Parents upset over wound on newborn

PHOTO: Parents upset over wound on newborn

A miscommunication between the parents of a newborn baby and a hospital has caused much anxiety and drama.

Mr Mohamad Darok Mohd Shaffir thought there was a serious problem when he saw an ulcer on his baby daughter's leg.

The gaping wound was about 2cm wide and located just above the heel on her right leg.

The flesh was exposed and looked like it was coated with dried pus.

"It looked very serious and I was so worried that there was something very wrong with her," the part-time banquet waiter told The New Paper.

To make matters even more worrying, his baby girl, who was born on Oct 19, was kept in the neonatal intensive care unit (NICU) at the KK Women's and Children's Hospital (KKH).

It led to much anxiety and worry, he said.

COMPLICATION

What he didn't realise was that this wound, a complication from an intravenous drip, will usually heal with local dressing and antibiotics.

Mr Mohamad Darok claims the hospital never explained this clearly to him.

KKH, however, said it gave him a detailed explanation.

Baby Nur Farhana was discharged from hospital on Nov 15 and is now back at the couple's Marine Terrace flat.

His wife, Madam Muliana Md Sarip, 33, is thankful that her daughter's wound was not infected and not something more serious.

"The wound looked so scary when we saw it. I was so scared," she said.

While Mr Mohamad Darok now accepts the hospital's explanation that the wound was not due to the lack of care on the part of the hospital staff, he is still upset that no one told him about it until he saw it some time last month.

"Why did the doctor in charge not contact us immediately to tell us about the wound? Whatever it is, they should have informed the parents."

KKH: FATHER WAS GIVEN EXPLANATION

The swelling on baby Nur Farhana's right ankle was a "well-accepted complication" of an intravenous drip, said Associate Professor Victor Samuel Rajadurai, senior consultant and head of the department of neonatology at KK Women's and Children's Hospital.

Staff at KKH have reviewed the swelling area twice since the baby was discharged on Nov 15 and it is healing well.

Dr Rajadurai said the father was given a "detailed explanation", including how it occurs and the appropriate medical care.

He said the swelling was caused by what is known as extravasation. This is when the fluid or medication from the intravenous infusion leaks out of the vein into the surrounding tissue.

The doctor added that most cases of extravasation are mild and do not require treatment. In about 1 per cent of cases, it can result in tissue injury causing ulceration of the skin.

NO LACK OF CARE

"Most of these cases will heal with local dressing and antibiotics," said Dr Rajadurai. "The fact that extravasation occurs does not mean that there was any lack of care in the treatment."

Dr Rajadurai said the baby had to be admitted into its neonatal intensive care unit after her birth as she had persistent pulmonary hypertension.

This is a severe condition where the pressure in the lungs is high, causing problems in breathing and blood circulation.

She had to be fed via a drip and this had to be transferred to her right ankle after some complications. Within an hour, a swelling with a white patch developed on the right ankle as a result of extravasation.

Dr Rajadurai said the drip was removed immediately.

"There was no visible broken skin at that time," he said. "The site was later reviewed by a plastic surgeon and the affected area was dressed with non-adherent dressing."

Dr Rajadurai said that the baby's father was insistent on discharging the baby, saying that his wife was upset that she was unable to look after her own baby. But on the advice of the medical team, he agreed to let the baby stay in the hospital.

"The hospital is always open to discussing with the parents if they had any concerns or doubts about the care provided to their child," said Dr Rajadurai.

tnp@sph.com.sg


This article was first published on Nov 27, 2014.
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