It is my hope that through sharing the events that transpired and contributed to Riley's fetal demise, I am able to prevent a similar situation from occurring in the future.
If you are expecting or plan to become pregnant, please use this information to educate yourself and ensure that no stone is left unturned. If I knew better my situation may have played out differently.
Please remember, that being a doctor does not mean that they know what is best, each situation is different and should be handled according to the risks and factors that exist.
If you are a doctor please use this information to ensure that your patients receive the care they and their pregnancy require to ensure that they are speared the anguish our family has endured.
My pregnancy was complicated from the start; I was experiencing chronic nausea, persistent vomiting, and diarrhea, accompanied by significant intestinal hemorrhage. Four months into the pregnancy I was hospitalized in very unstable condition due to frequent loss of blood caused by the intestinal hemorrhage I was experiencing, which was later diagnosed as Ulcerative Colitis (Crohn's Disease). I was admitted to the hospital were I received 4 units of blood via transfusion. My doctors were amazed that despite my condition my pregnancy was stable; Riley was thriving within me. Due to the course of the disease my pregnancy was considered to be high risk; my pregnancy was monitored very closely. Once I received the care I required my pregnancy progressed smoothly; until Riley's last month of life.
In my last month of pregnancy I moved to Canada, due to my grandfathers deteriorating state of health. I adjusted into life in my new home well, I transferred my prenatal records and care to a high risk OB-GYN, whom I believed to be competent and would provide me with the quality care my pregnancy required. On September 15th, 2003, at 41.6 weeks gestation, my pregnancy was pre-scheduled to be induced by my High Risk Fetal Care Physician in New York State, if I had not delivered by this time.
Nov. 25th, 2002: D.O.C. Riley’s life began; this is the date that my pregnancy was conceived. I believe in life at the moment of conception, Riley was alive within me.
March 11th, 2003: 15.3 wks. I received my first ultrasound, everything looked good; Riley was doing well, his development appeared normal and coincided with 15.3 wks gestation. Riley seemed content; my pregnancy was doing well despite the fact that I was not well. My condition was not diagnosed at this point in time. A second ultra sound was scheduled for March 24th. My due date was determined to be August 31st, 2003.
March 24th: 17.2 wks. I received a second ultrasound. It was determined I was in my 4th month of gestation, every thing appeared normal; there were no concerns of the pregnancy being at risk.
May 19th: 24.2wks. I received a third ultrasound; all was well and progressing smoothly.
Aug. 1st: 34.6 wks. I received a call from my sister in New Brunswick, stating that it had been decided that my grandfather would sign papers to be admitted to a nursing home when the time came that his care could no longer be managed at home. I needed to go home to see him; I knew if I did not get there I may never see my grandfather alive again. I know that I had some big decisions to make quickly. Despite my advanced state of pregnancy I knew that I needed to be there, it’s just something I had to do. I made arrangement to return to Canada so I could assist in my grandfather’s care and prepare for his move to a nursing home. I made plans and transferred my prenatal care to a High Risk OB-GYN.
Aug. 11th: 36.2 wks. I arrived in New Brunswick.
Aug. 13th: 36.4 wks. Granddad had a significant stroke; he was moved from my sister’s home to the hospital, where he would spend his final days. It was decided that due to the extent of the damage caused by Alzheimer’s and the impact of the stroke that we would allow granddad the dignity he deserved and allow him to pass in peace.
Aug. 15th: 36.6 wks. Granddad passed away.
Aug. 19th: 37.3 wks. Granddad’s Memorial Service and funeral.
Aug. 30th: 39.3 wks. I went to the ER as I was experiencing intense lower back and abdominal pain. I was admitted and sent up to Labor and Delivery, I was placed on a fetal monitor and then sent to Fetal Assessment for my fourth ultrasound, the ultrasound tech determined all appeared to be well with the baby. It was undetermined what caused the intense pain I was experiencing, it was decided that I was not in labor and I was discharged, with a prescription for Demerol to ease the intense discomfort.
Sept. 5th: 40.2 wks. I received a fifth ultrasound from Fetal Assessment.
Sept. 8th: 40.6 wks. I received a sixth ultrasound from Fetal Assessment.
Sept. 11th: 41.1 wks. I was seen in Fetal Assessment for follow-up.
Sept. 15th: 41.6 wks. This is the day that had been pre-scheduled for my induction to be started. I arrived at the hospital @ 7:30 for the induction or a C-section if Riley remained breech. I was placed in room 9, I waited for the perinatalogist to see me and determine Riley’s position. When he arrived it was determined that Riley’s head was down, thus induction was to be initiated. I received my first dose of Prostin @ 10:15am to prepare my cervix for induction, I would receive consecutive administration every 6 hours, if required until labor progressed. I was sent home and told to return in 6 hours. I returned and a second dose of Prostin was administered @ 7:00pm. I was then sent home and told to return in the morning. My water was to be broken and induction started at this time.
Sept. 16th: 42 wks. I arrived at the hospital @ 7:30, and was admitted and placed into room 6. Fetal monitoring was started; I then waited to be seen by the resident. I was told that the plan would be to break my water and have labor started. I waited for the resident to return. The floor become busy, I was told that the induction would be started later, due to the lack of staff at this time to care for me. I was sent home on pass and told to return in the morning. Before leaving a good fetal strip was required, (a 20 minute strip at a peak fetal heart rate of 160) I was given apple juice to stimulate Riley’s activity, I was then told I could return home for the evening and asked to call in the morning to make sure there was staff available to continue the induction.
Sept. 17th: 42.1 wks. I called the hospital to confirm that they had adequate staff available to care for me; I was told to come in, in an hour. I arrived @ 9:00 and was placed into Assessment Room 2 . I waited to be seen by the resident. I was seen by the resident and once again I was told that the floor was very busy and it would be best for me to return home until the afternoon. I was sent home on pass though by this time I was so irritated by the situation, I was reluctant to go home. I returned home, I called Labor and Delivery at noon as I was instructed to do, I was told to come in after lunch, at 1:00. I returned and was again placed in room 2; I was not placed on the fetal monitor at this time nor was my progress assessed. My sister stopped down to the nurses' station several times and was told that the induction would be started once there was staff available to care for me and continue the induction. I waited until 6:00pm just before shift change; no one came in to offer me food or drink or to see how I was progressing. I began to believe that my child and my well being did not seem to matter a great deal; I felt that the situation would not improve. The resident came down to tell me due to shift change that it would be best for me to return in the morning, when there would be adequate staff to care for me. Since my doctor was on staff for Thursday, I was told it would be better to re-start the induction then. I reluctantly signed pass and returned home.
Sept. 18th: 42.2 wks. I called the hospital and was told to come in; I arrived @ 9:00am. I was put into room 6 which had been set for my induction to be started, I was bumped out of the room for a patient whose water had broken and required the room, as it was set up for delivery. I was placed into room 2; after a long while of waiting my sister went down to the nurses' station and seen that room 7 was booked for me; I waited to be transferred, no one came for me. It was not until 6:30pm that a nurse came and moved me into room 5. My induction was started @ 7:00pm and the Pitoson was administered, another nurse came in and set up a delivery cart and placed it into the hall for pending birth, stating “Come morning you will have your baby to hold”. A resident came in @ 8:00pm and checked my cervix. There was concern about my induction having been started, as it was felt that my cervix was not favorable to continue the induction and administration of Pitoson; the resident left to speak with my doctor. My doctor came to see me and checked my cervix again and repeated that my cervix was not favorable enough for the induction to be continued. The doctor then had asked how long I had been receiving the Pitoson. The nurse told the doctor it had been about a 1/2 hour, when in fact it had actually been an hour and a 1/2. It was then questioned as to why the induction had been started and he was told it was in report to be started. It was apparent that there was an utter lack of communication occurring. I was removed from the drip and a 3rd dose of Prostin was administered @ 8:30pm. I was told by my doctor, that he would return @ 5:30am to break my water and restart the induction.
Sept. 19th: 42.3 wks. I woke up @ 5:30, as scheduled; my doctor had not come to see me. By 6:30 I rang for the nurse, to tell her I was feeling cramps, the nurse checked my cervix and stated that there was no change in my cervix. I told her that the doctor had told me that I was to have my water broken and the drip restarted. She had told me that my doctor had been up all night attending to deliveries and at this time was sleeping; I was then told that being there was no change in my cervix, I should go home and let nature take its course. The nurse went down and apparently told the doctor I decided to return home. She came back and ran a fetal strip on Riley, checked my blood pressure, and asked if I had had any previous problems with high blood pressure. I became concerned that my baby's heart rate seemed very irregular on the monitor; she stated that it was “a normal fetal heart rate, and to stop being paranoid, the baby was probably sleeping at this time in the morning”. She then went out of the room for a brief moment, when she returned she gave me a pass to sign and told me to return home. I was then told to return on Sunday to have my blood pressure and Riley’s fetal heart rate monitored.
Sept. 20th: 42.4 wks. I stayed at home for the day, hoping labor would start. Knowing I had my dates correct put me into my 42nd week of pregnancy. On Thursday evening when my doctor stopped the drip, I stated I was unable to start labor naturally; this was in my medical records that he received and failed to review. I had explained that it was not until my water was broken and contraction started that my cervix would begin to dilate as was the case with my first pregnancy, as well as having a family history of difficulty going into labor naturally. I wondered why I was sent home after all. I began to fear for Riley’s life as well as my own safety. I could have had my baby a half dozen times by now; I was very aggravated that my child and my care had consistently been “put off”.
Sept. 21st: 42.5 wks. I returned to the hospital and was put into room 2. The nurse came in and was unable to find the position of Riley’s head; she went to get an portable ultrasound to determine Riley’s position. Riley's heart was not checked on the ultrasound that I am aware of. I was then placed back on the fetal monitor. There was not a good heart rate, it was 50-60 BPM and recovered at 138 BPM. I told the nurse that Riley’s heart rate was not a normal FHR for my child, the resident told me that Riley was sleeping. She did not proceed to get a good fetal stripe on Riley. My blood pressure was taken and was a high as well. I told her I was in fear for my child's well being. I wanted a C-section; it would have saved my baby's life. I was told that being it was a Sunday and the floor was short staffed, there was not a doctor in house who was able to do a C-section, one would have to be called in, if she felt he was required. She told me to go home and call my doctor first thing in the morning, I returned home. I should have made the hour drive to another hospital, maybe someone there would have listened to my concerns.
Sept. 22nd: 42.6 wks. I called my doctor and made an appointment for 1:30. It was decided that on Friday September 26th I would be scheduled for a C-section. He then sent me up to Labor and Delivery for a work up and to make an appointment for Wednesday September 24th for pre-op and fetal assessment, I was fitted in and my pre-op was done at this time. I then spoke with the resident and was told that I did not have to return until Friday @ 7:30 am.
Sept. 24th: 43 wks. I now believe that this is the day that Riley passed away. I remember his last movements prior to going to bed. I was told by the tech in Fetal Assessment that due to the advancement of the pregnancy and of my weight that fetal movements will be less and difficult to feel. I remember Riley's first movements and his last.
Sept. 25th: 43.1 wks. I do not remember any movement. I am now sure that Riley had already passed away.
Sept. 26th: 43.2 wks, I arrived for my scheduled C-section @ 7:30; I was put into room 2 and then sent down to fetal assessment to determine Riley’s position. I was later told that they did not check for a fetal heart beat. It was @ 10:00 that my sister talked with my doctor and asked them to put me on an IV, as I had not had anything to eat or drink since 12:00am the previous night; he stated one would be started right away. It was not until 3:00 that a nurse came to place me on the IV and to do take a fetal stripe. She was unable to locate a fetal heart beat; she had another nurse come in to assist her, there was no heart beat to be heard. They went to get a portable ultrasound to do an ultrasound; I now knew something was gravely wrong. The perinatalogist came down shook my hand and sat on the foot of my bed; I knew. He looked up at me and spoke those dreaded words “I'm sorry, there is no heartbeat present, your baby has passed away”, I went numb. They took me to the operating room; when I awoke I held my lifeless child in my arms. I begged Riley to breath, just open your eyes, I prayed. This is not happening to me, this is not my baby, it could not be. Why did they ignore me and allow my child to die within me, it was one resident's decision to send me home on Sunday that made the difference between life and death for Riley, it was to be death.
Sept. 27th: I talked to my doctor regarding Sunday's fetal strip, he stated he was unaware of any problems or concerns. He went to review the fetal strip in question and was unable to locate it. He asked the resident who took the strip to come talk to me regarding my concerns. The resident denied the situation to have been of an urgent nature. I was so upset with her presence that I could not look her in the eyes knowing that Riley’s death could have been prevented. I only want to know why and to make sure, in the future that another family would be spared the anguish ours was enduring. This situation should not have been allowed to have occurred, knowing there was substantial opportunity for the situation to have been prevented.
Sept. 29th: I was allowed to leave the hospital on pass, to make arrangements for Riley to be laid to rest.
Oct. 2nd: Riley's memorial service and burial was held, after which, I picked out a headstone for Riley’s resting place.
Oct. 4th: I went through Riley’s belongings that I had accumulated for the day I would bring Riley home. I divided them among 2 expectant mothers. How my heart aches to hold my child next to it, my child who is in Gods care, until we meet again.
Riley’s life was played like a game of Russian Roulette. The chance to finally hold my child and see the color of his eyes and to hear his first crys was denied me. All my hopes for Riley and his future were denied me, I only want to know why? If Riley’s life could have been saved, why he was not saved? On Sunday September 21st I knew Riley was in distress it was appearant that his life was in danger, they could have saved Riley’s life, had they been competent and if my concerns had been addressed. Why had I sent home on Monday and told not to return until Friday? Why was I allowed to go that long without care so far along in my pregnancy? I feel had I received an appointment for Wednesday it may have made a difference. I wish that someone, anyone had listened to my concerns, someone who could have helped my child, instead of turning a blind eye.
