dated 3rd june 2008
Dear Ms Fairchild.
I am writing to you in response to your letter dated 15th may 2008 regarding the treatment you recieved at Torbay Hospital on 6th may 2008.
May i first convey my condonlences to you for the loss of your baby. I appreciate that this has been a very distressing and traumatic time for you. I also appreciate that waiting for a response to your letter has been very upsettingfor you and may have contributed to you not being able to come to termswith your loss and grief. I am very sorry it has taken time to speak to all the staff involved . This was complicated by the Doctor who saw you in A&E being on night duty and then being unable , due to an emergency , to keep her origional appointment with Karen McMahon, matron , who led our investigation. The delay was further compounded by the fact Karen McMahon was unavoidably not available , for personal reaasons , to assist with the investigation. Having now completed a full investigationi am in a position to reply to your letter. I have tried to cover the the issues that you have raised in the order that they appear in your letter.
Our records confirm that on the 6th may you came to the Accident and Emergency department and checked in at reception desk and were asked to take a seat. It is normal practice to ask patients to wait in the waiting room whilst reception informs the nursing staff and medical team that you have arrived. Unfortunatly , you started to bleed more heavily and when you informed recepption of this fact they quite appropiately asked you to gostraight through to the nurses station. The nurse immediately took you to a room where the doctor could see you.
(Gets disturbing from here )
It is Recorded in your notes that you were bleeding very heavily and passed blood and clots when you went to the toilet. The doctor who examined the products you had passed did put them into a glass specimen jar and bring them back into the room you were in . This is not normal practice . This was because she was unsure about the procedure to follow when a miscarriage happens in A&E and did not know where else in the department the jar could have been left safely. This point has been discussed in detail with the doctor who has acknowledged the distress this would have caused you and that to show you the jar was inappropiate and insensitive, She is very sorry about this and has asked that i convey her sincere apologies to you about this.
She did at this point want to examine you to ensure the bleeding was settling and you asked that your partner return first. The doctor left for a short while and when she returned you had explained to your partner what happened and i understand that he had seen the jar.
It is normal practice to take the products away and label them as sensitive specimen. This would be sent to the Laboratory to confirm they are products of conception. They are then kept for one month and following a short religious servicewould go to Torquay Crematorium. This process is normally discussed with the parents. I am very sorry that this did not happen. It has been identified as an area to be highlighted at the doctors training session and the next team meeting. This will ensure that all staff are reminded of the correct procedure and how important it is to be sensitive to parents who are suffering pregnancy loss.
I can confirm that your sensitive specimen was sent to the histopathology laboratory were they confirmed products of conception. but no foetal parts were identified . When a pregnancy is 7 weeks , as yours was , they foetus is very small. The scan you had on 1st may 2008 showed that it measured 9mm. It is possible that you passed it when your bleeding started . The gestation sac and the placenta and membranes would look as described and this is what you saw in the jar.
We are very aware that the A&E is not the ideal place to examine any woman who is having a miscarriage. Ideally , we would transfer you on arrival to the gynaecology ward where staff are particularly aware of women's need for privacy and sensitivity. Unfortunately , when you were admitted there were no beds availableon the gynaecology ward. We are trying to prevent this experiencehappening to anyone else and plan to make a designated room available on McCallum ward which can be used for women who may be miscarrying.
We do strive to give care of a high standard and are deeply saddened when this does not happen . We appreciate your comments and take all complaints seriously as it is through feedback such as yours that we get a full picture of patients experience and this , in turn , enables us to identify service improvements for the future.
I am very sorry that your miscarriage was such a distressing experience for you and appreciate that we could have helped to make this heartbreaking experience less traumatic for you . Please accept my deepest apologiers. I recognise that this letterr may not answr all your questions and if you want to meet with senior clinical staff to discuss this letter and your care please contact the matron for McCallum ward , Karen McMahon on .....................
As you may be aware your MP, Mr Adrian Sanders , has written to us about your case. I am therefore sending him a copy of this letter .
Sincerely
Acting Chief Executive