Bled to Death after giving Birth

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Did anyone read the horror story on today's SCMP about 2 women bleeding to death hours after giving birth at the Adventist and Canossa in less than 3 months. I couldn't find the story on the internet edition of the SCMP so cannot replicate it here. It was reported that the attending doctor was late coming to the rescue (I think about 4 hours after the nurse paged him) and nurses couldn't find any other specialist on-call doctors to help on time. I mean, for the charges the doctors and hospitals are charging, you would expect top-of the class medical services available, not just the nice amenities available which really is very trivial when compared to the medical services needed in an emergency situation.

A friend doctor once said to me that the safest private hospitals to give birth on the HK Island are the HK Sanitorium and St. Paul for its comprehensive medical services available, meaning it will be easier to locate a doctor, albeit maybe not an obs and getting access to a surgery and aneathetists. I've been to the Canossa, Adventist and Malilda and none of them looks very big or comprehensive in the medical services they provide so I would really think twice about having births there, esp if you are high risk!!!
 
Found the article and here it is:

Alarm on private emergency care

Apr 18, 2008

Senior doctors have called for urgent action to improve private hospitals' handling of emergencies after a mother bled to death at the Hong Kong Adventist Hospital four hours after giving birth.
One said finding a doctor in an emergency was a lottery.

Staff called the woman's attending doctor, but he was not immediately available. He arrived 40 minutes later. In the meantime, a second doctor was called to help; however, no emergency operation was carried out.

The death occurred on January 10, but the circumstances have only recently come to light.

The case was reported to the Department of Health. It was one of two maternal deaths at private hospitals in three months. A woman who gave birth at Canossa Hospital on February 26 suffered from severe bleeding and died on March 2.

The department cleared Adventist Hospital of wrongdoing. But senior doctors say steps need taking to uphold standards at private hospitals.

"The standard used by the department is incredibly low. There is obviously a mismatch with what we expect from any modern hospital," one doctor said.

Medical sources said the woman gave birth to the baby, her first, at about 4.30pm. About an hour later, she began to bleed. Nurses called the attending doctor at 5.45pm, then sought help from another obstetrician at the hospital in Stubbs Road, Happy Valley.

The mother was moved to an operating theatre just after 6pm. The attending doctor arrived at about 6.30pm and operated to try to stop the bleeding. She was certified dead shortly after 9pm.

The two doctors involved would not comment.

A spokeswoman for Adventist Hospital said it had an "efficient on-call system" for maternity services.

In emergencies, nurses would get help from obstetricians practising at the hospital's outpatient clinic, she said.

Alan Lau Kwok-lam, president of the Private Hospitals Association, said effective on-call lists had been in place at all private hospitals for years.

But several senior doctors said few of their colleagues knew of any private hospitals with good emergency arrangements and it was sometimes difficult to find anaesthetists for urgent operations.

"When emergencies happen, nurses have to call one by one to see who is available; getting someone to help is a matter of luck, like a lottery. Many doctors are reluctant to answer emergency calls for fear they could get themselves into trouble," one doctor said. "If there was a pre-arranged roster a doctor would have a duty to answer such calls."

An Adventist Hospital spokesman said: "We have expressed our sincere sympathy to the family."
 
While it's scary when anyone dies after something we consider so routine, I would say the department clearing the hospital of wrongdoing means that it was likely this lady would have died anyway, but there is far too much that we do not know in the story. She may have had DIC or something else that could not have been stopped. That does not mean that you shouldn't be cautious.

I am sure women have also died in the public system and other private hospitals. Systems fail and people do make mistakes and while it's a horrible tragedy, I wouldn't say that this type of event occuring rarely should keep someone from attending an otherwise good hospital.

Think of how many babies are born in the world safely, even at home. A rare emergency, that we do not have the full details of, does not make it a bad hospital. It is probably a sign for them to improve their response to such a situation, but again, there is far too much missing information.
 
On mine.....thanks for the article....this is not really helping me in wanting to have a biological child in HK. Good grief!
 
Yes I read the article and am a little concerned since I was going to pay my deposit to secure a bed at Adventist next week. I mean the risk of dying while giving birth these days is very small (esp in developed countries), and it sounded like it was the lack of emergency care in these private hospitals that led to the women's death. Really makes me think twice about choosing private vs public hospitals in HK.
 
Hmmm.....this is really sad, can't help but think of the poor baby and the family.

But really, there is not choice for some of us who needs to go down by elective caesarian ( for me I have a condition which makes natural delivery not preferred) as we we cannot go public.....
 
Maternal deaths are very sad and in our developed country very rare but they still do happen. We tend to assume that giving birth is risk free there days but there still is a risk involved and the biggest risk to the mother is a postpartum haemorrhage ? where the mother bleeds and won?t stop.

Hong Kong?s figures for maternal deaths are actually amongst the best in the world ? better than both the UK and USA. The maternal death rate is often used as a measure of the quality of a health care system.

Here are the figures for the world
http://www.unicef.org/pon96/leag1wom.htm
 
Wow, New Zealand's is REALLY high!!

Hong Kong does have pretty good health care really... but I actually do feel "safer" in the Public health care system over here, I think!!
 
Barbwong thanks for those figures, really interesting to see where all the different countries are placed.

I would assume that there are possibly stories in both public and private hospitals that we don not read about in the paper, so I'm not sure we can condemn one system or the other.
 
I agree with Rebekah and Smiles. Even though death from childbirth is rare in developed countries that doesn't mean it doesn't happen at all. Doctors are not infallible and patients are not always going to have the best outcome regardless of being at low risk. The article does not give much information regarding the patient's condition. This article appears to only be writing about the private hospitals and not giving any facts or figures for public facilities.

There are so many successful births yet we hear of so many horror stories dominating the media. I try to focus on the positive as I rapidly approach my due date and try to tune out the negative stories that seem to always buzz in my ear during pregnancy. Unfortunately, shocking and sad stories sell news papers and keep the coffee chats going.
 
I've found another web site which has statistics for just Hong Kong and gives a very positive image of our health system (both public and private together).

Hong Kong 2006 Year Book – Health – Introduction
http://www.yearbook.gov.hk/2006/en/08_01.htm
2006 Figures at a Glance
Infant Mortality Rate: 1.8 per 1,000 registered live births
Maternal Mortality Ratio: 0.0 per 100,000 registered live births
(Nil cases of registered maternal death)
Life Expectancy:
2006 - 79.5 (Male) and 82.5 (Female)
2033 - 85.6 (Male) and 88.0 (Female) projected

This infant morality rate was reported as the lowest in the world in 2006.

Hong Kong 2005 Year Book – Health – Introduction
http://www.yearbook.gov.hk/2005/en/08_01.htm
Vital Statistics in 2005
Infant Mortality Rate: 2.4 per 1,000 registered live births
Maternal Mortality Ratio: 1.8 per 100 000 registered live births
(One case of registered maternal death)
Life Expectancy:
2005 – 78.8 (Male) and 84.4 (Female)
2033 - 82.5 (Male) and 88.0 (Female) projected
 
While I'd agree that both mistakes and unavoidable deaths happen everywhere and HK's record is relatively good, it still seems alarming that the necessary doctors at Adventist were not available when needed. I would imagine that this problem is less likely to happen in the major public hospitals in HK. The fact that private doctors routinely refer difficult cases to the public system is an indication that mothers and babies do carry a higher risk delivering in private hospitals should something unexpected happen.
 
konradsmum - if you have a medical condition that makes a VB inadvisable, then you'd be able to get a CS at a public hospital. If it's a personal preference, maybe not so easy - but you'd probably get your wish. HK is notoriously CS happy - even in the public sector.

In the experiences of me and my friends who for 100% medical reasons simply cannot have a VB - they make you wait until 34/26 weeks before they will confirm a CS.
 
One of my friends knows the lady who died in Jan, and apprently she told the nurse that she was in pain and they told her it's normal and being her first baby she trust the nurse who only gave her some pain killer then it wasn't until her mum came to visit that they found out she was bleeding really bad.... this is so scary cause to a first time mum you just don't know what to expect and you trust the professionals to take care of you.
 
My friend is a doctor who worked in peadiatrics at Queen Mary hospital, she said that the public hospitals in HK are much better than the private. Queen Mary is one of the best as they are a teaching and research hospital of HKU and have all the best equipment and facilities. Private hospitals do not have adequate facilities for serious complications, e.g. mothers and babies are transfered from matilda hospital to Queen Mary if there is an emergency situation.
 
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