A national neonatal transfer protocol was implemented in TT in 2020 by the Health Ministry’s directorate of women’s health.
The policy came three years after the creation of the National Neonatal Committee, which assists the Maternal, Neonatal and Child Health Committee “in advancing this nation’s agenda of neonatal and perinatal health, in keeping with the sustainable developmental goal targets for 2030 and the sustainable health agenda for the Americas.”
In the recent incident at the Port of Spain General Hospital’s Neonatal Intensive Care Unit (NICU), seven babies died from late-onset neonatal sepsis following a bacterial outbreak between April 4-9.
The Pan American Health Organization's (PAHO) website says sepsis is a complication that arises "when the human body mounts an indiscriminate, and overt, response to an infection."
It adds that this is a medical emergency which can lead to irreversible tissue damage, septic shock, multiple organ failure and death.
Lab tests found three main types of bacteria: Serratia Marcescens, ESBL Klebsiella pneumoniae, and Klebsiella aerogenes at the NICU.
In a press release on April 11, the North West Regional Health Authority (NWRHA) said the deaths happened between April 4-9, during which it "observed a rapid deterioration in several neonates."
The families of the babies have since taken legal action, and investigations are underway.
Four other babies died between February and March, but the NWRHA said on April 19 that those deaths were not connected to the bacterial outbreak.
It said the unit is "operating in accordance with established standards."
The national neonatal transfer protocol outlines that neonates (newborns) suspected of having sepsis or as confirmed to have it must be transferred to the NICU by a paediatrician who should indicate what antibiotics and doses of same were administered.
It adds that if blood cultures were taken, the referring paediatrician or team should provide contact details for the laboratory where the sample is being processed, or bring the specimens to the NICU.
In addition to this, the staff members accepting those babies must wear the appropriate level of PPE as outlined in the ministry’s Manual of Infection Prevention and Control Policies and Guidelines.
That guideline says proper PPE includes gloves, gowns, waterproof aprons, goggles or facial shields (eye, nose mouth protection), and masks and respirators with particle filters (nasal and mouth protection).
The national neonatal transfer policy adds, “Transfer of patients with contagious or viral diseases of unknown transmissibility from newborns to adults must be done in a transport incubator with the minimal standards as indicated in this document. This applies to all SARS-CoV-2 (covid19) positive neonates, infants born to suspected or confirmed SARS-CoV-2 positive mothers.”
The accounts given by parents of babies who died at the NICU, in legal letters to the NWRHA, claim the authority failed to provide a clean, safe, and sanitised environment and failed
