By JESSICA LEEDER
Saturday, April 6, 2019
INDIAN ISLAND FIRST NATION, N.B. -- Carmen Barlow had a birth plan when she arrived at Moncton Hospital to deliver her son last summer.
It disintegrated almost immediately after she was admitted and connected to an intravenous drip.
"It went from a normal labour to hell," Ms. Barlow recounted at her home last week, bouncing her eight-month-old son, Logan, on her knee. "This nurse put in an IV. And I went from a zero to 10, where the pain was unbearable and I felt I might be ripped open," she said. "All of these things happened so fast. All of a sudden, I was having an emergency C-section and my son's heart rate wasn't there."
Ms. Barlow is among dozens of New Brunswick women who recently had emergency C-sections at Moncton Hospital and are now questioning the circumstances that led to their surgery, including whether they were unnecessarily given labour-inducing medication - without their doctor's knowledge.
The hospital announced last week that it fired a labour and delivery nurse after an internal investigation uncovered "strong evidence" that she had surreptitiously administered the contraction-inducing drug oxytocin to two patients, both of whom underwent emergency C-sections.
Horizon Health Network, which runs the hospital, released a statement late on Friday - almost one week after the firing was announced - saying it wants to hear from mothers who experienced quick onset labour and is prepared to discuss their medical concerns.
According to the Institute for Safe Medication Practices Canada (ISMP), oxytocin is often prescribed by doctors to induce or augment labour, but given incorrectly, it can cause maternal and fetal distress.
"The administration and the effect on mother and baby has to be monitored very closely," said Carolyn Hoffman, a registered nurse who is president of the ISMP. "Even a small dose can have a negative impact on the blood flow to the fetus."
It is not clear how much unauthorized oxytocin was allegedly administered by the nurse.
"The hospital took immediate action upon discovering this issue and launched an investigation," said Ken Gillespie, an obstetrician and chief of staff at the hospital.
That investigation, according to reports by CTV, included examining security footage of a nurse who appeared to be removing IV bags. "A closer analysis of IV bags found tiny puncture marks and traces of Oxytocin," CTV reported. Neither Dr.
Gillespie nor Horizon Health Network, which runs the hospital, responded to The Globe and Mail's repeated requests to verify those details.
The news outlet also reported that an unusual spike in emergency C-sections at the hospital raised red flags six months ago.
Dr. Gillespie did say in a video statement that the two patients who were confirmed to be victims of the nurse during the hospital investigation have been notified. "We can confirm that both mothers and babies are doing well," he said.
The doctor apologized on behalf of Horizon, which runs 12 hospitals and 11 medical facilities in the province, and called the situation "troubling for all of us who work here."
The nurse has not yet been named publicly. However, the New Brunswick Nurses Association, which licenses nurses in the province, has confirmed her licence was suspended last weekend to block her from working at a second medical facility that employed her. The name of that facility has not been disclosed.
On Friday, Jullie Rogers-Marsh, a spokesperson for the RCMP in New Brunswick, confirmed that the force's investigation into the allegations against the nurse is continuing and that no charges have been laid. She said the investigation began as a result of the information from Horizon, but numerous others have since called with concerns.
"This is a very serious and complex investigation that will take time," she said. "We do have a number of investigators involved in the file. They are pursuing a variety of avenues and talking to a number of people to determine the full scope of the allegations."
Scores of women and their families in and around Moncton spent the week scrambling to have their medical records released by Horizon in hopes the documents will help them figure out whether the terminated nurse had a role in their emergency C-sections.
"I don't know if I was drugged.
I just want to see if I'm one of them," Ms. Barlow said. "They said I had a dramatic birth. But it was traumatic."
Ms. Barlow suffered a uterine rupture and was told she may not be able to have more children.
John McKiggan is a medical malpractice lawyer based in Halifax. In addition to being retained as co-counsel by the two confirmed victims in the case, he received dozens of calls last week from women who are having trouble getting information about their care.
"What I'm being told by the mothers that are calling me is that the hospital refuses to tell the moms that are calling whether this nurse was even involved in their labour and delivery," Mr.
McKiggan said. "That's a silly response."
He said many women told him they were considering suing if necessary.
Allison Rouse requested her medical file from Horizon last week, but said the documents appeared to be incomplete. For example, the were no records of her receiving an epidural she requested and remembered getting at the hospital. Horizon did not respond to repeated requests for comment.
The Sussex, N.B., mother of two said she had a "picture perfect" pregnancy until the day in March, 2017, that she checked into Moncton Hospital to deliver her son, Paxton.
"Once you're in the hospital bed, the [fetal] heart rate monitor goes on your belly - that's how I know his heart rate was perfect," Ms. Rouse said. Things changed after her main nurse went on break. "That's when everything went south. It went south really fast," Ms. Rouse said.
She recalls her new nurse "fiddling with my IV bag."
"Within minutes [the baby's] heart rate just dropped. It pretty much stopped," Ms. Rouse said.
"My heart rate went up. The next thing you know I'm being knocked out and I wake up four hours later in recovery. I had no idea if [my son] was even alive."
She has spent much of the past two years harbouring a hunch that something caused her labour to change course.
"Even before all this came out, I've said something was off that night," Ms. Rouse said. "I believe if my assigned nurse didn't go for break, everything would have been fine.
"Something happened," she said. "And I want to know what."
Parents Carmen Barlow, centre, and Billy Pratt wake son Logan from his nap while preparing to go to Moncton Hospital to retrieve Ms. Barlow's medical records on Thursday.
DARREN CALABRESE/THE GLOBE AND MAIL