Professor slams failure to prepare blood for delivery
A failure to prepare blood before a delivery by Baptist Hospital doctors was substandard medical care that probably caused a mainland woman to die four days afterwards, a medical professor told an inquest yesterday.
Professor Warwick Ngan Kee, an anaesthesia and intensive care professor at Chinese University, questioned why no blood tests, screening and cross-matching had been done before the Caesarean operation on businesswoman Mandy Yang Feng, who died aged 39.
'Not to have taken blood pre-operatively for blood type and screening or blood cross-matching in a patient with a history of a previous Caesarean section constitutes substandard care,' Ngan said in an expert report. If it had been done, it would have guaranteed her blood was replaced faster.
Ngan said the delay was 'an important factor' that probably contributed to Yang's cardiac arrest and brain damage during the operation.
Yang died after developing complications from the rare problem of placenta accreta, when the placenta attaches itself deeply into the wall of the uterus. She lost 12 litres of blood and needed surgery to stop the bleeding.
Last week, the anaesthetist in Yang's case told Coroner Michael Chan Pik-kiu that the blood bank in the hospital had been slow in reacting to his repeated requests for blood.
It took about 24 minutes, more than double the 10-minute delay stipulated in the hospital protocol.
He also testified that unmatched blood was requested because it was an emergency and the patient was losing blood quickly.
Ngan called it a 'joint responsibility among the doctors caring for the patient and the institution' that no blood was taken for pre-operative blood-typing and screening.
'It is not clear whether this is institutional policy or a lapse in care or an oversight by the attending doctors,' he said.
Anaesthetist Dr Tse Shing-lan originally requested four packs of blood but when the bank failed to provide it he then asked for one pack, a decision that Ngan questioned.
'In this case, given the magnitude of the haemorrhage, this single unit was clearly insufficient,' he said, also noting that the request had followed repeated failures to obtain four units.
Ngan did not say whether four units would have been adequate.
The coroner is due to give a finding today.