[UPDATED] PAHO begins separate probe into NICU deaths

The North West Regional Health Authority’s (NWRHA) CEO Anthony Blake announced on April 22 that a team from the Pan American Health Organization (PAHO) commissioned to do an independent investigation into the deaths of seven babies at the neonatal intensive care unit (NICU) at the Port of Spain General Hospital (PoSGH) had arrived.

At a media conference on what Health Minister Terrence Deyalsingh termed “some unfortunate reporting” in the public domain, Deyalsingh, Blake and head of the NICU Dr Marlon Timothy delivered statements and then fielded questions from the media.

The conference was held at the Ministry of Health, Queen’s Park East, Port of Spain.

The Prime Minister at a post-cabinet news conference on April 18 at Whitehall, St Clair announced that a three-member PAHO team would do an independent investigation into the babies’ deaths.

On April 22, Deyalsingh made it clear that he would have no role in the investigation. He said he had not met the investigators nor would he.

“So no one could say that the minister inserted himself into the investigation. PAHO is doing an independent investigation having been invited by the Ministry of Health, through the office of the Chief Medical Officer, who is the focal point for PAHO.”

As for the investigation’s length, Deyalsingh said it would take as long as it ought to take to have a “complete, thorough, transparent, independent investigation...

“I, as minister, would not be putting a timeframe on it. The parents deserve that.”

Blake said the NWRHA’s management team had already met with the PAHO investigators.

He said the the three-member team came into Trinidad and Tobago on April 21 and moved swiftly to meet with the management team for a couple of hours in the morning on April 22, “to look at, firstly, the terms of reference for that investigation and to request from the NWRHA relevant documents and to schedule interviews and so on.

“And I want to say we are committed to providing PAHO with all of the information they need and access to all of the relevant persons in terms of interviews moving forward."

Blake also confirmed that the authority had received pre-action protocol letters from the lawyers of some of the parents in relation to the deaths of 11 babies, seven of whom belonged to the cluster occurring between April 4 and 9 involving a bacterial infection.

He said the babies who had died earlier were not connected to the April cluster.

The pending litigation and privacy issues constrained the authority from speaking directly and specifically about the individual cases, he added.

The conference delved into statements made by the Opposition, Trinidad and Tobago’s rising cases of premature births and the mood of the staff in the NICU.

Blake said staff at the NICU empathised with the parents who lost their children but that the staff, too, was going through an emotionally difficult time because of the matter.

CEO: NWRHA took immediate action

He said the NWRHA was working with the authorities to investigate the root cause and to prevent such incidents from happening in the future.

“Our commitment to transparency and accountability remains unwavering throughout this process.”

Blake said the authority immediately took action to address the issue and identify the cause when two neonates showed clinical signs of sepsis.

He added that the unit was immediately closed and all of the neonates were screened for infection, started on antibiotics and those meeting the relevant criteria, discharged.

Visitation was also restricted and there was also an increase in active surveillance for all patients, he said.

Blake said the NICU’s head, Timothy, alerted the hospital administrator to concerns about the NICU and immediate sanitisation done by an external provider.

He said the Caribbean Industrial Research Institute (Cariri) was also engaged and an air-quality surface swab and water testing were done.

He added the NWRHA’s internal domestic staff maintained stringent “infection, prevention and control IPC protocols moving forward.”

Blake said initial laboratory analysis confirmed the presence of three different bacterial organisms known to be associated with neonatal infections and further analysis was being done at the time.

He said despite its best efforts and implementation of intensive-care measures and antibiotics, all infected babies, a total of seven preterm babies died from the infection between April 4 and 9.

Blake began saying, “Today, with a heavy heart, I do stand before you to confirm that the number…” but stopped and quietly spoke with members of the table then said the NWRHA awaited reports from Cariri and PAHO to confirm the details of when the bacteria began and the extent, while the authority did its own internal investigations.

Blake said each death that occurred outside of the cluster between April 4 and 9 must be considered.

He said the authority understood the concerns and questions that arose from the tragic event and was fully committed providing updates and additional information as it became available.

This story was originally published with the title "PAHO team arrives, probe into babies' deaths begins" and has been adjusted to include additional details. See original post below.

The North West Regional Health Authority’s (NWRHA) CEO Anthony Blake announced on Monday that a team from the Pan American Health Organization (PAHO) commissioned to do an independent investigation into the deaths of seven babies at the neonatal intensive care unit (NICU) at the Port of Spain General Hospital (PoSGH) had arrived.

At a press conference on what Health Minister Terrence Deyalsingh termed “some unfortunate reporting” in the public domain, Deyalsingh, Blake and head of the NICU Dr Marlon Timothy delivered statements and then fielded questions from the media.

The conference was held at the Ministry of Health, Queen’s Park East, Port of Spain.

Blake said the NWRHA’s management team had already met with the PAHO investigators.

He said the three-member team came into TT on Sunday and moved swiftly to meet with the management team for a couple of hours on Monday morning, “to look at, firstly, the terms of reference for that investigation and to request from the NWRHA relevant documents and to schedule interviews and so on.

“And I want to say we are committed to providing PAHO with all of the information they need and access to all of the relevant persons in terms of interviews moving forward."

Blake also confirmed that the authority had received pre-action protocol letters from the lawyers of some of the parents in relation to the deaths of 11 babies, seven of whom belonged to the cluster occurring between April 4 and 9 involving a bacterial infection.

He said the babies who had died earlier were not connected to the April cluster.

The pending litigation and privacy issues constrained the authority from speaking directly and specifically about the individual cases, he added.

The conference delved into statements made by the Opposition, TT’s rising cases of premature births and the mood of the staff in the NICU.