An outspoken anesthetist says a lack of staffing could have contributed to the death of a newborn at Victoria General Hospital on Aug. 9.
Sue Ferreira went public with her concern over the shortage of anesthetists after she handed in her resignation to Victoria General Hospital in June.
Now in her last week on the job, she says the tragic death could have been avoided if there was a dedicated anesthetist in maternity. She’s calling on the B.C. Coroners Service to independently confirm this.
Vancouver Island Health Authority is bound by patient confidentiality not to publicly release details of the case, but in an email to media, Ferreira said a labouring mother required an emergency cesarean section at a time when the hospital’s lone anesthetist was occupied with other surgeries. A second anesthetist was called in, but the unborn child was in severe medical distress and died before delivery.
“What we know is that there was a delay in care. What we need to find out is whether that delay was the reason this baby did not survive,” Ferreira wrote.
Island regional coroner Matt Brown said he can’t investigate the case because the child is considered a stillborn.
“If it never took a breath, it’s not a live birth,” Brown said. “If there’s no birth, there’s no death for us to investigate.”
VIHA has initiated its own review, which chief medical officer Dr. Richard Crow said is standard procedure for any unexpected death in the hospital.
“Doing the review does not mean there’s anything untoward, the purpose is see if there are quality improvements that can be made,” Crow said.
He stressed that while other hospitals in the province have a shortage of anesthetists, this is not the case in Victoria where there are 40 anesthetists, including 21 who provide on-call service for maternity care at Victoria General. The one current job opening for a general anesthetist has nine applicants, he said.
VIHA has one anesthetist in the hospital at all times and has tried to recruit specialized obstetric anesthetists to work around the clock in the maternity.
In 2009 VIHA offered $1.88 million for the 5.4 anesthetists needed to provide that service, an equivalent of $348,000 per anesthetist, which Crow said is the maximum available funding for that specialty, a rate set by the province and the B.C. medical association.
James Helliwell, president of the B.C. Anesthesiologists Society, said the positions weren’t filled because no qualified anesthetist would work for that rate.
“In B.C. workloads are higher than the rest of the country … skilled anesthetists are choosing jobs elsewhere,” Helliwell said, calling on the province to launch an independent review into how to improve working conditions to recruit the needed anesthetists to the province.
To work around having an anesthetist dedicated to maternity care, VIHA undertook a risk analysis study in 2009 that highlighted the “severe or catastrophic risks” associated with needing to call in a doctor for an emergency C-section.
The report recommended ways to improve communication between hospital staff and assess when a C-section is likely, so the second anesthetist can be on their way sooner.
Crow said an anesthetist usually responds to a call within 10 to 20 minutes. And though he couldn’t speak to the Aug. 9 case in particular, he said he wasn’t aware of any undue delays.
“It would be highly speculative and inappropriate to try to say what contributed to the death before the review is complete,” he said. “It’s almost always multi-factoral.”
All hospital births in Greater Victoria and all high-risk births for Vancouver Island are handled at Victoria General. About 3,500 babies are born there each year.
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