She was referred to Southland Hospital,<\/a> where she had an ultrasound that confirmed the baby had died. She underwent an emergency c-section to deliver her stillborn son.<\/p>\nShe told the HDC that after the loss of her baby she was told she would be seen in the antenatal clinic at Southland Hospital in six months, for a debrief with clinical staff once the autopsy results had been received.<\/p>\n
Despite this, nine months later she had not received a follow-up appointment.<\/p>\n
Health NZ said it sincerely apologised for the delay in arranging a follow-up appointment and that the service had been under immense pressure and had been challenged by long waiting lists.<\/p>\n
\u2018Learnings that can be taken from our experience\u2019<\/p>\n
The woman told the HDC that there were learnings Health NZ needed to take from their experience.<\/p>\n
\u201cWe understand that as humans we all make mistakes and that in order to progress, we need to own it, fix it and learn from it,\u201d she said. <\/p>\n
\u201cAlthough there is nothing that can be done to fix losing our precious son, there are learnings that can be taken from our experience, to help improve our health system for other expecting mothers.<\/p>\n
\u201cWe left the hospital that day feeling dismissed, not listened to and feeling really uneasy about the situation.\u201d<\/p>\n
Deputy Health and Disability Commissioner Rose Wall said several factors contributed to the shortcomings of the woman\u2019s care.<\/p>\n
![\"Deputy]()
Deputy Health and Disability Commissioner Rose Wall.<\/p>\n
\u201cI consider that these shortcomings represent systemic failures for which ultimately Health NZ is responsible at an organisational level.\u201d<\/p>\n
Wall found Health NZ in breach of the Code of Health and Disability Services Consumers\u2019 Rights for failing to provide the woman with reasonable care and skill through failing to appropriately manage abnormal ultrasound findings and IUGR.<\/p>\n
\u201cSouthland Hospital did not undertake an adverse event review after the stillbirth of [the baby]. In my opinion, this was a valuable opportunity for its obstetric service to learn from this episode and make the necessary changes to its systems and processes to help prevent a repeat of [the couple\u2019s] tragic loss.\u201d<\/p>\n
\u2018Deeply sorry\u2019<\/p>\n
David Gow, Health New Zealand Chief Medical Officer \u2013 Southern and Te Waipounamu, said the organisation was deeply sorry for the distress caused and recognised \u201cthe profound long-lasting impact\u201d.<\/p>\n
He acknowledged the Commissioner\u2019s findings and had apologised to the family during an in-person meeting earlier this year.<\/p>\n
\u201cWe have also made significant improvements to our obstetrics services since this tragic event by introducing robust administration and workforce improvements, including recruitment to a full team of eight consultants.<\/p>\n
\u201cWe only now use regular locum staff, who are very familiar with our service, and these staff are supported by a locum induction and orientation guide that has been established with the assistance of a regular highly-experienced locum.\u201d<\/p>\n
Steps had been taken to improve communications with patients who experience loss, including the implementation of a separate wait list to arrange follow-up appointments with clinical staff in a timely manner, he said.<\/p>\n
The Commissioner recommended Health NZ provide an update to HDC on the effectiveness of the changes it has made to its obstetric service within three months of the date of the report.<\/p>\n
Brianna McIlraith is a Queenstown-based reporter for Open Justice covering courts in the lower South Island. She has been a journalist since 2018 and has had a strong interest in business and financial journalism.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cWe had finally been able to see a specialist after delays, I just wish it was someone who…\n","protected":false},"author":2,"featured_media":478018,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[6794,12513,11424,11423,2241,111,43,139,69,2247,15488,108816,6736,17454,1354],"class_list":["post-478017","post","type-post","status-publish","format-standard","has-post-thumbnail","category-new-zealand","tag-baby","tag-failed","tag-finds","tag-hdc","tag-hospital","tag-new-zealand","tag-news","tag-newzealand","tag-nz","tag-pregnant","tag-southland","tag-stillborn","tag-was","tag-whose","tag-woman"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/478017","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=478017"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/478017\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/478018"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=478017"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=478017"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=478017"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}