What if she didn’t use a scalp clip to monitor her baby’s heart rate? What if the doctor hadn’t performed a vacuum-assisted delivery? What if the cut on the newborn’s head from the scalp clip and the loss of blood had been discovered earlier? The Brampton, Ont., mom may never stop wondering, but what she says could help her family heal is an apology and accountability for what happened to her son. “I know by doing all these things, I’m not going to get the baby back,” Patel told CBC News. “But I need justice for my baby. I need answers about my baby.” Patel’s son Anant died two days after he was born at Brampton Civic Hospital in August 2021. His death was caused by complications from birth-related blunt force trauma to the head, an autopsy determined. That head injury included a laceration to the scalp, extensive bleeding between the baby’s scalp and skull, and bleeding outside his brain. “Throughout my pregnancy, she was perfectly healthy,” Patel said. “We try to find the doctor who delivered the baby, ask the questions, but that never happened.” Instead, Patel and her husband, Manish, met with management from Brampton Civic Hospital six months after their son’s death to pass a quality-of-care committee review completed by the health system. But the report did not mention the delivery doctor and focused largely on potential problems with their baby’s care after delivery. The meeting and review fell short of the accountability and apology the couple said they were seeking — both of which, a patient advocate says, are often difficult to achieve in Canada given the fear of legal repercussions. “It really shouldn’t be as hard as it is to apologize,” said Kathleen Finley, the executive director of the Toronto-based advocacy group Center for Patient Advocacy. “That’s all most people want. They don’t want to make a lot of money through a huge settlement.”
Hospital offers ‘sincere condolences’
The William Osler Health System, which operates Brampton Civic Hospital, told CBC News in a statement that it could not provide specific details or comment due to its policies and to protect the family’s privacy and confidentiality. “William Osler Health System extends our sincere condolences to the family for their loss,” spokeswoman Emma Murphy wrote. “We have a robust care review process to evaluate the care provided to patients. This process includes working with the family throughout the overall review and providing ongoing support to the family.” Two days after their baby died, a social worker from the hospital called the Patels and offered condolences and emotional support. In a statement, the William Osler Health System, which runs Brampton Civic Hospital, told CBC News it could not comment on the details of the family’s case, but offered its condolences. (Martin Trainor/CBC) The quality of care report, reviewed by CBC News, says the vacuum-assisted delivery “may have contributed to subgallon bleeding/subdural hematomas” — the only time a potential problem with the baby’s birth is mentioned. Vacuum-assisted birth occurs when a doctor puts a small vacuum on the top of a baby’s head to use suction to help remove the newborn when labor is not progressing. The Patels filed an anti-birthing complaint with the College of Physicians and Surgeons of Ontario (CPSO) in January. Their complaint will go before a committee this month to determine whether disciplinary action against the doctor is warranted. CBC News is not naming the doctor because no professional misconduct complaint has been made against them by the college at this time.
The couple say they were not consulted
In the CPSO complaint, the couple alleges the doctor caused a head injury to their baby during delivery and failed to notify the neonatal intensive care unit (NICU) of the injury and blood loss. failed to obtain informed consent for vacuum delivery; failed to adequately perform vacuum delivery resulting in injury to baby. and failed to meet with the family to discuss what happened despite requests to do so. Hospital records reviewed by CBC News include notes and reports from the doctor. In those records, the doctor says the risks and benefits of vacuum-assisted birth were explained to the couple and that Swati Patel agreed to go ahead with it. The doctor’s notes also state that “there was bleeding observed at the time of vacuum application after scalp clip removal – unclear if there was detachment or blood was from the vagina” and that the doctor was “careful not to pull hard” due to difficulty maintaining vacuum suction. The Patels maintain they were never consulted about the use of the loophole and asked Brampton Civic Hospital to make corrections to doctor’s notes in their medical records — a request that was denied. Anant Patel was taken to Brampton Civic Hospital’s ICU before being transferred to the Hospital for Sick Children in Toronto, where he died on August 31, 2021. (Submitted by Swati and Manish Patel) “The doctor removed the scalp clip and [the doctor] I put the vacuum and was trying to suck with the vacuum, at that time I saw a lot of blood,” said Manish Patel. “Later, when I describe to Sick Kids hospital exactly what I saw, the doctors at Sick Kids say that this blood was actually baby blood.” The Patels say their baby was very pale when he was born at 3:18 a.m. ET on Aug. 29, 2021 and, according to records, had “poor respiratory effort,” so he was taken to the ICU. William Osler Health System’s regional transport team was unable to provide “timely” transport of the baby to the Hospital for Sick Children in Toronto, so the NICU team tried to figure out what was wrong with the newborn while receiving instructions over the phone from Sick Kids to transport team arrived, according to the quality of care review. The report goes on to say that early recognition of a possible head bleed (later determined to be from the scalp clip in the post-mortem report) was also delayed because a head circumference measurement protocol was not followed as staff prioritized the baby’s breathing. Going forward, the care quality committee recommended a re-enforcement protocol with front-line staff and monthly audits to monitor compliance.
Blood loss not discovered for hours, parents say
The couple says their baby’s care team didn’t determine their son needed blood until several hours after he was born, when the specialized transport team arrived, took over care and ordered a blood transfusion. “Once they transplanted the blood where the scalp clip was placed, the blood started coming out of that injury and then they know the baby’s injury,” Swati Patel told CBC News. The post-mortem report confirms that “during transport, there was subgaleal haemorrhage as well as bleeding from the scalp laceration, which soaked several absorbent pads”. Tests and scans at Sick Kids after the Patels’ son Anant was transferred revealed the extent of the boy’s irreversible brain damage and how severe blood loss meant his heart could not pump enough blood to other parts of the body. causing his organs to begin to fail. Anant was weaned off the ventilator and died on August 31 at Sick Kids. His mother said she is still haunted by what happened and hopes that by speaking out, she can prevent the same thing from happening to others. “I can’t sleep at night,” he said. “I dream I’m in the hospital looking for the baby.”
More “therapeutic solutions” are needed.
Finlay, of the Patient Advocacy Centre, said an apology can be a powerful healing tool for patients and their families — one that doesn’t necessarily put Canadian hospitals and doctors at legal risk. “In Ontario, for example, we’ve had an apology law for over 10 years, which ensures that the apology cannot be used in legal proceedings,” Finlay told CBC News. Kathleen Finlay of the Patient Advocacy Center says getting an apology from a hospital or doctor after a medical injury in Canada shouldn’t be that difficult, given legislation in most parts of the country that prevents apologies from being used in legal proceedings. (Submitted by Kathleen Finlay) “It is never considered an admission of guilt, but an admission of sorrow and regret.” Most other provinces and territories have similar legislation. The center has also advocated for hospitals to appoint chief compassion officers to ensure patients are heard and treated in a way that takes account of their trauma. “We really need to find much better, faster, simpler and more therapeutic solutions so that families can move forward,” Finlay said. “It’s really important.” For their part, the Patels are awaiting the outcome of their CPSO complaint. “I will do my best to do all the things until I am vindicated,” said Swati Patel.
