbert showed that a biop­sy was done on Jay­don, whose clin­i­cal his­to­ry was ab­dom­i­nal dis­ten­sion, de­layed pas­sage of meco­ni­um with a ques­tion mark and Hirschsprung. In an­oth­er re­port in June 2017, the clin­i­cal his­to­ry was “con­sti­pa­tion/blood? Hirschsprung.” It al­so showed that the gan­glion cells were present in his in­testines on both oc­ca­sions, adding to Gilbert’s con­cern over whether her son re­al­ly had the dis­ease.

She said while she has sub­mit­ted the doc­u­ments nec­es­sary for Jay­don to un­der­go surgery at the Mi­a­mi hos­pi­tal, she has not yet made up her mind. Through her re­search, she said the Jack­son Memo­r­i­al Chil­dren’s Hos­pi­tal did gen­er­al med­i­cine as op­posed to the Cincin­nati Chil­dren’s Hos­pi­tal in the US, which has a col­orec­tal can­cer cen­tre that spe­cial­izes in treat­ing chil­dren with Hirschsprung’s dis­ease.

“Giv­en every­thing that has hap­pened, I don’t want six months af­ter we leave Mi­a­mi, that he has prob­lems again. I pre­fer to have him go to Cincin­nati where they spe­cial­ize in Hirschsprung,” she said.