A mother whose baby died in utero at Joondalup Health Campus while she was unmonitored for several hours after being induced was not consulted during an independent review of her horror experience.
Suzan Al Hulow and Ali Al-Khafaji’s baby son Amir died inside Al Hulow’s womb while in the care of the public hospital, run by private health provider Ramsay Healthcare, on March 22.
Suzan Al Hulow.Credit: 9 News Perth
An initial review of the incident by the hospital determined Al Hulow’s care was clinically appropriate, but the couple have been waiting since June for the report from an independent review by an external specialist.
A two-page report was handed to the parents and the family’s advocate Suresh Rajan on Tuesday, who blasted the review and said Al Hulow was not consulted once throughout the process.
“I would not actually give it the credit of calling it a report,” Rajan told Radio 6PR.
“It’s a two-page summary of the clinical issues that went to determine why baby Amir died, and none of that was actually in question.
“The reviewer did not speak with the family once. We haven’t had any contact with the reviewer whatsoever.
“What they’re looking at is whether there was an infection and whether the baby died as a result of the infection, whether the placenta was big enough to accommodate feeding this baby – it had nothing, nothing at all, to do with the requirements, the needs of what mom had spoken about.”
WA Premier Roger Cook said he was “surprised” that Al Hulow or Al-Khafaji were not consulted in the report.
“I would have thought they were a key component of any inquiry in terms of understanding the circumstances and the outcomes of the clinical practice, so that’s surprising to me,” he said.
Baby Amir died in the hours between induction and birth at Joondalup Health Campus.
Al Hulow claimed she was induced reluctantly with a catheter balloon and felt her waters break, but staff did not believe her.
She said she was not examined after this point for about five hours, and when staff did check on her Amir’s heartbeat was gone.
She gave birth to Amir on March 24.
The two-page report said Amir was a normal baby at 40 weeks when Al Hulow presented at hospital.
It said the care was appropriate and said Al Hulow’s recollection of her waters breaking was “not substantiated”, and there was no further evidence to suggest it had happened.
The report said it could not see how Amir’s death could have reasonably been avoided, and the only change in management that may have resulted in a different outcome was if the birth was scheduled earlier.
“I can identify no obvious deficit in the management of this patient leading to the fatal demise, or the subsequent management,” it said.
The report also rejected Al Hulow’s version of events around her request for a caesarean both before and after Amir had died.
“At the time of diagnosis of a baby’s demise, this is a very understandable reaction, however, there is no mention of [a request for caesarean] in the notes, either before induction of labour or after the diagnosis,” the report said.
“Had she insisted on a caesarean section at that time, it is likely that the request would have been accommodated, whilst making it clear that it was not what would be advised medically.”
Rajan emphatically rejected that and said Al Hulow asked for a caesarean several times, including on the Tuesday before Amir’s death.
Rajan claimed the hospital denied that request and scheduled her induction for Friday, March 22.
He said when they arrived on that day, Al Hulow again asked for a caesarean on three occasions.
“They kept saying, ‘No’ and, ‘No reason for it’. Just kept saying to her that it was inappropriate for her,” he said.
Ramsay Health Care WA manager Shane Kelly said the report’s findings found that Al Hulow’s care was appropriate and that nothing reasonable could have been done to prevent the outcome.
those findings supported the fact that her care was entirely appropriate, and there was nothing reasonable that could have been done to prevent the outcome.
He also defended the family not being consulted during the review.
“We met with the family and we ascertained all of their concerns, and we conveyed all of those concerns to the independent specialist who addressed them all in his response,” he said.
“It’s not always usual practice [for family to speak to an independent reviewer]. It’s more common to ascertain what these things are and provide those to the independent reviewer.”
Health Minister Amber-Jade Sanderson said Amir’s family had been told the review was only a clinical review and said the government would support them if they wanted to take their concerns to the Health and Disability Services Complaints Commission.
“I don’t think that any review is going to provide the closure that the family need,” she said.
“It is a devastating set of circumstances, but two reviews have found that the clinical care did not contribute to those circumstances, but that does not in any way take away from the trauma and the pain that she is feeling.”
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