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Need expert oppions as to my childs "care"

(1 Post)
Concerneddad Sat 19-May-01 01:49:25

To whom it may concern.

I am the father of an 18 year old son who suffers from the effects of cerbral palsy (spastic quadraplegia) and epilepsy.

For the past 7 years I've been trying to gather information in regard to the treatment of my wife just prior to the birth of our son, which I believe was mishandled by the attending doctors concerned.

For the past 7 years I've come up against a proverbial "wall of silence" from the medical proffessionals I've contacted in regard to this matter.

Could you find it in your heart to read what I have to say and give me your thoughts on them.
I am an opened minded person, who if it is proven to me that there is no fault attributable to anyone then I'll let this thing go, but if you read the notes, I think you will agree that there are questions to be answered.

All of this happened in 1983.

My wife began bleeding, contracting and in great pain at approx. 26 weeks gestation on the 24-6-83.

She was transported from home on the 25-6-83, via ambulance, to a private hospital in western Sydney. The only reason she was taken to this particular hospital was that it was the only one that her gyno/obst. worked from.

She was admitted to this hospital on that date, under the diagnosis of antepartum hemorrhage.

She was ordered to complete bed rest, and given pethidine and valium for the pain and to try to control the contractions.

My wife was a healthy 25 year old woman who didnt smoke an denjoyed only the occational drink.

We where continually told that the baby was fine, growing appropriatey etc.

My wife was given Anti D injection, as she is o neg blood and my son positive.

On the 30-6-83 a diagnostic ultra sound was performed which found:

"Baby has grown appropriately. No obvious signs of abruption of the placenta or tracks of haemorhage seen but there are a couple of aeas that wold be worthwhile following for evidence of change. One of these is at the junction of two lobes where a clear area can be seen behind the membrane, the other is behind the RT post lobe where there are quite large matsinuses. The baby is kicking very straight against one at the junction of the plac.lobes"

On the 8-7-83 her notes include the results of a pathology report which said:

"Vaginal swab containing coliform - dash sensitive to ampicilan please inform doctor"

From the notes that I have, which are only a copy of the discharge notes as the private hospital involved will not release all of the notes to us, do not mention the administration of any antibiotics even though they do mention the administration of many other pain killers and seditives, so I assume the antibiotics where not given.

From the 8-7-83 onwards there are numerous mentions of the baby being "hyperactive" with elevated heart rate.

On the 10-7-83 the notes say:

"8.00pm scant brown loss urine offensive large blood trace allautain ph6 sg 1000"

It has been explained to me recently by a leading pathologist, that this points to the original coliform infection continuing and spreading to the bladder and causing the urine to become acidic.

On the 11-7-83 my wife got very ill.

"2.45am patient vomitted in hand pad check moderate bright loss and urine hooditained. Feels that contractions may have woken her. Distressed.
3.00am monitor commenced 3/7 minutely mild contractions evident FHR satisfactory, baby active at times.
3.15 am Dr ***** phoned pethidine 100mgs and sprine 25mgs ordered and given.
3.30 am Contactions 2/60 patient transferred to labor ward.
3.45 am Contractions settled, irregular moderate pink loss
4.00 am BP 130/70 T39 P80
Contractions settling irregular moderate pink loss C/O several period pains soaked one quarter of pad.
5.00 am BP 130/70 T37 P88
6.00 AM BP 120/70 T37 P80
Dr **** notified re: patients condition. will be over to see patient early, contractions vague and irregular.
6.15 am Void at 200ml gush of blood soaked own pad.
6.45 am Contractions 7/60 - mild to moderate lasting 20 seconds. FHS remains stable at time of report.
BP 120/65 T37 P80 - irregular mild contractions 10/60. patient sponged."

Things settled down again after this though there are still mentions of hyperactive baby.

She remained on total bed rest being given pethidine, pentolal, pentabarb, konakion for the pain and contractions.

She continued bleeding ect right through her stay at this hospital.

on the 13-7-83 she began to pass blood clots on almost a daily basis. She also started suffering from back ache around this time.

On the 17-7-83 the notes state:

"heavily blood sained streslstreshy peices of membrane in urine plus one the size of a 10c piece, pad becoming offensive since 15- july please check with doctor."

The pathologist I mentioned earlier states

" It seems she continued with her coliform infection, that seems to have possibly spread to more tissues to cause these pieces to contaminate the urine sample with birth passage outflows from the infected site"

Still no mention of antibiotics being used.

On the 17-7-83 a second ultrasound was performed:

" baby has grwn appropriately re: vpd with body now above 50 centile previous description of placenta unchanged but due to rotation of the uterus ante lobe now to left post now rt we now feel that the bleeding is coming from the junction of the two lobes and is tracking down beneath the membranes on the left side."

On this day they began to give my wife steroid injections to help develope my sons lungs.

She remained on bed rest, still bleeding contracting and in pain till the 20-7-83 when she had a "moderate bright serous loss" [no time is given as to when this occured]

Pathologist states "possibly when the bag of waters protecting the baby burst"

No tests or examinations where undertaken at this hospital to assertain weather this was the case.

Things really started to go wrong from here.

"20-7-83 Patient complaining of bach aches regular contractions all of p.m. -
4.00pm nalin plus ventolin given moderate bright PV loss 5.50pm Docor contacted RT 10mgs of pethidine statin given
6.00pm give PT settle at all sedation
9.00pm Hitenly contractions monitor applied valium 10mgs given c nil 10mgs. Doctor **** contacted RT per phone needed Dr ***** 10mgs pentalost nfo 100mgs pentolal 10.05pm No effect
10.30pm Doctor ***** contacted will be over to see PT.
11.00PM PT seen by Dr ****** speculum examination c cross long, prosterior pluss close Pt to be put back to bed slept for only short periods slight nausea continued. Pt still complaining of frequent swab affribrol Pv loss continues slight/mod pink.

21-7-83
3.30am N/R - (cauld) FHH panadol

Patient has large bright PV loss at 7.00am then a c regular contractions presented cross shaking- CLS satisfactory FH13 sb Dr *** for transfer to **** hospital same arranged"

This is where their notes end.

They came to us and explained that their hospital was ill equoped to handle a preterm birth and that my wife would have to be tranffered to the nearest teaching hospital with a NNICU.

CAN YOU IMAGINE OUR HORROR TO FIND OUT AT THIS LATE STAGE THAT THIS HOSPITAL THAT WE HAD BEEN AT FOR A MONTH COULDN'T HANDLE THE VERY THING THAT MY WIFE WAS THERE FOR!

They did arrange for my wife's transfer.
Concidering that the hospital she went to was only a
10-15 min drive from the first hospital, and concidering that this last entry in there notes was at 7.00 am, I can't fathom why she didn't arrive at the second hospital untill 11.00am?

They sent with her a very sketchy letter stating "thank you for excepting Mrs Mills for further evaluation...."

Apon arrival at the 2nd hospital things had settled, yet again, so they set her up for further observation.

The first thing they did was to order an ultrasound to see if her waters had broken which they had.

At or around 5.45 things started to go wrong again.

The doctors came to me and stated" we either deliver the child now and take the risks associated with being born early or maybe risk loosing both mother and child!"

They state on the birth records "maternal pyrexia and fetal tachycardia" as there reasons for performing an emergency C section.

My sons condition at birth was grave, he had his chord around his neck x 2 and was not breathing, described to me at the time as a virtual still born.

He required immediate bagging in 100% oxygen.
He was introbated at 2 mins and transferred to the NNICU on a resus trolley.

It took the Doctors a long time to get him "STABALISED"

They couldn't get him breathing and eventually put him onto a respirator.

His first blood gas was taken approx 1hr after the birth which showed his blood ph level as 7.17.
His temperature was very low and he was wrapped in cottonwool and put into a thermal tunnle.
His temp some 5 hours after birth was still only 35.2
They took a photo of him to give to his mother just in case.


A histology was performed on the placenta.

It showed "obvious signs of abruption, mild vasculitis and accute chorioamnionitis"


He eventually he was put onto a phenobarbiton IV , for what reason I'm not sure, when he was about 20 hrs old.

The phenobarb continued to be administered every 48 hrs for a few months untill he is said to have become Phenobarb Toxic and removed from it.

After a week or 2 later he began fitting. This is when he had his first every neurological assesment done.

This is when we where told that he was "Obviously cerebral palsy - Spastic Quadraplegic with epilepsy. I'm surprised no one has told you this earlier" the neurologist told us.

MY CONCLUSIONS.

My wife was bleeding and contracting originally from causes unknown.

She went on to develope a urinary tract infection that progressed all through the rest of her pregnancy.

The infection was either not treated or was inappropriatly treated.

It has been explained to me that if, according to the notes, the infection was sensitive to ampicilin, simple antibiotics should have either stopped or greatly reduced the rate of infection.

The infection progressed to such a stage that it directly caused the PROM and subsequent preterm labor.

Given that these facts re: the infection and the possible cosequences of same, where common knowledge in 1983 the doctors are liable for the missed or miss diagnosis of this condition.

They are liable for their missed or miss treatment of the same.

If they treated it at all, surely it was obvious, as it must be to to anyone reading the notes, that the infection was getting worse not better and required more agressive treatment.

They are liable for not assertaining if my wifes waters had broken early on the 20-7-83 when the "serus loss" was noted, knowing the possiblity of infection after such an event.

They are liable for not informing us of their hospitals inadequatcies in being able to deal with a preterm labor.

I think even with the very best intentions of prolonging the pregnancy, it was, if not obvious, highly likely that my was would not carry this child to term, and therefore that in hers and the babies best interest, they should have been transferred to another hospital at a much earlier stage in proceedings.

They are possibly liable for the misdiagnosis of the placental abruption.

They are liable for the delay in transferring my wife and child early on the 21-7-83 to another hospital.

If this last bleed and complications that warrented transfer happened at 7.00 am why did she not arrive there till 11.00am given that the 2nd hospital was only 15 mins away?


The reason I have had to resort to sending this information via email to people such as yourself is that I have spent many many thousands of dollars in getting medico legal reports from so called experts, only to have them skip the points I,ve mentioned above, and they will not comment further on them either on or off the record.

Also due to my sons condition I my self am on a carers pension, and can ill afford to be outlaying such vast sums, even though I would if I had it.

As I hope you can see, there are many many questions that remain unanswered and I hope that you are willing and able to give coment on the above.

The main things I need to know is.

Do you agree with any or all of my conclusions?

Would you say that my wife and unborn child should have been at a specialised hospital at an earlier stage?.

Would you have done anything different?

If so what?

Thanking you in advance

Les Mills

lesmills@ozemail.com.au

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