By Kenton X. Chance
The mother of a 12-year-old girl with Vincentian and Trinidadian citizenship says she is suing the hospital in Trinidad where her child died on Jan. 2 having undergone there, three of five surgeries in connection with a brain tumour.
Vincentian Soflyn Roberts told iWitness News, on Friday, that the hospital discharged her daughter, Jasemine Wilson, notwithstanding the mother’s concerns about the condition of the child’s surgical wound.
Wilson died at 7:55 p.m. on Jan. 2 — 12 days after undergoing five surgeries in just over two months.
An autopsy conducted at the hospital concluded that the child died of “cerebellar tonsil herniation, cerebral oedema and hydrocephalus, ventriculoperitoneal shunt blockage, anaplastic medulloblastoma”.
However, the mother said that the pathologist she hired to witness the autopsy has suggested otherwise.
She said she is looking to bring a lawsuit on the ground “of medical neglect, … the [surgical] wound became infected while on the ward and [that Wilson] was discharged with the wound infected”.
However, Terrence Deyalsingh, the minister of health in Port of Spain, has challenged Roberts’ version of the events, as reported by a television station in Trinidad.
“The mother indicated that she was not ready to sign consent at that time … despite being counselled on the urgent nature of the case,” Deyalsingh said of the last of five surgical interventions that Wilson underwent in the weeks leading up to her death.
The minister said that the Trinidad television report contained “wild claims against the public sector” and called on the media outlet to issue an apology.
“… the way that story was carried, it was never told that she had surgeries in St Vincent [and] at [a] private hospital [in Trinidad], which were not successful. It was never said that the mother refused to sign the consent form,” Deyalsingh told a press conference on Jan. 4, two days after Roberts died.
In September 2019, Wilson, a Form 2 student at Girls High School, in Kingstown, began to vomit repeatedly and was diagnosed with a brain tumour after visits to multiple doctors in Kingstown.
A neurosurgeon was flown from Trinidad to Kingstown and, on Oct. 17, 2019 inserted a shunt, which drains fluid from a cerebral ventricle into the chest cavity — an EC$20,000 procedure.
Wilson was born in St. Vincent to her Vincentian mother and Trinidadian father and on Oct. 31, she was flown to Trinidad for medical attention.
Two neurosurgeons at that private hospital removed the tumour on Nov. 1, 2019.
They also sent samples to a laboratory for analysis, and the result later concluded that the tumour was cancerous.
Wilson was discharged from the private hospital on Nov. 8, 2019 after the removal of the tumour.
The mother said that after learning that the tumour was cancerous, she met with a dietician and changed her daughter’s diet. So effective was the diet, she said, that Wilson gained weight.
However, sometime around Dec. 4, the mother realised that the child was more tired than normal and had started to vomit again.
By that time, Wilson had become a Trinidadian citizen by descent, and, therefore, was able to access specialist medical attention at the public hospital.
There, doctors said Wilson’s ventricles looked large but that this was nothing to worry about.
Roberts told iWitness News that the doctors further said the vomiting might have resulted from the healing of the area where the tumour had been.
The child spent the night at the hospital, had a CT scan and was sent home the following day, Dec. 5.
Roberts took her daughter to a doctor at a private hospital on Dec. 6, and she was given medication for the vomiting.
Wilson took the medication but during the following morning, Dec. 7, she remained extremely tired, saying, even when she was eating, that she wanted to sleep.
She slept for several hours that day.
However when Roberts was taking her to the bathroom, the child stopped walking and got a seizure.
She was taken back to the same state-owned hospital, where a CT scan revealed that Wilson’s ventricles were large and pressure was building up in her head.
Doctors further indicated that the shunt appeared to be blocked, so Wilson had to undergo another surgery.
The mother said that asked a lot of questions and told the medical team of her daughter’s medical history.
She said she told them that the child had been through a lot and she urged them to take their time and examine her file carefully before “rushing” to do another surgery.
The mother further told iWitness News that she told the doctors that she would prefer if a particular doctor who had operated on Wilson before — who the mother described as “excellent” — performed the surgery.
However, the medical staff told them that that doctor was not on call and would not come in.
“So after an hour or so of asking them questions, I did sign the form and they went into surgery,” Roberts said.
After the surgery, Wilson was transferred to the critical care area on the paediatric surgical ward.
On Dec. 10, doctors ordered that Wilson be discharged although her blood pressure was high, as was the case when she was admitted.
The mother said she told the nurse she was not taking her daughter home in that condition, arguing that the high blood pressure was the reason for the seizure in the first place.
“So I refused to go home,” Roberts told iWitness News.
She said that doctor instructed another medical team to treat Wilson’s high blood pressure.
Roberts said this team was excellent, with the leader explaining to her the causes of high blood pressure and how the cause in Wilson’s case would be determined, through a series of tests.
The neurosurgical team came to dress the surgical wound on the same day.
They said that the wound was healing well.
“But remember I had already seen Jasemine with two other wounds before — the one from St. Vincent and the one from [the private hospital] and I know how the wound should heal,” Roberts told iWitness News.
She said the doctor at the private hospital had done “an excellent job of closing the wound and it was “so neat”.
“But when I saw the closure on the one (wound) at [the public hospital], I was not pleased. From the inception, I was not pleased with how the closure was done. The closure was very sloppy. It was like a child trying to sew something,” she said.
Roberts said that the outer bandage fell off Wilson’s wound overnight and the nurses replaced it and did so yet another time when it again fell off.
Wilson remained warded at the public hospital until Dec. 16, receiving medication for her HBP, which had begun to fall, though it remained higher than normal, Roberts said.
Around Dec. 12 or 13, the mother had noticed that the wound was oozing pus and brought this to the attention of the medical team, but more so between Dec. 14 and 16.
She said that on Dec. 15, when the hospital was again preparing to discharge Wilson, she told the nurse that the wound was oozing pus.
The mother said that she saw the pus on the sheets and called it to the attention of the nurse, adding that the neurosurgeon had told her that pus is an indication that something is wrong.
She said that it was Sunday and a junior neurosurgeon examined the wound and the following day, a senior staffer told her that Wilson was free to go home.
“I said to him, the wound is ‘pussing’; it is not healing.”
Roberts said that the doctors told her that the antibiotics that they would give to Wilson would take care of that.
However, that afternoon, Wilson was sleeping and the strips came off, exposing the wound itself.
The mother said she called the nurse who said she was going to dress the wound to discharge Wilson.
The woman said she expressed concern about the condition of the wound and used her cell phone to take a photo of it.
The nurse maintained that Wilson had been discharged but Roberts said she insisted that Wilson see a doctor before leaving the hospital.
When the nurse called, a doctor came, but the wound had already been bandaged.
Roberts showed the doctor the photo of the wound and the doctor said that the antibiotics would take care of it.
Roberts told iWitness News that the nurse asked the doctor if Wilson should be sent to another health facility near her home.
The doctor, however, said that was not necessary and said that Roberts should be given some gloves and saline to dress the wound.
Wilson was sent home on Dec. 16 and Roberts said she got a nurse to dress the wound daily at her home.
However, on Dec. 19, while dressing the wound, the nurse told them that something was wrong and Wilson should be taken back to the hospital.
Roberts took Wilson to another private facility because of the shorter wait time.
A doctor told her that the surgical wound was disintegrating and referred them to the public hospital, where they arrived around 2 p.m.
Roberts said that a neurosurgeon examined the wound and said that Wilson had to undergo another surgery.
“At that time, I was really upset and I became loud,” Roberts told iWitness News.
She said she told the neurosurgeon that before leaving the hospital she had begged them to look at the wound but no one bothered with her.
The mother further told the doctor that they were now coming again to ask her permission to allow “the same team of educated dunce, the same team that can’t think critically or analyse” to conduct another surgery.
Roberts told iWitness News the doctor was sympathetic, saying the hospital should have taken her complaints seriously.
The woman said she begged him to call another surgeon who had operated on the child before, but she was told that that doctor was off duty and had said he could not make it.
“I said to them, ‘You all want me to trust you all again with my daughter when you all messed up in the first place.’”
The woman said she asked to speak to senior personnel and she was referred to quality control, which, by that time — around 5 p.m. — was closed.
“I said to them, I am only signing this particular consent form because I have no other choice but I am not confident in you all… This could have been avoided.”
The mother said that after about two hours of discussions and deliberations she signed the form for her daughter’s fourth surgery.
After the surgery, on Dec. 20, the mother was told that the shunt was removed and the wound was closed at a different angle.
The surgeon further told her that the shunt was not blocked but that they had been concerned that the wound could have caused meningitis — an inflammation of the protective membranes covering the brain and spinal cord
The mother said that the surgeon further told her that they would monitor how Wilson’s body adjusts and if she began getting headaches, they would conduct another surgery and implant a temporary shunt to drain the fluid.
Sometime after 2 that morning, after having been moved from the recovery room, Wilson began making a snoring sound, as if she was congested.
The mother said she went twice to the doctor and asked him to check on Wilson, but the doctor said nothing was wrong.
Around 7 a.m., a nurse came and nebulised Wilson.
However, sometime later, Wilson began to drool a lot.
Roberts told iWitness News she went back to the nurse, having remembered that a doctor had told her that drooling is a sign that someone was becoming unresponsive.
The mother said she went to look for the nurse, but no nurse was at the station. The nurse later came and called the doctor, who examined Wilson.
Shortly after an ICU team came and the head of the team sternly asked what had happened to Wilson since the surgery but no one seemed able to explain, Roberts said.
The mother told iWitness News that the medical team tried about eight times to insert a breathing tube in Wilson’s throat.
“When I saw that, I became frantic and I began to cry…” Roberts said, adding that she was in the hallway when a doctor came to her.
“He said, ‘Mommy, Jasemine is really sick and normally I would never recommend moving a patient in this particular state but if we do not move her, she can die.’
“And he said, ‘She can die on the way moving from the ward going to the x-ray room doing a scan.’ He said, ‘Even during that particular part, she can die. She is really sick.’
“And he said, ‘Basically, there is nothing that we can do. But we have to do something.’”
Roberts told iWitness News that when Wilson was taken for the CT scan, doctors told her that her child would never be the same again.
“Basically, Jasemine will never be the same person. She may not be able to talk; she may not be able to whatever. But they said to me the most we can do now because the pressure in her head has gone up, we have to go in and we have to put in the temporary shunt.
“I said to them, I know my child. She would not want to live in this particular state. I began to cry and so forth. I cried, and I cried and I cried.”
The woman said that the doctors told her she had to sign the consent form so that a surgery – the fifth — could be conducted.
The scan had been done sometime after 10 p.m. and the doctors told Roberts she had to sign the consent form for the temporary shunt.
“I told her that the surgeon is telling us that it is not the build-up of pressure that is the problem. So why do you need to put in the external drainage.”
She said that the doctor told her that the liquid in her daughter’s head was not the problem and the shunt was to buy her some time.
“Listen to me; I was not going to sign at that particular time. They told me she was brain dead — she wouldn’t open her eyes. I wasn’t going to sign. I said, ‘Knowing her, she likes fight. So after consulting, after deliberating, I must be sign like after 11; 11-12, they went back in and they put in the temporary shunt.”
That was Dec. 21.
Roberts said her daughter was then taken to ICU and she (Roberts) was again told her daughter was really sick and would never be the same.
Wilson never regained consciousness after this surgery and remained in ICU for over a week until her death on Jan. 2.
Her mother told iWitness News that she does not want to disclose some of the things that took place there, because of her plans to take legal action.
She, however, said that one set of laboratory results had indicated, before Wilson’s death, that there were bacteria in her blood.
Roberts said that she hired a pathologist with some 30 years’ experience to witness the autopsy performed by the hospital’s medical team, on Jan. 7.
The mother did not disclose to iWitness News what the pathologist told her was the most likely cause of death, because she was considering legal action.
Roberts told iWitness News that she signed for the death certificate attaching to it a letter saying that she did so only to move the process along and not in acceptance of its content.
Wilson’s body has been released to her mother, who is making plans to have it returned to St. Vincent for burial.