A MEDICAL TRAGEDY

At an impromptu press briefing at the Health Ministry, Park Street in Port-of-Spain yesterday, at which members of the Caine family were present Health Minister Therese Baptiste-Cornelis said Government has accepted responsibility for the “tragic death” of Caine and her baby. An autopsy found that Caine of Trou Macaque, Laventille, choked to death on her vomit 24 hours after she went to hospital to deliver her first child. Her son also died. An autopsy determined that the baby was full term and died while Caine was in labour. Baptiste-Cornelis directed Chief Medical Officer Dr Anton Cumberbatch to commission an independent investigation with a report to be sent to Ramlogan for review.

Quoting from the AG’s legal opinion, Baptiste-Cornelis said “the list of errors and omissions that occurred here are plentiful and I do not propose to revisit them at this stage.” Ramlogan stated that after reviewing the case notes, he could “find little fault with strong criticisms of the manner in which this case was dealt with and on this matter, I expect we will have to accept responsibility for the tragic death of Ms Caine.”

He said the detailed recommendations contained in the report may be of use in terms of generic application. Ramlogan proposed that these and other recommendations could be amalgamated into a policy instrument issued by the ministry for immediate implementation.

According to Ramlogan: “It will be important for us to learn from these tragedies and take the recommended steps to ensure that best practice guidelines are developed and put into practice in the workplace to ensure the provision of the best health care services for the people of TT.”

Baptiste-Cornelis said Caine’s case was among three deaths referred (dengue deaths Vanessa Doon and Shiraz Khan were also referred) to the AG last December for review.

Baptiste-Cornelis said after reviewing the matters Ramlogan wrote providing his advice and direction to bring the matters to conclusion advising that “in all cases” legal counsel was sought on the issue of liability for negligence. Baptiste-Cornelis reminded that when she became minister she said any adverse event would be thoroughly investigated. She reported that during her tenure there were “a few” cases which were directed for “further analysis and feedback.” Baptiste-Cornelis said she received a draft of Ramlogan’s statement on Thursday and the legal opinion was officially received by the Permanent Secretary Sandra Jones yesterday. The PS contacted the family and a meeting was arranged at the ministry yesterday to discuss the AG’s report.

Baptiste-Cornelis said the North West Regional Health Authority (NWRHA) was directed to begin negotiations with the Caine family to reach “a suitable amicable solution in terms of compensation.” A recommendation was made for disciplinary action against “certain doctors involved in the case.” Baptiste-Cornelis said this will be dealt with by the Board of the NWRHA since Regional Health Authority boards were responsible for the actions of persons they employed.

Asked about the recommendations which Ramlogan mentioned, Baptiste-Cornelis said “no” she could not comment on what they were. She said recommendations were made in December on standard operating procedures which were not being followed. “People were informed of the things which needed to be followed and things which needed to be changed which the Ministry of Health was in the process of changing. These will continue.” All the recommendations from the three cases would be compiled since they all point to operating policies and procedures. Baptiste-Cornelis said there were policies and procedures from the Ministry that were not adhered to for reasons only known to those who breached them.

She said it was unprecedented for a government to admit liability and she had from the start of the investigation told the Caine family that if the responsibility was on the health sector, “we would pay.” Negotiations with the family would begin within a week.

“What they will look at are past cases forced upon by courts and procedures and this is a discussion which would take place. This is what you would call the out of court settlement. The family does have the option to choose to go into court and have lawyers battle over it.”

Baptiste-Cornelis said the NWRHA has been directed that it was accountable and had to settle.

Responding to the government/ministry accepting blame, Colin Joseph, the common-law husband of Nekeisha, said he was at a loss for words. While no amount of money can compensate

for his loss, Joseph said, “We just thank God everything has come out in the open and there was no cover-up. You know there is always cover up in TT. I am just glad they actually admitted responsibility in this case and we can move forward from here and get some kind of closure. It has been four plus months now. I am just thankful for that closure”

Caine’s mother Rosemin was overcome with emotion. She told media she was happy for an outcome but said the pain and hurt lingered because nothing could bring back her daughter. “I am just glad they accept the responsibility and justice has been served.” Nekeisha was her only daughter. Nekeisha’s aunt Sonia reminded that the baby Kymani was also lost. She hoped that her niece’s death would result in improvements in the health service.

Recent reports of babies dying and mothers dying have hit home with the Caines. “It is like what is going to happen? Who gains?” Another aunt, Carol said she did not want to see doctors get fired but wanted them to face the family and admit what they did.