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2009 Jan 19 - Health worker cries foul over untimely deaths

Health worker cries foul over untimely deaths

Joe Fernandez | Jan 19, 09 3:27pm

sabah health worker death irin gilbert 190109 gilbert

Distraught Kota Kinabalu health worker Gilbert Marcellinus Liwaji (pic), 46, who lost his wife Irin @ Irene Salain, 40, and unborn child at the Likas Womenís and Childrenís Hospital under tragic circumstances a day before the new year is crying foul and wants justice for his family in memory of "the light of our lives".

"We have advised him to lodge a police report to help kick start the process into motion since the hospital authorities have not been forthcoming on the double tragedy which hit him and his family," said Sapp (Sabah Progressive Party) information chief Chong Pit Fah who approached Malaysiakini with details of the tragedy.

Chong also help put out a press release to the media. "We suspect criminal negligence by the health authorities," he said.

The cause of death of mother and child, nine days overdue at the time of admission but allegedly not attended to with any great sense of urgency by the Likas hospital authorities, has been listed in the death certificate as "Amniotic Fluid Embolism (AFE) with DIVC (Disseminated Intravascular Coagulopathy) at 12.10am on Dec 30.

The cause is apparently a rare obstetric emergency, according to doctors in the know.

sabah health worker death irin gilbert 190109 irinGilbertís anxious moments began when Irin (pic) was referred to the Likas Hospital on Dec 26 by the Klinik Desa in Putatan, Kota Kinabalu, where she had been going for her regular pre-natal check-ups, sometimes accompanied by Gilbert who is attached to the Luyang Health Clinic.

"We want to know exactly what the hospital authorities did for my wife between Dec 26 and Dec 30 when she passed away. We understand the baby died several hours earlier," said Gilbert at his  residence yesterday in Kampung Matambai, Kepayan, a suburb of Kota Kinabalu.

"The hospital authorities never discussed anything with us or told us what they were doing for Irin. They knew she was nine days overdue but yet they kept us in the dark and did not seem to do anything.

'No staff around at that time'

"They waited for her to deliver on her own. They certified both mother and baby healthy despite she being overdue. She seemed healthy and normal. Now, sheís gone just like that. We canít take it."

Gilbert has four other children with Irin: Aaron, aged 20, Audrey, 19, Ayrton, 17, and Audry, 14.

The end for Irin, a long-serving staff of Sports Toto, apparently came rather dramatically.

sabah health worker death irin gilbert 190109 maizinHer aunt, Maizin (pic), who was the last family member to speak to her niece before she died, reported that she (Irin) was in some sort of distress when she spoke to her at 8.30pm on Dec 29.

"As we were speaking, she told me that her pains had come again. I told her to look around for the bell so that she can ask for help. But she could not find one. There were no staff around at that time.

"Suddenly, she gave a loud yell as if in pain and then the line went dead. I didnít suspect anything was amiss," said Maizin.

"Gilbert, according to her, was somewhere in the corridor at that time but actually we learnt later that he had gone home early that day. She had also experienced pains earlier at 4pm but again there was no one to attend to her at that time, according to her."

Evidently, the recurrent pains were a sign that "something was going seriously wrong" but went unheeded, recalled Maizin in hindsight.

Likas hospital authorities were not immediately available for comment on the tragic deaths.

Likas hospital, formerly the Sabah Medical Centre which was bought by the Health Ministry, has been under pressure along with private hospitals like the new Sabah Medical Centre, the Damai Specialist Centre and various government hospitals outside Kota Kinabalu ever since the Queen Elizabeth General Hospital in the city was declared unsafe and shut down late last year.

sabah health worker death irin gilbert 190109 familyA senior obstetrician and gynaecologist in Kota Kinabalu, contacted by Malaysiakini earlier today, explained that nothing really can be done if the cause of death was as listed and that questions could be raised over how long the patient was overdue since "most women who are due get their dates wrong unless an ultrasound has been done".

(Irin had an ultrasound done at a private clinic, according to Chong Pit Fah, when contacted later by telephone.)

Issue is one of case management

"Itís like someone suddenly dying of a massive heart attack or dying on the spot in an accident," said the obstetrician and gynaecologist who has been in private practice for many years and spoke on condition of anonymity.

"The issue really comes down to one of case management. Thatís where we should look first rather than immediately look for evidence of criminal negligence. However, I am not ruling out criminal negligence or even sheer incompetence."

According to the obstetrician and gynaecologist, "the rule of thumb" is that the older the mother, the less days are allowed for her being overdue despite even getting a clean bill of health.

"In this case, perhaps they should have done a caesarean section within five days rather than wait for the complications to arise later," said the obstetrician and gynaecologist.
"Of course, there are cases of even younger mothers (a fifth of older deaths) suffering Amniotic Fluid Embolism with DIVC. But the older Ė more than 35 years old - the mother, the higher the risk (five times younger mothers) and vice versa.

"Perhaps to satisfy the bereaving family, the hospital authorities should explain properly to them and disclose all aspects of the case.

"But I can understand them going public with their tragedy since the hospital authorities have apparently told them very little to ease their sorrow."


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