- 03-09-2006, 10:17 PM #1Registered User
- Join Date
- Dec 2003
- Sai Kung
I'd like to share our atrocious experience at Baptist hospital, which was a real eye-opener into the under-regulation and poor state of medical ethics among private hospitals in Hong Kong.
I'll deal with medical issues here, and save our experiences with the accounting staff for another post.
While we have no complaint with the services provided by the maternity nurses, who were by and large professional and attentive, we witnessed incompetence and poor ethics on the part of doctors and senior medical staff serious enough to give pause to anyone considering giving birth at Baptist.
In short, the obstetrics medical staff at Baptist rushed through the delivery procedure, falsified the APGAR score for our child at birth, and then lied about the profound cyanosis that appeared in our baby.
Late on February 4th, my wife went into labour and I brought her into hospital. She was admitted more or less without delay. The obstetric nurse examined her and determined that she had dilated to 3cm. Upon discussion with the nurse my wife, who was in considerable pain, requested a Caesarean.
Dr Liu arrived about 10 minutes later. He examined my wife and determined that she had dilated to 7cm – astoundingly fast, one might say. Dr Liu, his eyes bloodshot, also told me that he had been awake for 40 hours straight without rest.
My wife expressed a desire for a Caesarean. Dr Liu then said that the operating theatre was occupied with another pregnancy involving fetal distress, and that labour was perhaps too far along to allow waiting for the operating theatre to be free.
Not two minutes later, Dr Liu then pronounced my wife “fully dilated” and we consented to begin delivery. I was present in the delivery room. Within another five minutes or so, Dr Liu then said a vacuum delivery would be necessary. He made no attempt to coax my wife through natural labour.
It was difficult to tell whether his choice was made to spare my wife pain, or simply to expedite the procedure. He hurriedly inserted the vacuum device and began extracting the baby. Once the baby’s head emerged, one could see that the umbilical chord was around the baby’s neck. Dr Liu immediately clamped the umbilical chord, rather than waiting for a minute or two as good practice would demand, while most of the baby was still in the birth canal, and asked me if I wanted to cut the chord.
I asked him to wait longer before clamping the umbilical chord. He looked at me like my request was bizarre, and ignored it.
When the baby emerged, it was not clear to me whether she was breathing. It was at least three or four minutes before a nurse had completely aspirated the baby with tubes and she began to cry. By this time, however, profound cyanosis (where the skin turns blue) was evident on the baby’s face, lips and extremities. Dr Liu, who appeared shaken, explained that the baby “was cold”. After another four or five minutes the paediatrician arrived. The cyanosis was still abundantly clear, although it had begun to fade from the baby’s face.
The cyanosis in the extremities was still plain when the baby was moved to incubation several minutes later. Although I am not a doctor, I was also of the opinion that the cyanosis was at least partly the result of anoxia.
After my wife was settled in her room and I returned home early Sunday morning, I faxed Dr Liu a list of questions about the delivery. Later on Sunday, I spoke to the paediatrician, Dr Ma, when he came in to talk with my wife. As I had not yet heard from Dr Liu, I asked him about the baby’s APGAR score. I was astonished when he replied that the baby was given a “10”.
I told him that this was impossible, and that the score should be amended to reflect the truth. Cyanosis alone would require a score reduction, as would the delayed respiration – both of which I witnessed with my own eyes at one minute after birth. Also impossible would be a full “grimace” score, as the baby had no noticeable reaction until at least three minutes after birth.
Even the five-minute APGAR score could not possibly have been 10, given the cyanosis, which persisted at least until the baby left for incubation 15 or 20 minutes after birth.
Later that day I ran into Dr Liu. He told me he had not seen my fax. I told him of my concerns. He told me it was “a question of practice” and that “in Hong Kong, we always clamp the umbilical chord immediately after birth.” He said he had delivered 300 babies in “exactly the same way, with no problems.”
On Monday, Dr Liu visited my wife’s room. He asked me “do I still have to reply to your fax?” He also told me that the APGAR score was a “subjective” matter, and that I should not be so “square”. I replied that APGAR was not at all subjective, but was in fact intended to be as objective as possible, and that falsification of it was a serious ethical transgression.
“Outcomes are all that matter,” Dr Liu told me, “and the baby is fine, isn’t she?” I replied that that the consequences of anoxia may not be evident for months, and that if she exhibited learning disabilities or developmental delay, I would be certainly be thinking of what happened at birth..
He replied: “Are you going to blame me if the baby comes in second in her class instead of first?”
I wrote a detailed complaint to Baptist February 10. A month later, the hospital services manager, claiming to have conducted a "thorough investigation", presented an appalling concoction of distortions about the delivery and the events leading to it, and essentially denied that any cyanosis had occured.
Hence, I'm off to to the Medical Council, with limited expectations given the "self-regulated" nature of Hong Kong's private medical system. Nonetheless, I will be shouting from the rooftops about what I saw at Baptist.
- 03-09-2006, 10:44 PM #2
Richard -- best wishes to you.
I would have to say that you really should not get much hope up when dealing with the Medical Council. They have turned cover ups into an art form.
Having said that, see if you can get a good reporter at the SCMP who would be willing to follow up on this issue.
Last edited by shri; 03-09-2006 at 10:50 PM.
- 03-10-2006, 09:08 AM #3Registered User
- Join Date
- Feb 2006
Richard- my heart goes out to you and your family.
I was appaled by what you had just written about your experience with Baptist Hospital. Patients in hospitals should be treated with as much care as is required and due them. Regardless of what they pay for (and in the case of private hospitals, i'm assuming it's a lot). Giving birth is one of the most challenging experiences a woman and her husband goes through... what with all kinds of emotions surrounding the event. Least everyone in the hospital can do is really be "honest" and "responsible". Honest enough to admit when things are not going as expected and responsible enough to do what is right. I don't think you would have complained if the APGAR score was not a perfect 10, as long as you see that the doctors and nurses are trying their very best to help the baby. It is during these cases when you would rather get the "real" answer than the "sugar-coated" ones in order to help you move forward with a sense of what really needs to be done to further help the baby.
I hope your wife is doing well now, same with your baby.
Good luck with your plans to deal with the Medical Council.
- 06-28-2011, 10:47 AM #4Registered User
- Join Date
- Jun 2011
It's been quite a few years since your post, but I'd like to reply here to tell you things certainly haven't gotten better.
They've turned into quite the baby making factory that only cares about their bottom line.
Our Doctor, Dr. WONG Ying Grace (专业资格) was a horrible doctor. She mixes up the +/- stations when talking about the baby's pelvic station position... You have to drill her for information, you have to remind her about which tests you took the last time otherwise she forgets to check the results, and she shows absolutely no emotion or personal care to her patients... I thought she had a personality problem until I saw how she lit up only when she receives a personal call. She will also mislead you and add on ridiculously high charges for extras and say "they are hospital charges, but when you get your bill they will show up as the doctor's charges", she really thinks her patients are idiots.
When you ask what kind of bonding time the mother will be allowed to have with the baby after birth, they don't really give you a straight answer and Dr Grace says "not to worry, the baby won't remember anyway".
Viewing the baby after birth is something like similar to a zoo environment, you get to line up in a long queue and get to see your baby for 10 minutes behind a glass window. The mother can breast feed their baby once per day. They say they do this for security... it is a shame when an organization brainlessly says they do things for the sake of security without thinking about what they are trading off... I have a feeling the true reason is for them to keep everything running like the factory environment that it seems like... in-and-out in order to process as many people as they can. Mainland mothers have certainly increased the volumes, but they have a choice on how many people they accept in.
When you have a complaint or problem, they pass you off to Dr. FUNG Tak Yuen (冯德源医生) who is remarkably rude, doesn't listen to you and talks over you. What's worse is he says things, medical things, that are factually incorrect... He's supposed to be their most experienced Obstetrics doctor!
Their admissions department is worse, their replies are templated, and they'll mislead you with incorrect pricing information only to load on many extra charges once you are admitted... and these were not variable costs that could have applied to some patients and not to others, they are actual fixed costs that they could have quoted when they gave their "total" price as they called it. Speaking to someone about it wont do any good... they'll turn red with embarrassment because their is no disputing the facts, but will come up with ridiculous responses to do anything but take responsibility... It would be impossible not to be embarrassed while using the excuses they used!
This is my first experience with a Hong Kong hospital... and it was horrible as well as shocking, I really expected more. We later dealt with a Public hospital for some follow up issues... and while they seemed a bit rushed at times and they were just as overworked as the Private hospital doctors, the experience was better by leaps and bounds.
I'm not sure what has caused this kind of environment in the private hospital... perhaps it is because, as I understand, the Doctors are not technically employees of the hospital, instead they work as consultants who simply operate out of there. This creates no solid obligation or interest to protect the hospitals "brand name"... who knows, I'm just trying to dig at anything to explain how a hospital could be in such a bad state.... I mean even just this past January an elderly woman passed away at Baptist Hospital for no other reason than the doctor giving her the wrong medicine!
One thing is for sure, I won't be going back and don't recommend anyone else go there!
- 06-29-2011, 01:09 AM #5Registered User
- Join Date
- Sep 2009
- Hong Kong
David - I'm sorry you've had such a bad experience.
I have to say I'm surprised because we've had an opposite experience. We've been to Baptist before (for non-pregnancy issues) and have always been treated well. That's why we chose it for our delivery.
I've been seeing Dr. Jimmy Mak since my 1st trimester -- I'm now 30 weeks along. He's been great. He always remembers me and the details of my case. He called me personally at home a few times in the first trimester, when I was having threatened miscarriage symptoms. The pricing and billing has always been fair and consistent (he even waved away the charge for an extra scan once). The nurses are friendly and helpful, and remember me by name. (It might help that I'm a regular and a Cantonese speaker).
Now, I haven't actually given birth there. And I am less impressed with their maternity ward, which seems extremely busy and filled with mainland Chinese. I've gone up 3 times to talk to them about details -- like walking around during labor, or breastfeeding, but the poor nurses seem overwhelmed. I saw the line-up outside the glassed-in nursery and thought it looks like a mainland train station! Because of these issues, I'm going to pray to God that they have a private room available when I deliver -- since that's the only way you can have a private doula / midwife, and your baby living in for on-demand breast-feeding.
I'm not trying to dismiss your story. Everyone has difference experiences. And there may be a vast difference between doctors. I just hope my delivery goes well!
- 06-29-2011, 08:07 PM #6Registered User
- Join Date
- Jun 2011
I'm glad you have a doctor who seems to be paying so much attention to you. It sounds like with Jimmy Mak you'll be just fine! With our doctor I could never imagine her calling us, she doesn't even reply to emails that we send her. It really felt like we were cattle being pushed in and out every time we went for a visit.
I've gotta say though, the nurses and security staff are all so nice. They are very blunt and to the point, but in a friendly and natural kind of way.
I did forget to mention that my wife's water broke, and she had no contractions, they originally had her slated to start on oxytocin 12 hours later if she still had no contractions, but after 12 hours had come and gone, the doctor called in from off-site to say based on scheduling and convenience, she'd wait until the morning... I asked if it was not true that the baby should ideally come out within 24 hours of the water breaking, but she reassured us by saying in the UK they go up to 72 hours. We started on oxytocin in the morning and 4-6 hours in still no contractions... we opted for a c-section at this point because it was wasn't looking promising... after it was all said and done, we we're told that the baby was high risk because he was out of amniotic fluid for over 24 hours and a whole battery of tests needed to be run... We would have really pushed for getting induced earlier had we not been lead to believe there was no negative impact to wait. After the tests were said and done, it was determined that based on the results and the risk associated with being "dry" for so long, they'd keep him in the hospital on a very basic prophylactic set of anti-biotic... despite they were as basic as they get, the charge was over 4000HKD per day, but it would be stacked... meaning even though we still had a couple of days stay for the baby included in our package we'd be charged the bed fee from the obstetrics department as well as pediatrics.
Usually if I read a story like mine on the Internet, I'd be tempted to automatically assume that the author probably didn't conduct themselves too well, or was rude to the hospital staff throughout the whole process.... I can tell you that was not the case... We we're always very social, polite and even shared a few laughs with the doctors and staff... When it seemed like we weren't being treated well, or we were being mislead, it was me reassuring my wife that it was alright and the staff seemed to have extremely large workloads. After it's all said and done, and I look back at all the small things that have accumulated (many I have not even mentioned here), mixed in with some of the major issues, it's worth posting this rant and cautionary tale.
Again it seems like you're working with a great doctor... but if it comes time for labour and your doctor isn't available, if they give you a choice, opt for anyone other than our doctor!
You'll be happy with the rest of the staff who you'll be seeing most of the time anyway, the nurses are great there.
- 06-29-2011, 08:17 PM #7Registered User
- Join Date
- Jun 2011
I want to post somewhat of a defence for our doctor... I think that 85% of the issues that we had with her could be directly related to her workload. She seems very overworked and it really shows in the feeling we always got that she never had time for us. It's not an excuse though, some doctors handle heavy workloads better than others, ours clearly doesn't do well with it. I'm not sure if she has the ability to reject new patients if they are already at maximum capacity to offer quality treatment and care... or of that is the job of the hospital... but I would have much rather been rejected and found somewhere else, or after our experience I would have sooner flown back to our country to deliver instead!
- 06-30-2011, 12:26 AM #8Registered User
- Join Date
- Sep 2009
- Hong Kong
What a story. I'm sorry your wife and child had to go through that. I hope everyone is home, safe and healthy now.
I could see your point about the workload. They're obviously pushing those doctors to the brink. I always schedule my appointments well in advance, and many times, I get a call asking if I can change times or days, which is tough for me, since I work. Then, when I show up, there is often a very long wait. I highly suspect that the hospital double- or triple-books doctors. (One day, both women sitting next to me had appointments with the same doctor for the same time!)
It's not such a big deal for pre-natal check-ups -- it's just annoying. But I can see where overbooked doctors can be a problem if you have a high-risk delivery like your wife.
Again, I hope all is well with your family! Thanks for the cautionary tale. :)
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