Another baby dies at crisis hospital

Administrators at the besieged Blacktown Hospital will investigate the death of another baby in the hospital’s obstetrics department.

Blacktown Hospital. Picture: Jonathan Ng

Administrators at the besieged Blacktown Hospital will investigate the death of another baby in the hospital’s obstetrics department, where doctors are despairing at what they say is critical under-resourcing.

The western Sydney hospital was plunged into crisis this week when the entire obstetrics staff threatened to resign after requesting for months that the department’s staffing and access to operating theatres be increased.

NSW Health Minister Brad Hazzard has ordered a review after the unexpected deaths of four newborns at the hospital over the space of 18 months.

On Wednesday, a fifth baby died. The Western Sydney Local Health District is investigating the circumstances and the hospital is unclear whether clinical ­issues contributed to the death, but doctors say resourcing ­issues were a contributing factor.

The death occurred after a 39-weeks pregnant mother, who reported feeling unwell, had been admitted to the hospital and gone into labour. Her baby had a normal heartbeat in the morning but by mid-afternoon when clinicians checked, they could not find a heartbeat.

It was too late for a caesarean section to be performed.

NSW Health Minister Brad Hazzard at NSW Parliament House. Picture: NCA NewsWire / Jeremy Piper

District health administrators will investigate the death and a review known as a root cause analysis will be performed.

“I think it was avoidable,” said one doctor familiar with the case. “The infant missed out on the opportunity for an emergency caesarean section.

“There are clear system factors involved.

“The predominant theme is junior staff who are busy, expected to be in more than one place at one time, resulting in a delayed recognition of the severity of the situation.

“I’m confident the midwives and junior medical staff were doing the best job possible given the circumstances, but in an ideal world the mother would have been continuously monitored and periodically assessed and she wasn’t. I’m sure that was to do with staffing issues.”

General manager of Blacktown and Mount Druitt Hospitals Ned Katrib extended his sympathies to the baby’s family.

“The death of any baby is deeply distressing, and our thoughts and sincere condolences are with the family during this incredibly difficult time,” he said.

“While a healthy and safe birth for a mother and infant is the goal for all labour and delivery units, sadly in some instances this does not occur.

“All adverse clinical incidents are investigated in line with NSW Health incident management policy. The care and safety of ­patients remains the top priority for all healthcare staff at Blacktown Hospital.”

The number of births at Blacktown Hospital has increased markedly in recent time. Roughly 4200 babies a year are delivered there, while nearby Westmead Hospital performs 4900 births. Westmead, however, has about five times the number of skilled full-time equivalent staff to Blacktown.

The doctors who have threatened to resign have been requesting more registrars after several were transferred to Westmead.

Apart from the consultant obstetricians, Blacktown Hospital’s obstetrics department is largely staffed by unaccredited registrars, senior residents or career medical officers who are clinically untrained.

A root cause analysis performed following the death of a baby, Nigella, at Blacktown Hospital in June found similar systemic problems.

The Sydney Morning Herald reported that the root cause analysis of Nigella’s death found “the obstetric unit was effectively staffed by one registrar or career medical officer and one senior resident or medical officer with a limited specialist skill set.”

Hospital administrators have now promised obstetricians a dedicated theatre.

However, the hospital executive angered the concerned doctors this week when it said it would staff the hospital with ­locums if they walked out.