1st baby born in 2004 is dead
When on our newscast of January second we ran a story on the first baby of 2004 delivered at the Karl Heusner Memorial Hospital, we never dreamed that less than a week later we would be reporting the child’s death. But while infant mortality is no stranger to Belize, there is evidence that this incident was preventable. Patrick Jones has the story.
Patrick Jones, Reporting
The death of four-day-old Antoine Miles was a shock to his parents and a surprise to doctors at the Karl Heusner Memorial Hospital, who diagnosed the baby with jaundice shortly after he was born on New Years Day. Head of Paediatrics at K.H.M.H., Doctor Victor Rosado, says the condition is not difficult to treat.
Dr. Victor Rosado, Head of Paediatrics, K.H.M.H.
“In newborns it is quite common. I would say almost two third full term newborns can develop some type of jaundice, and it is even much more prevalent in premature babies. In newborns, sometimes due to the different blood types of the newborn with relationship to the mother’s blood type, sometimes due to Rh factor, which is a very high risk factor for developing jaundice, and most of the time it’s basically due to immaturity of the new born liver and that has to do with what we call physiologic or normal jaundice.”
But baby Antoine was diagnosed with pathologic jaundice and was scheduled for phototherapy and further tests to determine the extent of condition. But before doctors could run the tests, Medical Chief of Staff, Doctor Fernando Cuellar, says the four-day-old baby was taken out of the hospital by his mother against medical advice.
Dr. Fernando Cuellar, Medical Chief of Staff, K.H.M.H.
“It was brought to her attention that the baby would have benefited from staying in the hospital a little bit more to be observed, especially for the jaundice to run further tests.”
On Sunday morning baby Antoine was returned by his dad to the emergency ward after he stopped breathing, but he was dead on arrival. Doctors believe that the decision to remove the child prematurely from the hospital, contributed to his death.
Patrick Jones
“Did the paediatrician or did a doctor at K.H.M.H. explain in explicit terms to Miss Usher what could have happened if she took a jaundiced baby home?”
Dr. Fernando Cuellar
“I wouldn’t be able to quite honestly say at this point because our investigation haven’t been finalised, but the medical officer did indicate that the baby would benefit from being in the hospital a little bit longer.”
Patrick Jones
“Do you think she understood what that meant?”
Dr. Fernando Cuellar
“Again, I wouldn’t be able to say for sure, I wasn’t there. But from all indications, she seemed to understand. She didn’t have other risk factors that would send a flag up for example, she is not a first time mother; she had previous children already. She had a certain level of culture and education that was acceptable. She didn’t have any obvious psychiatric illness for example.”
While the option of leaving the baby in the care of the K.H.M.H. was available to her, Marcia Usher today told News 5 that it was never explained to her and that had she known it was available would have taken it.
And the case is further complicated by a dispute over exactly why the baby died. While the medical examiner has listed the cause of death as jaundice, Dr. Cuellar says a second opinion may be necessary.
Dr. Fernando Cuellar
“I would beg to differ a little bit from the clinical. And again, I am no paediatrician but I have consulted with the guys and the paediatrician. And I know myself that jaundice could kill you, but not in such a sudden way. The direct cause of death could be something else other than the jaundice.”
Dr. Cuellar says the decision to get a second opinion on the death of baby Antoine will only be made if the parents of the child are not satisfied with the autopsy report, or if an internal procedural investigation at K.H.M.H. leaves more questions than answers. Jaundice, which literally means a yellowing of the colouration of the skin, is not exclusive to newborns, but Dr. Rosado says because of the vulnerability of babies, it must be properly diagnosed and treated. He says there is no reason why in this day and age any child should die of jaundice in Belize.
Dr. Victor Rosado
“Definitely not. That has to do not with treatment available, but it has to do with policies in place, it has to do with public education, it has to do with accessibility to treatment centres. Sometimes we get babies born in villages and when they come to Karl Heusner Hospital the jaundice is at a severe level where even with blood exchange transfusion, we are not able to salvage the baby’s life.”
Patrick Jones, for News 5.
Dr. Rosado says that while hard statistics are not readily available, Belize is on par with other countries where as many as two-thirds of all babies are born with some level of jaundice. As to the self discharge policy at K.H.M.H., Dr. Cuellar says the patient’s bill of rights supersedes all other policies and there is nothing that doctors can do legally to keep a patient hospitalised against their will. Baby Antoine Miles will be buried on Wednesday morning in Belize City.
