THE PROFESSIONAL COMMITTEE CONCLUDED FV HOSPITAL HAS NO PROFESSIONAL ERRORS; NO VIOLATIONS OF MEDICAL EXAMINATION AND TREATMENT.

Regarding the case of the pregnant woman HAH (residing in District 7, Ho Chi Minh City) recently sent an appeal about her childbirth at FV Hospital (May 2021), on 10^th March 2022. FV has held a meeting with the Professional Committee including participation of independent obstetricians in Ho Chi Minh City to arrive at an accurate and objective conclusion concerning the case. FV have now resolved the complaint of Ms H, provided a comprehensive report to the Health Department (HCMC), as well as provided timely information to the media to assist the full understanding of the incident so they can report the complaint accurately.

The conclusion from this meeting will help Ms H and her family have a full understanding of the expertise, ethics, efforts and responsibility of the FV medical team and doctor’s involvement in the case. Additionally, it will assist our medical staff and doctors find contentment in their work following the many articles reported that have been one-side, that have caused significant mental distress to the leadership team, doctors, and medical staff over the past few days.

The Professional Council meeting took place on the 10^th March 2022 at FV Hospital with the participation of Independent Obstetricians in Ho Chi Minh City, FV Hospital Director and Deputy Medical Director of and representatives of relevant departments. After comprehensively reviewing the medical examination, treatment and obstetric care; and questioning relevant doctors; the Professional Council concluded:

1. FV Hospital and Dr Vo Trieu Dat did not violate the medical examination and treatment regulations, and did not make any professional errors.
2. The indication for induction of labour on request after the patient’s 39th week was appropriate, especially in the context of the Covid-19 epidemic.
3. Dr Vo Trieu Dat undertook the C-section in time.
4. FV Hospital promptly diagnosed the postpartum haemorrhage and acted appropriately to save the life of the patient. This complication can occur during any birth often with fatal outcome even in country with advanced healthcare provision.
5. Dr Vo Trieu Dat has monitored the patient’s post-partum for more than 2 months (6 weeks postpartum) and the patient has completely recovered.

Thus, it can be confirmed that FV Hospital did not violate the medical examination and treatment regulations, and there were no professional errors in the care of Ms H.A.H during the delivery of her child. 

FV Hospital hopes that Ms H and her family will calmly review and recognise with an objective, and accurate approach recognising the responsibility, efforts and expertise of the medical team who provided her care; We wish to emphasise the doctors who provided timely medical intervention that was appropriate, saved the life of Ms H as well as preserved the uterus to retain fertility. Therefore, the information in some newspapers that Ms H “lost her ability to have children” is inaccurate false assertion. 

FV Hospital hopes that the media organisations who have published one-sided and inaccurate reports will urgently retract the articles and remove them from their website and social media channels, as that are damaging to FV reputation and the mental health of the medical team.

It is regrettable that some organisations have reported one side, inaccurate and hasty articles without cooperation of FH Hospital. Should the correct retraction not be forthcoming FV will raise a complaint to the governing body of the press and media management agencies. If required, FV Hospital shall initiate legal measures to protect the legitimate rights and interests of the hospital as our medical team.

In order for the media to have more objective detailed information about the case of Ms H we summarise the case as follows:

Obstetric Care of Ms H.A.H at FV Hospital from 14 May to 25 May 2021: Dr Vo Trieu Dat provided care to Ms H during her entire pregnancy However, at the time Ms H was admitted to the hospital for delivery, Dr Dat was unavailable as he was performing another delivery. Dr Nam was a doctor on duty at the Obstetrics and Gynaecology Department at that time. He accompanied the midwife to examine and provide care to Ms H. The midwife continuously closely monitored Ms H labour process following all correct procedures. She regularly provided updates of progress to Dr Dat in the delivery room. The fact that painful uterine contractions and rupture of membranes is a common phenomenon after the induction of labour. According to the procedure, the midwife will monitor until the cervix is ​​dilated 3-4 cm; at this point the doctor will take over the care in the delivery room. In the case of Ms H, the midwives observed signs of foetal distress on the foetal heart rate and contractions (CTG) chart, when the cervix was on dilated 2 cm, that was reported to Dr Dat who recognised the need for an emergency C-section. The C-section went well and the baby was born in a healthy condition.

Postpartum haemorrhage due to cervical induration is an obstetric complication that can occur after giving birth as the uterus cannot contract after the baby is born causing bleeding. This occurred in Ms H case. The doctor performed an arterial ligation procedure and transfused a large amount of blood for Ms H. to save her life, save the uterus to maintain her fertility. The assertation that it was “impossible to have more children” was incorrect.

Ms H was monitored in the Intensive Care Unit (ICU) and then in the High Dependency Unit (HDU). The loss of a large amount of blood led to haemorrhagic shock, causing acute kidney failure. Dr Dat sought the opinion of Dr Binh (Internal Medicine specialist) Dr Binh diagnosed acute pyelonephritis requiring 14-day course of anti-biotic and hospitalisation. Dr Binh’s diagnosis was based on the history of multi-resistant urinary tract infection 4 month before and the use of a catheter. However, Ms H refused treatment and was discharged the following day. Dr Binh has worked at FV for many years and we fully believe in his professionalism and honesty. Dr Binh may have been overly concerned, but we believe that he was correct and honest in his recommendations and treatment plan for Ms H We have written to and responded to all of Ms H’s questions and apologised if the doctor’s suggestion upset her.

Ms H. continued to have regular post-natal follow-up with Dr Dat is in good health. Approximately 4 months after giving birth, Ms H and her husband brought their child to see Dr Dat to thank him. At that time, Ms H confided that during the time of birth, Ms H received negative information and comments about FV Hospital from a friend, she believes this negatively affected and confused her and had complained about the hospital services. Ms H then apologised to Dr Dat.

Regarding the treatment of burns on the left hand of Ms H’s son:

– On 31^st December 2021, at 16:26, Ms H and her husband brought their son to the FV Hospital Emergency Department, for treatment of a hot water burn. 4 minutes later at 16:30 (the report of “more than 1 hour later” is inaccurate), Dr Dieu Paediatrician on duty), examined the burns, that were not serious and the doctor has classified the burn as 1st degree with some places at 2nd degree. The care plan for the baby recommend:

• Clean the burn with 0.9% sodium chloride isotonic solution
• Bandage each finger separately with gauze and apply Silvirin 1% cream (Silver sulfadiazine)
• Paracetamol for pain relief
• Alphachymotrypsine medicine

– According to the hospital regulations, any paediatric patient under 3 years old must be examined by a paediatrician. For burn patients, depending on the severity of the burn, the opinion of a burn specialist, surgeon or emergency doctor is sought. In this case, due to the low severity slight burn, Dr Dieu could sufficiently manage the case.

– Dr Dieu requested that the child should return daily for dressing change, and re-examined with Doctor Dieu four days later at the Outpatient Clinic. However, the family did not bring the baby back to FV hospital until 25 January 2022 (after more than 3 weeks) when he was examined by Dr Xuan Anh due to vomiting for 3 weeks. At this point the burn has fully healed. Dr Xuan Anh advised Ms H. to take the baby to the Children’s Hospital for an intensive examination of the baby’s digestive problems as the baby’s digestive problems were not related to the burns or the wound treatment.

– However, it seems that someone told Ms H family that Alphachymotrypsine can cause stomach ulcers in children and the family believed this was the cause of the child’s persistent vomiting, to which Ms H returned to FV, claiming that Dr Dieu had prescribed the wrong medicine to treat burns.

– On 11 February 2022, the family met with the Deputy Medical Director who confirmed that this medicine cannot be the cause of the baby’s vomiting problem. This medication is used in Vietnam to treat inflammation, reduce swelling after burns and has no contraindications for use in children.

– On 15^th February 2022, a Medical Review meeting was held to review the treatment provided for the child, the participants included the Head of Paediatric Department, two Doctors of Paediatrics Department, Head of Emergency Department, Hand Surgeon, Medical Director and Deputy Medical Director. The meeting concluded as follows:

• It is correct to ask a paediatrician to examine a paediatric patient following the hospital regulations, children less than 3 years must be examined by a paediatrician.
• Second degree burns in a small area, do not require a burn specialist and can be treated by a doctor of Emergency Department, Doctor of Paediatrics, Doctor of Hand Surgery Department.
• Alphachymotrypsine is prescribed to reduce inflammation so prescribing it for 2nd degree burns is not a mistake, although its effectiveness may be low. This medicine is not contraindicated for children and no side effect of vomiting or stomach ulcers is known.

– On 17 February 2022, the family had a meeting with the Medical Director, who explained to the family the conclusion of the meeting. It is important that the child had previous vomiting and reflux problems in the past (May 2021), the provisional diagnosis was gastroesophageal reflux disease, despite no further examination added because the baby’s condition has improved as noted by the doctor during the examination visit on 29^th October 2021. Therefore, we strongly recommend the family to have a full examination for the baby on this protracted vomiting problem.

– In summary, we are very sorry that the family felt that the treatment for the baby was not appropriate, but we assert the treatment was correct with no shortcomings. It is regrettable the family have been given wrong information about the side effects of Alphachymotrypsine. In this case the treatment worked well. The use of this drug is highly unlikely to cause adverse effect to the digestive system. We provided Ms H and her husband a written explanation and advised them to take their son to have a thorough examination concerning his digestive problems.

To review the treatment of Ms H.’s son objectively, FV Hospital established a Professional Committee with the participation of burn specialists and paediatric gastroenterologists from the leading paediatric hospital. On 8^th March 2022, the Committee met, questioned the treating doctors and concluded:

– The process of handling burns and the treatment are appropriate: the diagnosis and treatment of second-degree burns, the area of ​​2.5% in the baby’s hand position according to the prescription of the treating doctor and how to handle it is completely reasonable, following the correct standard and protocol.

– The prescribed medication is correct with the right dose. All medications prescribed that are not associated with or trigger an attack of GERD

– The process of receiving and treating patients did not violate medical examination and treatment regulations, without professional and technical errors.

As stated above, once again, FV Hospital affirms that the hospital made no professional errors in both during the pregnancy of Ms H as well as in the process of treating burn for her son.

Once again, we hope that the editorial board of the news organisations that have reported inaccurate and biased articles about the above case will revise the title and content of the articles for the sake of accuracy and honesty, following the conclusion of the Professional Committee meeting on the 10^th March 2022 at FV Hospital. 

Sincerely,