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Expert to review Winnipeg girl's accidental death following surgery

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Manitoba's chief medical examiner is calling for an expert review, rather than an inquest, after a Winnipeg girl died following minor surgery.

Dr. Thambirajah Balachandra said Thursday afternoon he would not be calling for an inquest into the death of 10-year-old Ashuza Halisi, which he ruled as accidental.

Ashuza, the oldest child of immigrant parents, had day surgery to repair a hernia on her umbilical cord at the Maples Surgical Centre on March 11. The surgery, to repair an outward bulging of the abdominal lining around the navel, is considered a minor procedure.

Her mom was told Ashuza would be well enough to go home the same day and all she'd need for pain was Tylenol.

But overnight her mother, Ephemie Nyelele, found the little girl panting, covered in sweat with cold hands and feet. Her mother tried cardiopulmonary resuscitation and called 911. Paramedics also tried CPR but at Children's Hospital the girl was pronounced dead on arrival.

Death caused by perforated bowel

Balachandra confirmed Thursday the cause of Ashuza's death was a perforated bowel, a known but rare complication of the surgery performed.

"An autopsy confirmed death was due to acute peritonitis (infection of the linings of the bowel) due to a perforated ileum (small bowel), most likely due to complications of recent umbilical hernia repair," the medical examiner said in a statement Thursday.

Normally in deaths like this, the medical examiner orders an inquest using his authority under the province's Fatality Inquiries Act.

But in this case, Balachandra decided to use a section of the law that allows him to make direct recommendations to the Attorney General -- or to other relevant agencies or departments.

In this case, the Winnipeg Regional Health Authority ordered a review immediately following the child's death, so Balachandra recommended the WRHA call in a pediatric surgeon from outside Manitoba to review the surgery and recommend ways to prevent similar deaths.

WRHA already acting on recommendation

In response, the Winnipeg Regional Health Authority said it's acting on the recommendation.

WRHA chief medical officer Dr. Brock Wright will make the appropriate arrangements to retain a pediatric surgeon from outside the province to examine the review of the case so that any recommendations can be received and acted on as quickly as possible, the WRHA said in a statement.

"We know this has been a very trying time for the Halisi family. We are working with Maples Clinic to see what improvements can be made as a result of this case," Dr. Wright said in the statement.

He added instructions provided to families following day surgical procedures are already being reviewed, and at least one change in policy has already been made: Follow-up calls to patients’ families are now made within 24 hours — rather than 48 hours — of the procedure.

Wright said the WRHA and the Maples Surgical Centre look forward to receiving any other recommendations from the out-of-province pediatrician.

The WRHA also remains in contact with the Halisi family and will continue to provide them with updates, the statement said.

The family could not be immediately reached for comment.

History

Updated on Thursday, March 28, 2013 at 2:47 PM CDT: Corrects lede.

March 29, 2013 at 5:06 PM: corrects information about family

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