Dear folks:
I'd like to share our atrocious experience at Baptist hospital, which was a real eye-opener into the under-regulation and poor state of medical ethics among private hospitals in Hong Kong.
I'll deal with medical issues here, and save our experiences with the accounting staff for another post.
While we have no complaint with the services provided by the maternity nurses, who were by and large professional and attentive, we witnessed incompetence and poor ethics on the part of doctors and senior medical staff serious enough to give pause to anyone considering giving birth at Baptist.
In short, the obstetrics medical staff at Baptist rushed through the delivery procedure, falsified the APGAR score for our child at birth, and then lied about the profound cyanosis that appeared in our baby.
Late on February 4th, my wife went into labour and I brought her into hospital. She was admitted more or less without delay. The obstetric nurse examined her and determined that she had dilated to 3cm. Upon discussion with the nurse my wife, who was in considerable pain, requested a Caesarean.
Dr Liu arrived about 10 minutes later. He examined my wife and determined that she had dilated to 7cm ? astoundingly fast, one might say. Dr Liu, his eyes bloodshot, also told me that he had been awake for 40 hours straight without rest.
My wife expressed a desire for a Caesarean. Dr Liu then said that the operating theatre was occupied with another pregnancy involving fetal distress, and that labour was perhaps too far along to allow waiting for the operating theatre to be free.
Not two minutes later, Dr Liu then pronounced my wife ?fully dilated? and we consented to begin delivery. I was present in the delivery room. Within another five minutes or so, Dr Liu then said a vacuum delivery would be necessary. He made no attempt to coax my wife through natural labour.
It was difficult to tell whether his choice was made to spare my wife pain, or simply to expedite the procedure. He hurriedly inserted the vacuum device and began extracting the baby. Once the baby?s head emerged, one could see that the umbilical chord was around the baby?s neck. Dr Liu immediately clamped the umbilical chord, rather than waiting for a minute or two as good practice would demand, while most of the baby was still in the birth canal, and asked me if I wanted to cut the chord.
I asked him to wait longer before clamping the umbilical chord. He looked at me like my request was bizarre, and ignored it.
When the baby emerged, it was not clear to me whether she was breathing. It was at least three or four minutes before a nurse had completely aspirated the baby with tubes and she began to cry. By this time, however, profound cyanosis (where the skin turns blue) was evident on the baby?s face, lips and extremities. Dr Liu, who appeared shaken, explained that the baby ?was cold?. After another four or five minutes the paediatrician arrived. The cyanosis was still abundantly clear, although it had begun to fade from the baby?s face.
The cyanosis in the extremities was still plain when the baby was moved to incubation several minutes later. Although I am not a doctor, I was also of the opinion that the cyanosis was at least partly the result of anoxia.
After my wife was settled in her room and I returned home early Sunday morning, I faxed Dr Liu a list of questions about the delivery. Later on Sunday, I spoke to the paediatrician, Dr Ma, when he came in to talk with my wife. As I had not yet heard from Dr Liu, I asked him about the baby?s APGAR score. I was astonished when he replied that the baby was given a ?10?.
I told him that this was impossible, and that the score should be amended to reflect the truth. Cyanosis alone would require a score reduction, as would the delayed respiration ? both of which I witnessed with my own eyes at one minute after birth. Also impossible would be a full ?grimace? score, as the baby had no noticeable reaction until at least three minutes after birth.
Even the five-minute APGAR score could not possibly have been 10, given the cyanosis, which persisted at least until the baby left for incubation 15 or 20 minutes after birth.
Later that day I ran into Dr Liu. He told me he had not seen my fax. I told him of my concerns. He told me it was ?a question of practice? and that ?in Hong Kong, we always clamp the umbilical chord immediately after birth.? He said he had delivered 300 babies in ?exactly the same way, with no problems.?
On Monday, Dr Liu visited my wife?s room. He asked me ?do I still have to reply to your fax?? He also told me that the APGAR score was a ?subjective? matter, and that I should not be so ?square?. I replied that APGAR was not at all subjective, but was in fact intended to be as objective as possible, and that falsification of it was a serious ethical transgression.
?Outcomes are all that matter,? Dr Liu told me, ?and the baby is fine, isn?t she?? I replied that that the consequences of anoxia may not be evident for months, and that if she exhibited learning disabilities or developmental delay, I would be certainly be thinking of what happened at birth..
He replied: ?Are you going to blame me if the baby comes in second in her class instead of first??
I wrote a detailed complaint to Baptist February 10. A month later, the hospital services manager, claiming to have conducted a "thorough investigation", presented an appalling concoction of distortions about the delivery and the events leading to it, and essentially denied that any cyanosis had occured.
Hence, I'm off to to the Medical Council, with limited expectations given the "self-regulated" nature of Hong Kong's private medical system. Nonetheless, I will be shouting from the rooftops about what I saw at Baptist.
Sincerely,
Richard Latker
I'd like to share our atrocious experience at Baptist hospital, which was a real eye-opener into the under-regulation and poor state of medical ethics among private hospitals in Hong Kong.
I'll deal with medical issues here, and save our experiences with the accounting staff for another post.
While we have no complaint with the services provided by the maternity nurses, who were by and large professional and attentive, we witnessed incompetence and poor ethics on the part of doctors and senior medical staff serious enough to give pause to anyone considering giving birth at Baptist.
In short, the obstetrics medical staff at Baptist rushed through the delivery procedure, falsified the APGAR score for our child at birth, and then lied about the profound cyanosis that appeared in our baby.
Late on February 4th, my wife went into labour and I brought her into hospital. She was admitted more or less without delay. The obstetric nurse examined her and determined that she had dilated to 3cm. Upon discussion with the nurse my wife, who was in considerable pain, requested a Caesarean.
Dr Liu arrived about 10 minutes later. He examined my wife and determined that she had dilated to 7cm ? astoundingly fast, one might say. Dr Liu, his eyes bloodshot, also told me that he had been awake for 40 hours straight without rest.
My wife expressed a desire for a Caesarean. Dr Liu then said that the operating theatre was occupied with another pregnancy involving fetal distress, and that labour was perhaps too far along to allow waiting for the operating theatre to be free.
Not two minutes later, Dr Liu then pronounced my wife ?fully dilated? and we consented to begin delivery. I was present in the delivery room. Within another five minutes or so, Dr Liu then said a vacuum delivery would be necessary. He made no attempt to coax my wife through natural labour.
It was difficult to tell whether his choice was made to spare my wife pain, or simply to expedite the procedure. He hurriedly inserted the vacuum device and began extracting the baby. Once the baby?s head emerged, one could see that the umbilical chord was around the baby?s neck. Dr Liu immediately clamped the umbilical chord, rather than waiting for a minute or two as good practice would demand, while most of the baby was still in the birth canal, and asked me if I wanted to cut the chord.
I asked him to wait longer before clamping the umbilical chord. He looked at me like my request was bizarre, and ignored it.
When the baby emerged, it was not clear to me whether she was breathing. It was at least three or four minutes before a nurse had completely aspirated the baby with tubes and she began to cry. By this time, however, profound cyanosis (where the skin turns blue) was evident on the baby?s face, lips and extremities. Dr Liu, who appeared shaken, explained that the baby ?was cold?. After another four or five minutes the paediatrician arrived. The cyanosis was still abundantly clear, although it had begun to fade from the baby?s face.
The cyanosis in the extremities was still plain when the baby was moved to incubation several minutes later. Although I am not a doctor, I was also of the opinion that the cyanosis was at least partly the result of anoxia.
After my wife was settled in her room and I returned home early Sunday morning, I faxed Dr Liu a list of questions about the delivery. Later on Sunday, I spoke to the paediatrician, Dr Ma, when he came in to talk with my wife. As I had not yet heard from Dr Liu, I asked him about the baby?s APGAR score. I was astonished when he replied that the baby was given a ?10?.
I told him that this was impossible, and that the score should be amended to reflect the truth. Cyanosis alone would require a score reduction, as would the delayed respiration ? both of which I witnessed with my own eyes at one minute after birth. Also impossible would be a full ?grimace? score, as the baby had no noticeable reaction until at least three minutes after birth.
Even the five-minute APGAR score could not possibly have been 10, given the cyanosis, which persisted at least until the baby left for incubation 15 or 20 minutes after birth.
Later that day I ran into Dr Liu. He told me he had not seen my fax. I told him of my concerns. He told me it was ?a question of practice? and that ?in Hong Kong, we always clamp the umbilical chord immediately after birth.? He said he had delivered 300 babies in ?exactly the same way, with no problems.?
On Monday, Dr Liu visited my wife?s room. He asked me ?do I still have to reply to your fax?? He also told me that the APGAR score was a ?subjective? matter, and that I should not be so ?square?. I replied that APGAR was not at all subjective, but was in fact intended to be as objective as possible, and that falsification of it was a serious ethical transgression.
?Outcomes are all that matter,? Dr Liu told me, ?and the baby is fine, isn?t she?? I replied that that the consequences of anoxia may not be evident for months, and that if she exhibited learning disabilities or developmental delay, I would be certainly be thinking of what happened at birth..
He replied: ?Are you going to blame me if the baby comes in second in her class instead of first??
I wrote a detailed complaint to Baptist February 10. A month later, the hospital services manager, claiming to have conducted a "thorough investigation", presented an appalling concoction of distortions about the delivery and the events leading to it, and essentially denied that any cyanosis had occured.
Hence, I'm off to to the Medical Council, with limited expectations given the "self-regulated" nature of Hong Kong's private medical system. Nonetheless, I will be shouting from the rooftops about what I saw at Baptist.
Sincerely,
Richard Latker
.