Hospital officials cleared in death of nine infants

Officials of the Rizal Medical Center (RMC) in Pasig City were cleared of responsibility for the death of nine infants from neo-natal sepsis, or blood infection, two weeks ago, Health Secretary Francisco Duque III said yesterday.

In a press briefing, Duque also noted similar findings on the cases of six other infants who developed sepsis, but survived.

Duque said the fact-finding committee created to probe the incident and experts from the National Epidemiology Center (NEC) of the Department of Health (DOH) found that the babies got the infection not from the hospital, but from their mothers.

"The newborns got ill with difficulty of breathing, poor suck and fever within 90 hours after delivery. This suggests that mother-to-child transmission has occurred even before the delivery," the health chief said.

He said the power outage at the hospital caused by typhoon Milenyo had "no bearing" on the sepsis incidents.

"FFC (fact-finding committee) and NEC searched for hospital factors that can explain this occurrence, however remote. Both the FFC and NEC were unable to link contaminated hospital equipment to the outbreak (of newborn sepsis)," Duque added.

The officials cleared by the committee are RMC medical director Winston Go, chief of clinics Dr. Bernardita Javier, chief nurse Louise Marie Flores, administrative officer Buddy Ortego and the supervising nurse at the delivery room.

Duque, however, maintained that RMC officials are "not yet off the hook" because the teams discovered that neo-natal sepsis cases at the RMC had significantly increased this year.

The fact-finding committee was composed of Dr. Riego Javier, deputy executive director for medical services at the National Kidney Transplant Institute; Dr. Gener Becina, chair of the department of pediatrics at the National Children’s Hospital; Dr. Virgilio Castro, chair of perinatal committee at the University of Sto.Tomas; Dr. Abelardo Alera, chair of the infection control committee at the San Lazaro Hospital; and Ma. Carmen Buenaflor, hospital infection control officer at the Philippine Heart Center.

The committee was created after 15 of the 28 infants born at RMC last Oct. 4 developed sepsis. Eventually, nine of them — two of whom were also premature — died of infection.

NEC director Dr. Eric Tayag clarified that the symptoms of mother-acquired infection manifest right after birth up to six days.

"This is aptly called ‘early onset sepsis,’" Tayag explained.

If the infection was acquired from the hospital, the babies should have exhibited the illness seven days after delivery.

He said some "risk factors for sepsis" were already present among many mothers when they delivered their babies. These were prematurity, low birth weight and other obstetric complications.

The health conditions of many of the mothers had made it risky to deliver babies. They had fever, urinary tract infection or upper respiratory tract infection and some do not undergo proper pre-natal care.

‘Not yet off the hook’

Records showed that from Jan. 1 to Oct. 15, 2005, the prevalence rate of neo-natal sepsis at RMC was 14.4 per 1,000 or 83 cases while the case fatality rate (CFR) for this condition was 7.8 per 1,000 or 45 cases.

During the same period this year, the prevalence rate was 32.3 per 1,000 or 127 cases while the CFR is 7.6 per 1,000 or 69 cases.

"The increase in incidence and mortality rate of newborn sepsis at RMC this year compared to last year is alarming and should have alerted hospital officials to impose corrective actions," Duque said.

He added that the DOH legal service would conduct a formal inquiry in the wake of this new development.

If the concerned officials are found liable, they will face administrative charges.

When the investigation started, Duque asked the officials to go on leave. The DOH will now determine whether the officials will have to extend their vacation or transfer to other hospitals.

"The increase is pronounced. That point to some degrees of negligence perhaps. They should have improved maternal care at the hospital ..... The hospital staff may have fallen short to exercise the highest standard of care to prevent the outbreak even if this was not hospital-acquired," he said. — Sheila Crisostomo