Delay in getting blood to patient

PUBLISHED : Tuesday, 15 November, 2011, 12:00am
UPDATED : Tuesday, 15 November, 2011, 12:00am


Baptist Hospital's blood bank took more than twice as long as the prescribed time to supply blood to a mainland woman who died at the hospital last year, four days after giving birth, a coroner's inquest heard yesterday.

Businesswoman Mandy Yang Feng, 39, died after developing complications from the rare problem of placenta accreta, when the placenta attaches itself deeply into the wall of the uterus. It can cause haemorrhaging during childbirth and surgery is commonly required to stop the bleeding.

Yang's anaesthetist, Dr Tse Shing-lam, told the inquest that Yang lost 12.6 litres of blood on March 3 last year, the day she gave birth to a daughter. But the blood bank took 24 minutes to supply the blood after the first of many requests for it.

'It exceeded my usual anticipated time - it should have arrived in 10 minutes,' Tse said, citing the time limit in the hospital's protocol.

He said repeated requests were made to the blood bank for the blood to be sent quickly. Based on his experience, Tse said, the patient's condition would not have become so serious if the blood had arrived earlier.

Yang's husband, Shi Jian, told the inquest about a conversation he had with Dr Lam Man-ho, the obstetrician in charge of the delivery, in which Lam said: 'The uterus and the placenta got stuck together. The last operation was so bad ... Was that [done at] a small hospital?'

Lam was asking about an abortion Yang had on the mainland in 2005. Shi told Lam that the abortion had been conducted at a big hospital - suggesting the level of care should have been good.

Lam told the inquest that placenta accreta was very rare. 'I haven't encountered one [before] in my professional life,' said Lam, a specialist in the field for more than 16 years.

After Yang gave birth, at first her uterus did not respond with the normal contraction, he said. '[But] after I finished massaging [her], the uterus relaxed again,' Lam testified.

Lam said he realised in January, after Yang visited his clinic in Admiralty, that her unborn baby was in the breech-birth position - set to be delivered feet first. But Shi, the husband, said he was told everything was fine during prenatal examinations.

Shi said he spent only a short time with his wife after her baby - their third daughter - was born. 'I was asked by a nurse to take some photos, but I saw that [my wife] was in some discomfort,' he said. 'She told me, 'I'm having trouble breathing'.'

Shortly afterwards, Yang underwent a two-hour operation to have her uterus removed. She lapsed into unconsciousness after that, and died on March 7.

The inquest continues today before Coroner Michael Chan Pik-kiu.