Hospital turf war ‘putting babies in danger’

Doctors allege the lives of critically ill babies have been risked repeatedly for years by transferring them unnecessarily.

Olivia Peaper needed a heart and lung bypass at 10 days old.

Doctors allege the lives of critically ill premature babies have been risked repeatedly over the past three years by transferring them unnecessarily across Sydney for heart surgery.

The claims emerged amid a fierce turf war over cardiac services between the city’s two major children’s hospitals.

In one case last year an extremely premature triplet was transferred from the Royal Hospital for Women at Randwick, in Sydney’s east, to the Children’s Hospital at Westmead, in the city’s west, for heart surgery.

Randwick doctors believed the surgery could have been performed safely at the Sydney Children’s Hospital at Randwick, on the same campus.

Instead, the Westmead-based team that runs cardiac services for both children’s hospitals insisted the surgery take place at Westmead, resulting in the baby being separated from its siblings for nearly two months. The mother was from overseas and did not speak English.

The case is one of a series of ­examples of avoidable or “sub-­optimal” transfers of babies across Sydney which Randwick-based doctors allege have placed children at “unnecessary risk”.

Mother of three Samantha Peaper told The Australian it was “scary” that cardiac services were being run down at the Randwick children’s hospital. Her daughter Olivia, now aged one, owes her life to the hospital’s only cardiac surgeon, who is on call 24 hours a day, seven days a week, and was available when she needed help.

Olivia as a healthy 17-month-old with parents Tim and Samantha and sisters Chloe and Paige. Picture: John Feder

A streptococcal infection picked up when she was just 10 days old raged through her body “like a fire”, according to her ­father Tim. Her lungs stopped functioning properly and filled up with fluid. When other treatments failed, doctors at Randwick performed an urgent surgical procedure to connect her to an ­extracorporeal membrane oxygenation machine to bypass her heart and lungs. Her condition was so unstable they did it in the intensive care unit, without taking her down to theatre.

Doctors warned her parents she might not survive, but Olivia is now a thriving toddler.

Randwick-based doctors have highlighted other cases in which a cardiac surgeon has not been available to perform lifesaving surgery. In a case in 2017 a pre­term baby weighing less than 1kg was transferred from Randwick to Westmead for a relatively common cardiac procedure because no surgeon was available to come to Randwick.

Also in 2017, a “blue” baby with critically low oxygen levels, a condition which can cause brain damage, was transferred to Randwick from St George Hospital, in Sydney’s south. On arrival, the baby was diagnosed with a serious heart condition, requiring urgent surgery.

The procedure had been performed at Randwick many times but the cardiology team insisted the baby be transferred to Westmead. The second transfer did not occur until four hours later, in a move Randwick doctors believed increased the risk to the baby.

The cases are outlined in a letter, excerpts of which have been seen by The Australian, which says there have been a “number of clinical cases of concern” over the past two to three years, involving transfers to Westmead which doctors “felt could have been avoided” and cases involving “sub-optimal transfers” they believed “placed the babies at unnecessary risk of harm”.

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In another case in 2017, a baby born outside Sydney with a suspected heart problem was due to be flown to Randwick but instead was diverted to Westmead.

This meant a baby born the same day at Westmead private hospital with a serious condition known as a tracheo-oesophageal fistula had to be transferred to Randwick for urgent surgery because the beds in the Westmead intensive care unit were full. This condition can cause babies to be unstable during transfer and meant his treating doctors would be far away from his home for years of follow-up treatment.

In yet another 2017 case, a baby born with multiple congenital anomalies had surgery at Randwick, also for TOF repair. The baby was then forced to travel to Westmead for heart surgery that had safely been done at Randwick for many years.

The dispute stems back to 2012, when the administration of the cardiac units at the two children’s hospitals was merged and Westmead-based doctors were placed in charge. Some Westmead doctors believe cardiac surgery should be concentrated at their hospital for better results and say in some of the cases equipment was not available at Randwick to perform the procedures in the safest way. Doctors at Randwick say cardiac surgery is crucial and if equipment is viewed as necessary it could be provided at relatively minimal cost.

The medical staff council at Randwick last month passed a motion of no confidence in the executives and board that run the two children’s hospitals, and in their networked management structure. The acting head of the Sydney Children’s Hospital at Randwick medical staff council, Angus Gray, last week wrote to the council’s 156 members canvassing options for “major transformations” to the way the hospital is run. The letter warns “children will die at SCH without a full functioning cardiac surgery department”. Separately, the medical staff council at the Royal Hospital for Women, also unhappy, voted last week to seek an options paper for the women’s and children’s hospitals at Randwick to be run together.