NWRHA blanks parents' request — No $$ for medical experts

THE North West Regional Health Authority (NWRHA) has blanked a request from the parents of babies who died at the Port of Spain General Hospital's Neonatal Intensive Care Unit (NICU), to pay for a foreign specialist medical expert to review the medical records of their babies.

Parents have threatened legal action against the State for negligence in the death of their babies and have retained legal counsel from Freedom Law Chambers led by former attorney general Anand Ramlogan, SC.

The denial came in a letter addressed to Freedom Law Chambers's Sue Ann Deosaran on April 30, from Pollonais, Blanc, de la Bastide and Jacelon attorney Alana Bissessar. This firm is representing the NWRHA and was responding to two preaction protocol letters sent on behalf of baby Roxanne Richards and Ekon Marcelle on April 23 and 24 respectively.

The letter said the NWRHA believed the request to be "wholly unwarranted" as there was no basis for such a request.

"In any event, given that the internal investigation and the PAHO (Pan American Health Organization) investigations are still ongoing, there is no need for your client to obtain such a report at this time," Bissessar said.

In an immediate response, Deosaran fired off a legal letter describing the authority's stance as "shocking."

The letter sent to the NWRHA's attorneys said that without the medical specialist to analyse the records, the parents of the babies would not be able to seek justice.

"Our clients are from the lower rungs of the socio-economic ladder and cannot afford to hire a medical expert. They are cleaners, cashiers, security guards and others are unemployed. Their babies have died in negligent circumstances that cries out for justice.

"The NWRHA is therefore very much aware of the fact that they (the parents) will not be able to pursue their claim for medical negligence if they are not given the required financial assistance to obtain a medical expert report.

"The NWRHA’s strategy is sadly clear – refuse to pay for a medical expert, in which case, they cannot file a claim for medical negligence," Deosaran said.

"By adopting such a stance, the NWRHA is in effect saying to the public that only the rich and powerful can sue for medical negligence in this country, because they are the only ones who can afford to hire medical experts to independently analyse and review medical records and produce an expert report for the court.

"Of course, this strategy takes into account the fact that the rich and powerful do not seek medical attention from public hospitals because they seek private medical attention at nursing homes or go abroad for medical care."

Deosaran's letter reiterated that the normal fee for a medical expert is around US$10,000 and the families have international experts willing to assist for half that price (US $5000).

The initial preaction protocol letter asked the NWRHA to agree to pay fees for a specialist to review and analyse the medical notes and prepare a report to advise whether the treatment and standard of care fell below what was reasonable and acceptable.

The search for a foreign medical expert to advise the parents came about after several local doctors declined to assist them saying there would be a conflict of interest, since at one time or another, they would have done work for the various RHAs.

FAMILIES TO GO PUBLIC

Following the NWRHA's refusal to pay for the mothers' foreign medical experts, Deosaran said in her letter that the families are left with no choice but to go public with an appeal to try and raise the funds so they can get justice for their dead babies.

Deosaran said a media conference will be held with the mothers who would ask for donations to hire a foreign medical expert.

"The mothers are not prepared to allow their babies’ deaths go in vain. They want the facts and circumstances surrounding these deaths to be reviewed and interrogated by the courts. No amount of compensation can bring back their babies, but they wish to ensure the system and standard of public health care is improved and systemic failures rectified.

"They do not wish for their own worst enemy to undergo the anguish, pain and suffering that they have had to endure. They are therefore motivated by a higher sense of justice and purpose, namely, ensuring that no more babies should die as a result of medical negligence," Deosaran said.

However, the attorney noted the mothers are not keen on making a public appeal as they believe it will be humiliating to have to beg for funds. It said this is tantamount to the NWRHA rubbing salt and pepper into their wounds.

The letter on behalf of the NWRHA also dismissed several claims made in the parents' preaction protocol letter, which the NWRHA described as "various general unfounded allegations."

For one, the letter defended the NWRHA's internal investigation into the deaths.

"It is standard practice that all Regional Health Authorities conduct an internal investigation when there is an adverse event at any public hospital in accordance with internal policy. In fact, you ought to be aware that in most organizations that is the standard practice. We note that you continue to make unsubstantiated and groundless allegations of tampering with evidence, sanitizing of records and intimidation of witnesses, all of which we have already addressed in earlier correspondence."

In response, Deosaran's letter said while the internal investigation may be standard practice, it took issue with the lack of communication from the RHA on its status, time frame and procedure.

It also said both families are yet to receive the report as promised.

"Ekon Marcelle died on June 4th 2022. His parents were promised a copy of your internal investigation report. Two years later, they are still waiting on it. Perhaps the investigation is still ongoing. Roxanne died on December 24th 2023. Over four months have passed and her family is likewise yet to be provided with a copy of the internal investigation report."

On issues raised that PAHO never contacted the parents to get their side of the story during its investigation, Bissessar's letter said this was outside the NWRHA's control.

The letter also denied claims there was a "mad scramble" to clean out the blood group area by removing all of the old refrigerators that were in a dilapidated state. It said there are no dilapidated refrigerators within the regional health authority's haematology laboratory and no refrigerators were replaced or removed from the laboratory in the recent past.

It said repairs were conducted on April 23, on two of the three refrigerators that were awaiting repairs.

"All other refrigerators at the laboratory are fully functional, properly maintained and monitored, and decontaminated in accordance with the required and acceptable standards."

It also denied there was any rush to "reinvent the haematology department," saying the sanitisation of work areas within the laboratory is a standard daily practice.

"This Department underwent a rigorous audit process in December 2023, and any non-conformances identified were resolved by March 28, 2024, with the Department being recommended for certification by the independent Jamaican National Accreditation Agency." (
See Page 11)