Unanswered questions at KHMH Press Conference

vlcsnap-2013-05-31-21h23m04s50The Karl Heusner Memorial Hospital (KHMH) promised answers with regard to its investigation into the deaths of seven premature infant babies who died as a result of contracting the bacterium Enterobacter cloacae. A total of 13 babies died in 15 days at the hospital but the remaining six are confirmed to have died as a result of various complications due to prematurity. We shared some highlights of yesterday’s press conference with you yesterday but there were still some unanswered questions at the end of the media briefing. How did the bacteria get into a jealously guarded space that had been cleaned between the first index case in February and the first death in May? Who slipped down in their duties? And most importantly, who will be held responsible? Director of Medical Services Dr. Adrian Coye’s responsed to the question of what, if anything, had been ruled out as a cause of the presence of the bacterium, and what it would take to establish how it got there.

Dr. Adrian Coye – Medical Chief of Staff:
vlcsnap-2013-05-31-21h23m31s70That’s difficult to answer because we have not identified a source.  So I then can’t say what has been ruled out, but [one:]the measures that we’ve taken have stopped the spread of this infection.
Two: The measures that we have put in place, reemphasizing  safety measure practices, wearing gloves instead of using soap and things like that. Maybe these measures have made an impact.  And so I cannot rule out and say that it’s not interpersonal, or if it is from equipment itself. We have not been able to demonstrate from the equipment, or anything, a positive culture.

Dr. Coye added that it was even possible the bacterium had mutated between February and May, making it resistant to certain kinds of antibiotic treatment. He later took responsibility for informing the CEO, Dr. Gary Longsworth, of what was occurring after a wave of premature babies had died inside the ward, backtracking on the CEO’s earlier insistence that he learned of the deaths via the parents complaining to the press. However, he noted that since the hospital has instituted immediate measures after the spread of illness inside the ward there have been no deaths. Six babies have been transferred elsewhere in the hospital, four in the adult intensive care unit and two in a section of the Maternity Ward. The hospital has announced a review of its policies in the long and short term to prevent a similar outbreak from occurring again. The Chair of the Board of Governors of the Hospital Authority, Chandra Nisbet Cansino, listed a series of recommendations including communication between physicians and patients, warning nurses and doctors working in the pediatric area that poor behaviour toward patients will not be tolerated.  CEO Dr. Longsworth committed to having the current NICU reopened in approximately 2 months, as renovations have already started with Government funding and donations from the business and general public. Meanwhile, the hospital has obtained the services of two visiting physicians sponsored by the Pan American Health Organization (PAHO) to assist in the investigation. One of them, Dr. Ricardo Bustamante, said that from his observations the hospital reacted in time and these things do happen, around the world, and while that is no excuse, it is a reality. He added that training of personnel should be continuous and rigorous. Ministry of Health CEO Dr. Peter Allen told PLUS News after the press conference that it will be difficult to assess blame as so many want.

Dr. Peter Allen – Ministry of Health CEO:
vlcsnap-2013-05-31-20h25m35s115As the investigation proceeds, and as Dr Coye was describing here, I think you’ll see that it’s extremely difficult to say this person was at fault, or this person was negligent, or this persons head must roll, because it was their fault that this happened.  What’s clear is that processes and systems and procedures, the same type of change, the same type of evolution that we’re describing, must be applied and must be applied vigorously. The standard procedures, the protocols, must be applied vigorously throughout, not just the KHMH, but through all our hospitals.

Moving forward, Prime Minister Dean Barrow committed to a new wing of the hospital for intensive and pediatric care.

Prime Minister Dean Barrow:
vlcsnap-2013-05-31-19h32m49s217Construction was to have been funded by the donations realized by through Kim’s fundraising efforts.  Commitments in that regard have been made by, among others, the Gobie Challenge Foundation and discussions are ongoing with the Oak Foundation and a number of European outfits but the actual money has been a little slow in coming as a result of the very necessary procedures that must be gone through with the funding agencies.  What government will now do, is to find the very first half a million dollars so that construction can start immediately. I think we have disbursed some of the money already Dr. Allen. That should see the project through the next few months, while the promised donations are being unlocked, and the entirety of the 3 million or so is gotten together to complete what will be the KHMH state of the art facilities for our babies and children. 

No timeline was given for the completion of the investigation.

Today, Citizens Organized for Liberty Through Action (COLA) is saying that after the press conference, there were more questions than answers. COLA asserts via a press release that “For all their investigation thus far, the hospital has failed to answer why if it reacted as swiftly as it claims to have, so many premature babies died. It has failed to link the index case reported in February, if indeed there is any link, to the cluster of deaths in May, especially since it claims the infected NICU was cleaned after the first sign of Enterobacter cloacae was found. This is troubling to us and suggests at the very least negligence on the part of the staff and administration, especially as the hospital has admitted that it has not ruled anything out as the possible source of the infection of the NICU. Finally, the hospital has manifestly failed to establish who, if anyone is responsible for the presence of the bacterium and the subsequent deaths” Now COLA says it has formed its own investigative committee to analyze the two press conferences held by the KHMH since the unfortunate deaths of the newborns after which it will present its findings and recommendations on the way forward.

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