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UWI DEFENDS DOCTOR

By Anna Ramdass
By anna.ramdass@trinidadexpress.com

The University of the West Indies (UWI) yesterday defended its consultants as well as the doctor who performed the botched Caesarean surgery, saying the doctor had a successful record of over 100 surgeries and required no supervision.

On March 1, Quelly Ann Cottle underwent a C-section  by a young specialist Registrar at the Mt Hope Women’s Hospital where the head of her seven month old son— who was to be named Simeon— was sliced open, penetrating the brain tissue.

The doctor has since been suspended pending the outcome of an independent investigation into the baby’s death.

Health Minister Dr Fuad Khan had initially questioned why an elective surgery was set for Carnival Saturday and why the consultant was absent.

North Central Regional Health Authority (NCRHA) management has sent letters to both consultants questioning their absence and why the doctor was unsupervised.

The NCRHA also sent a letter to UWI requesting the cooperation of the consultants in the investigation.

In a release yesterday, UWI stated that given the doctor’s qualifications and track record, it was not necessary for the consultant to be present.

Referring to Cottle’s case, UWI stated that one consultant was on pre-approved leave while the other was on call.

It noted that standard operating procedures set by the Ministry of Health provide that Caesarean sections in all high risk cases should have a Registrar or Consultant in attendance. 

The release stated that at the Mt Hope Maternity Hospital, it is the established practice that an experienced Specialist Registrar would conduct the C-Section but would have access to advice and support and, if needed, intervention by the Consultant. 

It added that standard practice under the Trinidad and Tobago health care system does not require an on-call consultant to be present at the time of a C-section being conducted, unless there is a special need to do so.

“In the case of Mrs Quelly Ann Cottle, the Specialist Registrar (employed by the RHA, with no conditions or restrictions to functioning in this capacity) who undertook the procedure, is an experienced Specialist Registrar in O&G who holds the MRCOG — Membership of the Royal College of Obstetricians and Gynaecologists Certificate (London),” stated UWI.

It stated that records would indicate that the doctor, within the last two years, performed over 100 unsupervised and successful C-Sections at the Mt Hope Maternity Hospital, including those for high-risk pregnancies. 

“It is within this context that when Mrs Cottle’s C-section was scheduled, the UWI consultant who was on call, and was accessible, was not requested to be in attendance,” stated UWI.

UWI stated that at the Mt Hope Women’s Hospital, the NCRHA has four units in Obstetrics and Gynaecology and of the four units, three are led by RHA Consultants and one (Unit A) is led by UWI Consultants. 

It stated that the UWI led team is the only unit within O&G that has two consultants — both of whom are UWI staff and who also do clinics, ward rounds and teach surgeries in addition to being on-call on a rotational basis. 

UWI stated that these consultants operating at the RHA are Honorary Consultants to the RHA and supervise junior medical staff who are employed by the RHA.

The family of baby Simeon are awaiting a final autopsy report which should be ready by tomorrow before they proceed with funeral arrangements.

Following is the full statement released by UWI:

The University of the West Indies (The UWI) is saddened at the loss of baby Simeon’s life and at the time of this unfortunate event, wishes to extend sincere condolences to the family. Given the recent media reports emerging on this matter, it has become necessary for The UWI to intervene and clarify the standard operating procedures relative to its Consultants operating in Obstetrics & Gynaecology at the Mt. Hope Maternity Hospital, Eric Williams Medical Sciences Complex.

At the above-named hospital, the North-Central Regional Health Authority (RHA) has four teams (or Units) in Obstetrics & Gynaecology (O&G); of the four Units, three are led by RHA Consultants and one (Unit A) is led by UWI Consultants. The UWI-led team is the only Unit within O&G that has two Consultants - both of whom are UWI staff and who also do clinics, ward rounds and teach surgeries in addition to being on-call on a rotational basis. UWI’s Consultants operating at the RHA are Honorary Consultants to the RHA and supervise junior medical staff who are employed by the RHA.

In this particular case, one of The UWI’s Consultants from Unit A was on pre-approved leave (of which the RHA was duly notified) while the other was on call. Standard operating procedures set by the Ministry of Health provide that Caesarean sections in all high risk cases should have a Registrar or Consultant in attendance. At the Mt Hope Maternity Hospital, it is the established practice that an experienced Specialist Registrar would conduct the C-Section but would have access to advice and support and, if needed, intervention by the Consultant. Standard practice  under the Trinidad & Tobago health care system does not require an on-call Consultant to be present at the time of a C-Section being conducted, unless there is a special need to do so.

In the case of Mrs. Quelly Ann Cottle, the Specialist Registrar (employed by the RHA, with no conditions or restrictions to functioning in this capacity) who undertook the procedure, is an experienced Specialist Registrar in O&G who holds the MRCOG - Membership of the Royal College of Obstetricians and Gynaecologists Certificate (London). The records will indicate that he has also performed, within the last two years alone, over 100 unsupervised and successful C-Sections at the Mt. Hope Maternity Hospital, including those for high-risk pregnancies. It is within this context that when Mrs. Cottle’s C-Section was scheduled, the UWI Consultant who was on call, and was accessible, was not requested to be in attendance.

 

Medical practitioners from The UWI’s Faculty of Medical Sciences at the St Augustine Campus have been serving the people of this country, the region and internationally with distinction since 1967 and they will continue to perform their duties diligently in the interest of the health and well-being of all. The UWI as a responsible institution providing critical academic and clinical support services to the RHAs in the discharge of their functions within the public health care system will continue to strengthen its processes and systems to ensure that its role and functions in such environments remain relevant and cutting-edge. 

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