According to reliable information reaching SMN News a cesarean operation was performed on the patient and the baby who was also in distress was sent to Barbados for treatment since the St. Elizabeth Hospital in Curacao was unable to accept the patient due to the lack of space.
While the young mother's death is considered to be mysterious, doctors at the St. Maarten Medical Center it is alleged neglected to take the right decisions when it was needed. SMN News also understands that the medical facility is now looking to play the blame game instead of taking responsibility for the death of the young woman and her new born baby. Doctors believe Shaka Wilson and her baby died because she had severe HELLP syndrome.
In an interview with SMN News Dr. Michel Petit who is currently in France said he saw Wilson on a few occasions he said the was a patient was about six and half months pregnant when he first saw her. Dr. Petit said Wilson used to see Dr. Tjon Kon Fat and she was transferred to him when that gynecologist left the island. He said based on the file he received from the first doctor the young woman was healthy, her blood work was normal and there was no need for fear. Dr. Petit said one month later he saw the patient for the second time and she notified him that she was admitted to the hospital. Dr. Petit said the doctors that were brought in from Holland took care of the patient and even though he is her specialist they did not inform him that she was hospitalized and what their findings were. Dr. Petit said the patient told him that the doctors who admitted her told her she was in premature labor. He said the doctor did take some blood tests and probably treated her but none of this was reported to him. "Normally when a pregnant patient is admitted the doctor who treated her would send a note to her doctor so he could be aware of her conditions but none of this transpired in Wilson's case." Dr. Petit said. Dr. Petit said early Wednesday morning he went to the St. Maarten Medical Center to visit the patient who at that time was in intensive care unit. It was then I looked through her chart and saw the blood tests that were done a month prior when she was admitted the first time. "The least the doctor could have done was to make sure a second blood test was done to make sure the lab did not make a mistake or at least follow up on her case because her blood count then was enough to raise a red flag."
Dr. Petit said when he saw the patient for the second time he examined her and there was no sign of premature labor, her blood pressure was normal. Dr. Petit said he then advised the patient to return to his clinic in three weeks for further monitoring. He said that date has not yet reached but on Tuesday last week the patient went to his office to see him. He said when he saw the patient he immediately saw she was in distress and in pain. "She told me she was having pains in her belly (Epigastric area) Dr. Petit said he checked the patient and again confirmed that she was not in premature labor. Dr. Petit said the patient also informed him that she was admitted to the hospital over the weekend(second admission) but up to then the hospital and its doctors on duty did not notify him of the patient's hospitalization. "I immediately decided to re-admit the patient and I called the doctor on duty and informed him about her. I asked him to evaluate her condition since he is the one on call, and I told him there was something unusual going on. The doctor in question asked me if she had high blood pressure and I assured him her blood pressure was normal." Dr. Petit said even though the main symptom of HELLP syndrome is high blood pressure, but Wilson's pressure was normal.
Dr. Petit said later that evening he was having dinner with another experienced gynecologist when he received a call from Dr. Randal Friday who told him that he was at the hospital and he heard of the patient's condition. "It was after the doctor on duty received the blood results he informed Dr. Friday".
Dr. Petit said to date the doctor on duty who was responsible for the patient never called him to inform him of her conditions and what they she was diagnosed with. "Based on the conversations with Dr. Friday I gave him my advice which was to operate immediately. " But he was informed that the doctor in charge did not want to operate because the patient had severe HELLP syndrome and her platelets were very low. According to what I was told by Dr. Friday the patient had no coagulation and the risk of operating was rather high.
He said the hospital did not have the amount of blood needed and the doctor felt it was better for him to wait for blood which was to be sent from Curacao the following day. "The patient was very sick but the doctor had to take an immediate decision to assist the baby and mother. The longer the doctor waits to take a decision on when to operate is worse for both baby and mother Dr. Petit said. "I told Doctor Friday who was informed about the case that it is critical and the patient had to be operated upon immediately because time is not on their side. I informed them that it is a risky situation because the patient had no coagulation then but by the next day her situation would worsen. I cannot say if I was there the outcome would have been different. But one thing for sure I would have informed the relatives of risks involved and I would have done otherwise."
In that case the baby would have had at least 12 hours more on his side. On St. Maarten it's the decision that counts, there is no blood bank and other necessities here and doctors have to use their best judgment to save lives. "What bothers me is that the doctor on call never made contact with me and the next morning he transferred the case to another gynecologist because he did not want to take responsibility if she died." Asked why he did not go to the hospital and to take over. Dr. Petit said he was not the doctor on call and neither was Dr. Friday and it is not ethical for either of them to intervene unless the doctor on duty calls them. "This patient was the sickest person I have seen in my entire career and this doctor never called me for us to decide together and to see how best we could pool our efforts to help the mother and baby. Instead he was there shaking and all nervous and afraid to make decisions." Dr. Petit said he is the one who admitted the patient and not even out of courtesy he was called and informed. He said on Wednesday morning when the doctor transferred the patient to another doctor that doctor went to see him at his office and they both looked at her file together. "It was then I went to ICU to see her chart and to see if I could determine what was going on."
He said if he was in such a position he would have called every gynecologist on St. Maarten or those abroad for advice because the patient was very sick. "I cannot reproach anyone for the decision they took. It is clear the doctor chose to wait for the blood because he wanted to save the mother. One has to remember that when she was admitted on Tuesday her blood was very low and there was not enough blood at the hospital."
Dr. Petit said the month before when the patient was admitted her platelets was lower than normal and the doctor who admitted her did not pay attention. He said when the first blood test was done the patient had a platelet count that was over 170,000 and when the second blood test was done a month ago it was 70,000. This shows that her platelet count dropped by 60% and the doctor did not take heed. Even though all of this happened the doctor who treated her when she was in the hospital did not see it fit to notify him.
SMN News learnt that the St. Maarten Medical Center already had an autopsy conducted on the patient to determine the exact cause of death.
Asked to comment on the case the Medical Director of the St. Maarten Medical Center Dr. George Scot said without the consent of the direct family it is not the policy of the SMMC to react, nor discuss the medical treatment of a patient. We regret the unfortunate death of the patient and her infant and we wish the family all the strength they need to cope with this loss.
The SMMC reported this case to the Inspector of Public Health the same day and started an investigation into the cause of death because of the strange and rapid developments that lead to this. Therefore an autopsy was performed on Friday with the permission of the family. "We will await the results of this investigation and organise a meeting with all specialists who were involved with her treatment. After receiving all information we are willing to make a comment with the consent of the family."
Without knowing the content of the interview with Dr Petit, Dr. Scot said he wants to make clear that they have an understanding that Dr Petit on his request does not do any on-call service to patients under the condition that he does not treat pregnant patients in his regular practice, but refers them to his colleagues who do on call service. The reason for this is that treatment of pregnant patients requires on-call availability.
For more on HELLP Syndrome can be found here.
http://www.americanpregnancy.org/pregnancycomplications/hellpsyndrome.html.
