Saturday, October 09, 2004

'Fetus' Tossed Into Calgary Hospital Trash Compactor

Hospital to probe disposal of fetus
Mother asked to keep remains for memorial service;
hospital apologizes for error
Deborah Tetley
Calgary Herald
October 9, 2004

The Calgary Health Region has launched an
investigation and officials are offering a distraught
mother an apology four days after a hospital employee
discarded the woman's miscarried fetus in the trash.

But Tarin Alvarez said apologies are not enough and
demands to know who is to blame for the error that saw
the fetus put in the trash compactor at the Peter
Lougheed Centre.

With emotions ranging from anger to sorrow, a tearful
Alvarez told the Herald she wanted to keep the remains
to hold a burial service for the child she named
Mohammed, after his father.

"I cannot get this picture out of my head of my baby
in the garbage," said the woman, who was four months
pregnant. "Sorry is not going to be enough. I want to
know who did this and I want to look in her eyes and
ask her where I will go when I want to light a candle
for my baby, or visit my baby.

"Where do I go for the rest of my life when I think of
my baby -- to the garbage?"

CHR officials said an investigation is underway to
find out why the remains were left in a plastic bag on
a counter in the emergency room while Alvarez was
being attended to by a nurse.

"Our sincere apologies go out to this family and the
mother," said Janet Umphrey, vice-president of the
region's northwest portfolio. "The (fetus) was
inadvertently discarded by staff who didn't know they
were remains. We are very sorry and this should not
have happened."

Although the investigation is in its early stages,
Umphrey said it appears hospital practises were not
followed.

"We have policies and procedures in place and in this
case not all of them were followed," she said. "This
is a very serious issue and we will take all the steps
necessary to ensure this does not happen again."

Alvarez's ordeal began Oct. 3 when she visited the
emergency room at Foothills Hospital, complaining of
abdominal pains and bleeding. Following an ultrasound
she was sent home.

The next afternoon Alvarez spontaneously delivered in
the bathroom of her southeast home. Her sister, Anna
Alvarez, was already en route to the house and called
911 upon arrival.

Knowing she wanted to bury the fetus Tarin Alvarez
asked paramedics to save the remains, which they
placed in a plastic bag and put in the ambulance.

Upon arrival at the hospital, the bag was put on a
counter in the emergency room while staff tended to
Alvarez. According to policy the nurse should have
then taken the remains, placed them in a plastic
container, labelled it and sent it to the lab for
tests -- which is done in every case, Umphrey said.

Instead, the nurse was called away and the fetus sat
unattended, the lab transfer and labeling never
complete.

"We don't know if it was a cleaning staff or another
staff member," Umphrey said, "but the remains were
picked up and taken away."

Once the error was discovered staff fanned out and
inspected trash containers, to no avail.

Hours after losing her unborn child -- and while her
family was making funeral arrangements -- Alvarez
suffered a second blow when a nurse visited her room
and told her the news.

The mother offered to look through trash cans to find
the fetus.

"I wanted my baby. I told them I would get up and find
it," she said. "I would dig in the garbage for the
baby myself."

It was then, Alvarez said, the situation became more
grim when the nurse took a very long pause before
saying the fetus was placed in the trash compactor
machine, making it virtually unretrieveable.

"I can't imagine this baby, that had little developed
arms and legs, being (disposed of) like garbage," she
said. "How could they not have known? It was in a
clear bag."

Health officials say it is not uncommon for women who
have suffered a miscarriage to keep the remains.

Lucy Pascal, CHR's pregnancy and infant loss program
co-ordinator said about 75 per cent of women who
experience early miscarriages view the event as a
"significant loss" and plan for a memorial service.

Roughly half of those women will opt to leave the
fetus with the hospital to be included in a biannual
memorial service, while the rest take them home to
plan memorials and bury the remains.

About 1,500 women have miscarriages each year in
Calgary.

The review will be exhaustive and involve a team of
medical and quality improvement officials not involved
in Alvarez's care, Umphrey said.

"We will look at how we can ensure that this doesn't
happen again. From emergency to the paramedics to the
patient unit we will look at it all."

Alvarez has been in touch with a lawyer, trying to
determine if she has any legal options.

"Regrettably there is probably not a lot we can do for
her in terms of damages, considering we are talking
about the rights of an unborn child that would have
never seen life," said lawyer Michael Birnbaum, who
has not been retained by Alvarez. "What is actionable
is the trauma and psychological loss to Tarin. There
has to be some recourse by the health region for her
pain and suffering."

Alvarez, who works at Calgary Family Services as a
personal care aide, said she is unable to work while
she recovers physically and emotionally. She contacted
the Herald because she wants the CHR "to be held
accountable."

Pascal said the region has offered ongoing counselling
and is keeping in touch with the mother.

"My heart just goes out to her," Pascal said. "She has
suffered two losses."