Parallel pathway issue - doctor recalls watching pregnant woman die

An anesthesiology and critical care specialist recalled the pain of watching a pregnant woman lose her life because the cardiothoracic surgeon could not attend to her in time.

Dr Abdul Jabbar Ismail revealed that the incident, which occurred when he was serving in a government hospital in Sabah, left him with post-traumatic stress disorder (PTSD).

He was responding to a comment on social media regarding the debate over a suggestion for Universiti Teknologi Mara (UiTM) to open its cardiothoracic surgery postgraduate training programme to non-bumiputera trainees.

This was proposed as a solution to the issue of graduates who obtained qualifications in that speciality from overseas institutions not being recognised locally.

Speaking to Malaysiakini, Jabbar revealed that the deceased was seven months pregnant.

In his post, the doctor, who now teaches at Universiti Malaysia Sabah, said his hands are “shaking” because of “flashbacks” of the incident.

“I have witnessed many, many deaths simply because of no cardiothoracic surgeons.

“The most significant case that gave me PTSD trauma was a young pregnant lady with ascending aorta dissection and decompensated heart failure due to severe mitral regurgitation.”

There are currently two cardiothoracic surgeons practising in Sabah, one in Hospital Queen Elizabeth II and another in the private hospital Gleneagles.

Transferring patients from public to private hospitals involves a lengthy bureaucratic process, especially if the patient is not covered by insurance.

In this case, Jabbar said the patient was stable enough to be transferred from a district hospital to Kota Kinabalu and was maintaining well in the ICU, waiting for the cardiothoracic surgeon to complete another life-saving operation.

“Stable enough to be transported from district to my ICU, maintained well in ICU waiting for that one cardiothoracic surgeon to finish saving the life of another aortic dissection patient.

“But unfortunately unable to maintain her stable condition long enough to reach her turn for emergency corrective surgery when her heart stopped and I had to do CPR for hours cause I refused to give up… which in the end had to let go,” he said.

Imagine if it’s your wife, husband, or child

Jabbar said after the incident, the question “What if we had enough cardiothoracic surgeons?” continued to linger in his mind.

“Only if we had just one more cardiothoracic surgeon.

“(But) it’s all in the past… It’s all ‘if’... and imagine I had to break the bad news to the husband.

“Imagine saying cardiothoracic surgeons (are) not important and the patient is your own wife or husband or child?” he added.

Jabbar was responding to another post which downplayed the importance of cardiothoracic surgeons.

A search on the National Specialists Registry revealed that 88 doctors have listed cardiothoracic surgery as their first or second speciality. - Mkini