Infant mortality investigation: weakness in communication with K.H.M.H. management
A press conference is scheduled for this Thursday in Belize City to provide an update on an investigation into a nosocomial outbreak inside the neonatal intensive care unit of the Karl Heusner Memorial Hospital. The alarming statistic that twelve premature babies died in May alone due to the outbreak caused panic in the population and the hospital quickly closed the unit for a month. The first trace of the bacteria was detected in February and although the hospital has only confirmed deaths in May, there are some families that contend that their newborns died even before. This morning, we got a first reaction as to what went horribly wrong at the hospital. News Five caught up with Chairlady of the Board of Governors, Chandra Nisbet-Cansino, who took off her hat as Coordinator for the Ride Across Belize and gave Duane Moody an update.
Duane Moody, Reporting
On May twentieth, following reports on News Five, the national referral hospital admitted an unusually high number of deaths of newborns; twelve babies had died in May. The cause of death of seven babies was confirmed to be due to the hospital-acquired bacteria, enterobacter cloacae. Chairlady of the Board of Governors at the K.H.M.H., Chandra Nisbet-Cansino, says that while they are still gathering information, the investigation so far is pointing towards weaknesses in communication with management.
Chandra Nisbet-Cansino
Chandra Nisbet-Cansino, Chairlady, Board of Governors, K.H.M.H.
“The investigations right now are basically showing that the pediatricians did what they were supposed to do. It also shows weaknesses in communication with management and higher levels of management. There are lots of things that we need to address urgently, but first and foremost are the patients that are there now and that will continue to be there.”
Duane Moody
“So that would mean that it would be more an issue with management?”
Chandra Nisbet-Cansino
“You can make that judgment tomorrow.”
Francis Gary Longsworth
In a statement made at a press conference last Wednesday, C.E.O. of the K.H.M.H., Doctor Gary Longsworth, claimed that he was only made aware of the concerns about the neonatal deaths following a news report.
Dr. Francis Gary Longsworth, C.E.O., K.H.M.H. [File: May 23rd, 2013]
“It went out to the media, one of the parents went to the media I believe, and that actually prompted the investigation because up to that point, we were not aware that situation was developing. It really became apparent when the babies died in significant numbers in a short period of time.”
But who will ultimately be held responsible? Nisbet-Cansino refrained from comment, but said that all questions will be answered on Thursday.
Chandra Nisbet-Cansino
“We are having a press conference tomorrow we are still gathering information that we will give to the public—very revealing information on exactly what transpired and specifically for each death for the month of May and you all will be able to ask questions and get a full report of exactly what transpired.”
Cansino, however, claims that the investigation has shown that no other fatalities due to the bacteria occurred prior to the deaths recorded in May.
Chandra Nisbet-Cansino
“The favor case is what they call in epidemiology an index case which is where there is a case where the bacteria showed up once. That baby got well and that baby went home. And it is really the typical behavior of a bacteria that is colonizing that reaches to the point of an outbreak. So between February and May the deaths that happened—we’ll get the details tomorrow—there were no deaths related to that specific bacteria.”
Duane Moody
“Only in May?”
Chandra Nisbet-Cansino
“Only in May.”
Duane Moody for News Five.
We’ll have more details on the findings of the investigation in Thursday’s newscast.
This was negligent on part of the hospital = administrators+quality control and medical staff assigned to this unit. SINCE FEB this was happening and NO-ONE spoke out- LET US NOT FORGET- babies died here – human beings life were taken away due to NON-CARING- IRRESPONSIBLE HOSPITAL. WHO HAS resigned? WHO will go to Jail? WHO will loose thier license to practice?
People keep the pressure on.
How come we no hear from UNICEF? Where is Human Rights? Where are the CHURCHES on this? How about the 20odd thousand gays that were rushing the polls a few weeks back?
Maybe this is a clear example of how serious about Human Rights they are.
THE BUCK STOPS ON LONGSWORTH’S DESK. Was he just sleeping and colleting his paycheck while the babies were dying/
EVERY PATIENT DEATH SHOULD GENERATE A MANDATORY REPORT, starting with the treating doctrors and nurses, and move all the way up through the chain of command — if there is one. How can a man pretend to be CEO if he doesn’t have a system in place to have relevant information reported to him?
Maybe he’s a fine doctor, but he apparently is no hospital adminstator or executive.
ALSO — the report says that the one specific bacteria did not kill babies before May, but we know that many babies died there, at least in February through May, and some reports are that the epidemic of death started in December.
THEY MUST DETERMINE AND REPORT WHY ALL THOSE OTHER BABIES DIED! Until they know that, they have not solved the problem, they have not even identified it! KHMH’s own report is that 7 babies died of the pone bacteria in May, and 5 others died of unreported causes. THAT’S UNACCEPTABLE.
I think Dr. Mendez should be appointed to investigate and maybe take over running the hospital, or better yet, all of the government hospitals. He appears to be one doctor who cares and who is honest, doesn’t try to baffle us with b— s—.
Indeed that’s what they say that this bacteria enterobacter cloacae was the cause of death for the May neonates, what abuot the deaths prior to that? What happened with the closure of the icu in December? Why aren’t they bringing this up? Wasn’t it because of a bacterial outbreak then? to Ms. Chandra, to Mr. Longsworth, tell me what happened December 10th, December 11 when the babies from ICU were taken to Pediatrics? Didn’t babies die because of bacteria, maybe it wasn’t the famous enterobacter cloacae, but wasn’t it another bacteria then? Wasn’t klebsella pneumonea in the ward? Tell us, what all infections are n the ward, tell us what all our babies must fight off at the ward….Explain to us how you claim to have learned from the media when the ICU had been closed and babies moved? Explain to us how this information doesn’t reach your respective desks…please do..
and another thing, i believe it requires an investigation from a third party. Like an audit, where an third party conducts eh investigation, otherwise I believe there is conflict of interested, and what is reported to the public is selective and biased.
Infections can happen all around the planet, and I don’t see how justifying deaths worldwide puts Belize in a better position. It is such a pity Mr. Longsworth claims that he only learned of the infection outbreak from the media….how can one sit behind a desk as ceo and not know what is happening within his own hospital. So it is claimed that this enterobacter cloacae outbreak is a May thing, then tell me Ms. Chandra, tell me Mr. Longsworth, what all bacteria is in the ICU? December had Klebsiella Phneumoniea, and if I recall correctly in December the ICU was closed down because of bacterial outbreak…do you remember this? Do you remember when the babies from ICU where taken to pediatric? Do you? Or it never reached your desk because it wasn’t your kids fighting for their life in the ward? Do you recall this?
No yes, KHMH is the only hospital that offers such care for babies, shouldn’t that be reason enough to strengthen the unit. The talk about neonates is so small, but you know, these babies like yourself or anybody else fight for life, they are admirable, because a lot of us would simply quit, but these babies fight, and they fight until their last breath….
You all should be ashamed of yourself, and you all know what, I believe the investigation should be third part, like an audit, if you are investigating your own faults there is room for selectivity and bias….Jeez you people need to start doing your job….
New Delhi metallo –beta (β )-lactamase 1 (NDM-1) is an enzyme that makes bacteria resistant to a wide range of beta-lactam antibiotics. These include the antibiotics of the carbapenem family, which are mainstay for the treatment of antibiotic-resistant bacterial infections. The gene for NDM-1 is one member of a large gene family that encodes beta-lactamase enzymes called carbapenemases. Bacteria that produce carbapenemases are often referred to as “superbugs” because infections caused by them are difficult to treat. Such bacteria are usually susceptible only to polymyxins and tigercycline. NDM-1 was first detected in Klebsiella Pneumoniea.
Study by M. Tato, T. M. Conque, P. Rucz-Garbajosa et. all “ Complex Clonal and Plasmid Epidemiology in the First Outbreak of Enterobacteriaceae Infection Involving VIM-1 Metallo-β-Lactamase in Spain: Toward Endemicity?” found that Klebsiella Pneumoniea – MBL monoclonal epidemics COEXISTED (exist at the same time) with Enterobacter cloacae – MBL muliclonal epidemics in hospitals.
December had Klebsiella Pneumoniae….i have no nursing degree, but doing my homework helps, and I have to be no genius to understand the above…is not always a good idea to rely on what others say, especially when there is conflict of interest…a third party should do the investigation, doing your own investigation calls for subjectivity.