Amid overwhelming expressions of grief, Liloutie Ashantie Ramlall Khamis, 33, and her newborn son were laid to rest on Sunday, by family members who are now seeking answers to why certain procedures were taken.
Khamis of Beehive, East Coast Demerara, whose official cause of death was hypovolemic shock and rupture of the spleen due to a Caesarean section (C-section), and her son are the country’s latest maternal and infant mortality cases and her relatives feel there was some degree of negligence on the part of the attending physician. The woman died at the Davis Memorial Hospital, while her son succumbed later at the Georgetown Hospital.
According to her sister Parbattie Ramlall, Khamis and her husband had tried for 12 years to conceive without success.
When they learned earlier this year that Khamis called Shanti was pregnant the family was overjoyed. For nine months they eagerly followed the developments.
“We would be rubbing her belly and listen to he heartbeat and the baby was normal, kicking hard and healthy, healthy,” the sister said adding that due to the high risk associated with pregnancy at her sister’s age, Shanti visited Dr Galton Roberts’ clinic every Monday.
“Last Monday, she visit the doctor at he clinic and he told her that if by next week she didn’t deliver that she should walk with her bag and he will induce her,” Ramlall said.
She explained that other than swollen feet her sister was showing no sign of discomfort until Tuesday when she started experiencing pains.
The family took her to Davis Memorial Hospital where a midwife who examined Shanti said she was not in labour and called the doctor. According to Ramlall, the doctor asked the midwife to give Shanti an enema and wait for him to arrive. On his arrival, Ramlall claimed, Roberts inserted a tablet into Shanti and left. About an hour later the young woman started to complain of severe pain in her back and abdomen. Soon after, Shanti, who her family described as having no tolerance for pain, began bleeding and was rushed to the theatre.
Her sister said the doctor told the family that when he cut Shanti, he found a pool of blood that was not coming from below. Trying to find the source of the bleeding the doctor reportedly cut higher and found that the young woman’s spleen was ruptured.
“They had to remove the spleen. When they remove the spleen, she was still bleeding and she went into cardiac arrest and her heart stopped,” Ramlall said.
Her son, who had been delivered, later died of neonatal respiratory distress at the Georgetown Public Hospital Neonatal Intensive Care Unit (NICU) where he had been transferred for care.
Her family feels that there was some degree of negligence on the part of her attending doctor.
When contacted by Stabroek News for a comment Dr Roberts said all the information he has in relation to Shanti was confidential. When pressed as to whether the family can grant permission for the information to be released Roberts responded, “That can never happen.”
The family is also questioning why Shanti was not offered a C-section earlier.
“Since in her second trimester her husband told her to schedule a C-section because of the high risk associated with her age,” Ramlall said, adding that her husband also told her not to go to the public hospital because of high number of maternal deaths occurring at the institution.
“My sister was 38 weeks pregnant. Baby could born at 36 weeks. Baby could born at 37 weeks. My sister was 38 weeks; they could’ve done a C-section and my sister would’ve been alive,” a distraught Ramlall said.
Ramlall, who is a trained nursing assistant is convinced that Shanti was given Cytotec to induce labour. She noted that a patient who has been given Cytotec needs to be closely monitored.
Cytotec (misoprostol) is not actually not approved for use by pregnant women. It is prescribed for the prevention of gastric ulcers associated with the use of nonsteroidal anti-inflammatory drugs. The use of this drug has been associated with maternal deaths across the world as it is has been noted to have serious adverse effects. These include maternal or foetal death; rupture or perforation requiring uterine surgical repair, severe vaginal bleeding, retained placenta and pelvic pain.
The family is now looking for answers. They want to know how Shanti’s spleen got ruptured. “We need some answers, the doctor not giving us information. I know that when doing a procedure you inform patient and their family,” Ramlall told Stabroek News.
Their search for answers may however prove to be a difficult one.
