Doctors at the Tupua Tamasese Meaole Hospital are eager to medically pin point the true cause behind complications for local patients who recently had open heart surgery.
A team of 40 cardiologists and support medical staff from New Zealand performed the series of complicated surgeries about 4 weeks ago.
Since then, 2 two of the patients have died, 2 were rushed to New Zealand for emergency medical attention and the rest are recovering locally.
“There are a range of factors to look at because what happened is unusual when compared to the relatively good outcome of the first operations last year,” General Manager of National Health Services, Dr. Stanley Dean, tried to point out yesterday, when asked by Newsline.
“Normal complications from surgery usually occurred between 24 - 48 hours after surgery, not after the patients have been dispatched to go home.
Dr. Stanley is curious about the level of care the patients exercised when they were released to go home.
“The extent of the surgeries was very serious and it was important for patients to take extra care until they were properly healed, so that is one area to look at as part of the investigations.
“Most of the patients we had last year were mainly girls, this time it was mostly boys and most of those who had complications were boys compared to only one girl.”
Cardiologists and other medical specialists have been traveling back and forth between New Zealand and Samoa to continue treatment and monitor the progress of recovery for the patients, including the second male who died at the weekend.
Dr. Stanley believes it will be a while before they can narrow the cause of the complications down.
He did however emailed to Newsline on Monday a full account of what transpired from the time the patients were operated on to when the complications started.
The written statement was prepared before the 2nd patient died :
1. The team
Dr Benjamin led the second cardiac mission team of forty staff from New Zealand inclusive of doctors, nurses, technicians and allied health workers. The first group arrived in Samoa on the 24th July 2008. They brought along 4 tons of medical equipments hired from Mercy hospital, kilos of donated medical supplies and medications from various companies in New Zealand.
2. The Operations
The operations started on Friday 25th July and the last two cases were on Wednesday, 30th July 2008. Fourteen patients were operated on, of which 13 patients had repairs/replacement for rheumatic valvular heart disease, and one with pericardial window for pericardial effusion. There were no major problems during surgery.
3. Post operative care:
There were no major complications in the first 48 hours after surgery. All were discharged home after five or six days in the ward. Instructions for home care were given and most of them were on medication like warfarin to prevent anticipated complications. The patients were followed up by the medical team.
4. Complications
During post operative visits, some patients noted to have increasing heart sizes. ECHO showed pericardial effusions and were advised to treat conservatively as they are expected findings post surgery. The complications noted were; one wound infection and seven have pericardial effusions.
5. Outcome & Management plan
* Two patients were sent to New Zealand on Sunday, 10 August 2008, one had chest wound infection (mediastinitis) and one with symptomatic pericardial effusion (early tamponade), and they are reported stable.
* One patient died on the 9th August 2008 who was admitted with gastroenteritis two days earlier.
* One patient had cardiac arrest on Monday, 11 August 2008. He had CPR, cardio-centesis and was ventilated. He had multi-organs failure; his heart (due to severe valvular heart disease) renal, liver and brain. He is in critical condition.
* A team from New Zealand, inclusive of a Cardio-thoracic surgeon, Cardiologist, and Anaesthetic technician arrived on early Tuesday morning, 12 August 2008. Four patients with pericardial effusion were drained under local anaesthesia. Other patients were called in for ECHO and assessments and were found to be stable. This team went back to New Zealand after two days.
* An Intensivist from New Zealand arrived on Thursday morning, 14 August 2008, to provide further assistance in the care of patients.
* The patient from American Samoa is reported doing well.
6. 2007 patients
The team was also able to meet up with six of last year’s patients. Some of the patients of last year are away overseas in New Zealand and Australia. They are all doing well.
7. In Conclusion
* Open heart surgery is major operation. Patient and family are advised before signing consent of fatal complications that can happen preoperative, intraoperative and post operative.
* Everyone involved with this mission are devastated. It is very unfortunately that it cost life this time. It was never our intention to bring tragedy and sadness to patients and families.
* We are working very closely with our colleagues in New Zealand to provide care to other patients with problems.
8. From the cardiac mission in New Zealand
All the members of the New Zealand Good Samaritan Heart Mission to Samoa firstly wish to extend their deepest sympathy and condolences to the family of Muipu Salatiule on his unexpected death following his cardiac surgery. While the complexity and severity of this major surgery carries post operative risks of major complications and death, when such complications occur they are always a shock and of great concern to the clinical team.
The New Zealand Good Samaritan Heart Mission to Samoa is totally committed to the open heart programme and to strengthening patient care in Samoa. We acknowledge that setbacks can occur, however we remain determined to learn from experience of the two cardiac missions which have most certainly saved lives and with God’s help continue cardiac surgery in Samoa to assist those in need of heart surgery.
9. Condolences
I would like to take this opportunity to CONVEY OUR SINCERE CONDOLENCES TO THE FAMILIES WHO ARE MOURNING THE LOSS OF THEIR LOVE ONES.
IA FAANAFANAFANA LE ATUA I AIGA LOTO FAANOANOA.
Ma le faaaloalo lava.
Dr. Stanley Dean
General Manager – National Health Services.
Basicly my thought is and my question is WHY ARE YOU GUYS RELEASED THE PATIENTS HOME AFTER 6 DAY FROM THE SURGERY DAY? And isn't supposed to be release after three weeks or four weeks cause myself only I do have experience about people that have heart problem they should keep these patients in the hospital after sugery and do something to drained out all the bad fluids from the surgery and i guess nobody have any thoughts about bad fluid in the body of a human being after surgery thats why they did have all those infections and went threw patient kidneys and livers and it also cause brain damage. So what happened now is that nobody can't do anything at all cause its to late for them to work on it again and plus all the germs and bad fluids is all over the patiens body and nothing else can do and its to late...... I feel so sorry to the love of our life which is one of the patients.......
saddened written by Staka,
August 22, 2008
i'm sure all involved are saddened by what has transpired. no one meant for this to happen. i do know losing a loved one is the hardest thing to go through. my prayers go out to the families involved. ia, faamafanafana le Atua i outou loto.
CONSENT AGREEMENT written by Jemin,
August 22, 2008
One of the most important things that a patient must be told prior to either a minor or a major surgery is to sign a consent agreement. This process is used to take some of the responsibilities away from the attending physicians should something bad happen to the patients as a result of surgery. A consent form for a major heart operation has to include infection and death as one of a possible post-op anticipatory outcome.
The consent protocol, however, does not excuse the medical personnel involved from following the proper medical procedures and exibiting superb medical care. An investigation should be conducted to indentify where exactly our medical system falls short on post-op patient care.
God Bless..
priorities first written by Disgusted,
August 26, 2008
the basic health care in Samoa is appauling..and whose idea is it to get complicated cardiac surgery a priority..obviuosly the health advisors from NZ to Samoa themselves need advice.
The purpose of these visits are for these doctors to develop their own carreer profile and help only a handful of the thousands that really need help we should bann such missions from overseas and concentrate on improving the infrastructure in health
Honoring the heart surgeons written by Susie, August 26, 2008,
August 27, 2008
I for one is very grateful for the service to humanity these surgeon performed. I thank you for taking this to the next level. Because of their help, it will benefit generations to come because of the knowledge and the understanding. It's hard to lose a love one but you forgot how many lives they saved. Signed Honor for your service.
Submit News from your Area If you would like to submit News for possible publication in both the online and print version of Newsline please feel free to email us at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Become a News Blogger Have a passion for writing? Interested in writing articles for Newsline? Email us at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
. We are looking for Bloggers from around the world to contribute to our site.
Subscribe to this comment's feed
So what happened now is that nobody can't do anything at all cause its to late for them to work on it again and plus all the germs and bad fluids is all over the patiens body and nothing else can do and its to late......
I feel so sorry to the love of our life which is one of the patients.......