A state review has found that 7 of the 11 stillbirths that occurred during the 2013-2014 period could have been avoided.
These deaths occurred at the Djerriwarrh Heath Services at the Bacchus Marsh and Melton Regional Hospitals.
In 2013 and 2014 there where a higher than expected number of stillbirths and newborn deaths in the Djerriwarrh Health Service. In 2013, there were seven stillbirths and newborn deaths at Djerriwarrh, and in 2014, there were three stillbirths and newborn deaths. In a review of these cases conducted by Professor Euan Wallace Director of Obstetrics and Gynaecology Services at Monash Health has found that five of the deaths in 2013 and two in 2014 may have been avoidable.
Victorian Health Minister Jill Hennessey described the events at the health service as a ‘series of catastrophic failures’ and promised full support to the affected families.
An investigation has been launched into an undisclosed number of doctors and midwives employed at the Djerriwarrh Health Service including the former head of obstetrics and gynaecology, Surindar Parhar. It was through this complaint that the number of deaths was identified as being higher than expected.
The Australian Health Practitioners Registration Agency had conducted an investigation into Dr Parhar after a complaint from another doctor in 2013.
During the investigation that endured delays in its findings, Dr Parhar was still employed. By the time he was advised of the restrictions that were to be placed on him Dr Parhar had left the hospital. Dr Parhar did not renew his licence to practice medicine, and his name was struck off the register recently when the renewal expired. There is no direct link between Dr Parhar and all of the deaths.
In findings of the review conducted by Professor Wallace, it was found that the perinatal mortality rate at the hospital was ‘significantly higher than the state average and much higher than you would expect at a ‘Low risk’ unit.” It was also said that the hospital ‘lacked high-quality education’ and staff were ‘inadequately skilled’ in monitoring fetal heart rates.
Lisa Fitzpatrick (Australian Nurses and Midwifery Federation Victoria secretary) indicated that midwives had raised concerns over practices at the hospital and further claims that these concerns were not listened to.
“Staff are very distressed and disturbed at what’s happened, and they’re also relieved because we know our members here have been raising concerns about clinical risk, and we passed those concerns onto the previous hospital’s executive,” she said.
Health Minister Jill Hennesey sacked the Djerriwarrh board after becoming aware of the infant deaths and appointed a new delegate, John Ballard.
“We are putting in place measures to ensure that the present and future safety of the health services and maternity services are in place and, importantly, providing support to staff.” Mr Ballard said.
For some families affected by this it has been over two and a half years since they endured the initial tragedy of losing a baby. “There is nothing that will ever mend the loss of losing a child” Hennesey said, “To learn that the death may have been avoidable, but for a series of system failures, can only compound that loss and pain.”
The families in all cases have been contacted over concerns over their child’s death.
Two families have contacted the firm Maurice Balckburn Lawyers about the deaths of their babies. Slater and Gordon are also working on two potential compensation claims with two affected families.
“It is now evident that Djerriwarrh failed to adjust or update its practices in recent years.” Ms Hennesey said.
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