Timeline on the VJH babies' death events
TIMELINE ON THE VJH BABIES' DEATH EVENTS
1. In his address to midwives, senior medical officer at the Victoria Jubilee Hospital (VJH), Dr Orville Morgan, raised concerns over the high rate of stillbirths at the island's major maternity institution.
2. Dr Morgan called on the midwives to lead research in determining the cause of the high level of stillbirths.
3. Ten newborn babies died - VJH report.
4. Two infants confirmed with Group B Streptococcus (GBS) infections successfully treated and sent home.
5. Sixteen newborn babies died - VJH report.
6. Four of five cases of infant deaths occurred within two days after birth (range seven hours - two days) - Tufton committee report.
7. Findings in keeping with Group B Streptococcus (GBS) - Tufton committee report.
8. Committee said GBS transmission mode is from mother to infant, as opposed to being from health care facility associated infection.
9. The GBS status of the mothers delivering at VJH, especially mothers with premature labour, those with a history of recent vaginal discharge at least four weeks prior to delivery, and those with recent history of urinary tract infection was UNKNOWN - VJH report.
10. All cases of early neonatal deaths list the primary source of transmission as from mother to child.
11. The microbe can survive outside the body for up to seven days - VJH report
12. Overcrowding in both the nursery and on the Labour Ward at VJH - VJH report
13. Concerns raised about the impact of repeated vaginal examinations on the risk of transmission of GBS infection to the newborns - VJH report.
14. Both the VJH and Tufton Committee reports list identical cases where the infections and deaths occurred
15. Sunday Gleaner broke story on October 9 of babies dying from bacterial infection at VJH.
16. Health Minister Dr Christopher Tufton said he did not know of the deaths.
17. Tufton sets up committee and orders investigation.
18. Four days later, on October 13, the minister announces findings at a press conference.
19. Health ministry acknowledged that four babies died.
20. No mention of the VJH report and the 26 babies who died.
VJH REPORT RECOMMENDATIONS
21. Do spot environmental sampling in the VJH delivery ward.
22. Swab cots and beds where patients are housed, especially on surfaces that are touched often.
23. Limit swabbing to 10-15 swabs.
24. Conduct thorough terminal clean of delivery suite(s) and post-delivery suites, as per protocols.
25. Swab mothers between 35 and 37 weeks. Take one swab of vagina (vaginal introitus), and one of rectum (insert swab through the anal sphincter)
26. Clearly indicate by label mother's response to penicillin.
27. Request susceptibility testing for Clindamycin and Erythromycin
28. Routine hand hygiene by health care professionals caring for infants colonised or, infected with GBS is the best way to prevent the spread to other infants (2009 Report of the Committee on Infectious Diseases, Red Book, AAP).