12 June 2009

Friday, 12 June 2009 was one of the darkest days in my family, when I lost my beloved grandmother. While I don't see the point in a further investigation to pursue legal action, as nothing will bring her back, I hope by sharing my family's experience, I can raise some awareness on patient's rights. Even if only one family is saved from having to go through what my grandmother had to go through, it is definitely more than worth it:

After my grandmother was admitted to the A&E ward sometime between 7 & 8 am that Friday morning, the doctor in charge of her case came out to explain that they suspected either heart attack or internal bleeding in the digestive system. However, an endoscopy to be confirm the latter had to wait until her BP, recorded as low as 67 by the medics who responded to our 995 call, stabilizes at a normal level. We had to wait outside the ward without any access to her as we were told only patients were allowed inside. By 11 am, we were told she was responding to the fluids they were giving her and her BP was slowly climbing up and that she was still weak but in stable condition. Around 3 pm, while I went away to grab lunch, my aunt was instructed to wait at a lift lobby by the main block as they were going to transfer my grandmother to the endoscopy centre, and we could not enter the A&E ward which had a short cut. Interpreting that as a sign that finally she was stable and strong enough to go through the endoscopy, I was very relieved and rushed to catch up with my aunt at the particular lift lobby on the 2nd floor, where my aunt was told to wait.

After a few minutes, I grew anxious and decided to ask around as there was no sign of my grandmother nor any signage leading to endoscopy centre where we were waiting. At the advise of a staff there, I rushed back to A&E, only to be told that my grandmother was still inside A&E ward. I was told to be on standby outside the ward and that the doctor will come and explain my grandmother's conditions as well as get our consent form before they could transfer her to the endoscopy centre. Just as I was going to pick up my mobile phone to contact my aunt, I received an sms from a cousin who bumped into my grandmother at the ********** Wing, all the way at the other end of the hospital, where the endoscopy centre is. I immediately confronted the A&E staff who subsequently apologized and confirmed that my grandmother was already on her way to the endoscopy centre.

In the end, we did not proceed with the endoscopy. While my aunt managed to convince my grandmother to proceed with the procedure, despite her initial reluctance, the doctor advised them that she was in good enough condition to be warded first for observation for the night, and that the endoscopy could be done the following day. The whole trip from one end of the hospital to the other was wasted and my grandmother was sent back to A&E as they claimed the bed in the regular ward was not ready for her.

Back at the A&E ward, when we complained to the doctor in charge of my grandmother's case, she explained that there was some confusion because the endoscopist did not follow standard procedure whereby he/she was supposed to go to A&E ward to personally check on my grandmother's condition, discuss her condition with us and getting our consent before actually proceeding with the transfer (Note: The reason given was that the doctor was too busy at the endoscopy centre). Instead, the endoscopist had instructed for my grandmother to be transferred first and for the discussion as well as consent to be done at the endoscopy centre, which was at the ********** Wing, at the other end of the hospital from where the A&E ward is. On hindsight, I still feel strongly that the doctor should not have transferred any patient with potential internal bleeding without first checking whether or not he / she is stable enough to be moved around.

When we checked on her condition with the doctor at A&E, we were told that she was doing well enough even to be eating porridge (Again, on hindsight I keep blaming myself for not asking: Potential internal bleeding in the digestive system vs porridge?). At the moment, relieved to hear that, we decided to take a break and grab a bite at the the food court. Around 5.30 pm we received a phone call on my aunt's mobile that my grandmother was being transferred to Ward 78 bed 9 and that we could see her there. We rushed there only to find bed 9 empty. When my aunt called to check with the A&E ward, they said that she was on her way. Standing outside the room, it was that time when I heard a nurse yelling "Code Blue" behind the drawn curtain of bed 10. We decided to step aside to make way for the nurses and doctors who rushed in. We were calmly waiting by the nurses' counter, not realizing that it was my grandmother in bed 10 until a doctor stepped out of the room a few minutes later and asked for relatives of my grandmother's. She told us she was in critical condition and she asked if anyone of us knew what happened that morning and what she was admitted for.
I could not believe my own ears ( I still don't) that the doctors at the ward had no record of my grandmother's condition.

Within less than an hour after that, we lost her.
Our only consolation is that we managed to get my grandfather by her bedside during her last moments.

I understand later from one of the nurses that when she received my grandmother in the ward, she was already in non-responsive condition. No info was available on her condition from A&E, except from an earlier phone call informing a transfer of a patient with potential internal bleeding case. As this is the first time ever she had received a patient in non-responsive condition, she decided to call the police, who later came to take her away. Believing that she could still hear and feel pain, we made the decision to insist on no autopsy. I suppose the decision also means we will have to live the rest of our lives without knowing for sure what really caused her death. The death certificate stated "hypertensive heart attack". I can't help but wonder if a case of mishandling by the hospital should have been added in. I just wish the doctor could have checked my grandmother's condition personally before instructing for the transfer.

I just hope there's a way we can make sure patients and their families are aware of their rights in the public healthcare system, and hopefully noone else will end up where my family is today. Maybe something within the line of how the Miranda rights still has to be cited in US in every single arrest the police makes. Maybe a prominent notice by the entrance? I don't know....