Maternal deaths at MetroWest hospital prompt state probes
Two women died after arriving to give birth at MetroWest Medical Center, prompting <br/>a state investigation
Seveny Fuchu’s doctor sent her to the hospital to deliver two weeks before her due date last fall. Her husband raced out of work and met her there with a suitcase. The child they had waited for, through two miscarriages, was coming thrillingly early.
Over the next 36 hours, however, Fuchu’s blood pressure climbed dangerously and her legs swelled, classic signs of a condition called preeclampsia. When the baby’s heart rate began to falter, doctors at MetroWest Medical Center whisked Seveny off for a caesarean section, telling Kenny Fuchu to wait outside, he said. As an urgent code sounded overhead and nurses rushed in with bags of blood, his anxiety grew.
When he was finally ushered in, Kenny Fuchu saw his newborn son sleeping in a bassinet. But his wife was gone.
Through a window, he could see doctors trying to resuscitate her in an adjacent room. “Everything changed in a second,’’ he said.
Seveny Fuchu, 35, was one of two women who have died soon after arriving at the Framingham campus of MetroWest Medical Center to give birth in the past nine months. The women’s deaths — relatively unusual in Massachusetts — have prompted state investigations and come amid increasing focus on the high rate of pregnancy-related mortality in the United States.
Seveny Fuchu died Oct. 26, and the hospital responded with a “corrective action plan’’ that included new guidelines for treating women with preeclampsia. During a five-day inspection last February, state investigators cited MetroWest for not fully implementing the plan.
Three weeks after the inspection, another woman died following an emergency caesarean section at the hospital, according to a fund-raising website created by a friend. Department of Public Health officials confirmed they are investigating a second woman’s death in February, but would not confirm the patient’s identity. They said the inquiry is ongoing, and they would not comment further.
Shelly Weiss Friedberg, a spokeswoman for Tenet Healthcare, the Texas corporation that owns MetroWest, declined to comment on the deaths, citing patient privacy laws.
The Centers for Disease Control and Prevention recently put the national rate at about 17 women per 100,000 live births. The World Health Organization said the US rate is higher than that of countries including Canada, France, Germany, Great Britain, Greece, Ireland, Italy, and Spain.
Black women in the United States are at much higher risk, while Hispanic women have slightly higher mortality rates than whites.
The Massachusetts rate has been consistently below the national average. Five women died of pregnancy-related causes in 2014 — 6.9 per 100,000 live births, according to the health department’s most recent data.
It is one of the few states where public health officials study the medical records and autopsy reports for every woman who dies, to pinpoint causes. If they find her death could have been prevented with better medical care, the department requires hospitals to improve their procedures. They believe at least one-quarter of deaths are preventable.
In February, Suely Frois, 40, of Framingham, arrived at the MetroWest emergency room eight months pregnant, and suffered several heart attacks, according to a friend, Drita Protopapa, who created a website to raise money for the family. The complications mounted, prompting doctors to have her airlifted to Tufts Medical Center. But they could not save her. Her son, Adam, survived.
In Fuchu’s case, doctors decided to induce delivery before her Nov. 10 due date because of her preeclampsia diagnosis, a potentially dangerous complication of pregnancy, her husband said.
MetroWest called her death “likely not preventable’’ in a report it filed with the public health department that was obtained by the Globe through a Freedom of Information request. Because it did not consider the death preventable, the hospital said, it still planned to bill her insurer for her care.
But attorneys hired by Kenny Fuchu say that, based on his wife’s medical records, doctors and nurses did not follow appropriate procedures when caring for her. Her blood was not tested at regular intervals to look for a worsening of her condition, and she was not given medication to manage her high blood pressure, they said. And physicians decided to perform a caesarean section only when the baby developed an abnormal heart rhythm.
“It clearly speaks to the general attitude that [the medical profession] approaches this issue with,’’ said Mary Wenham, a member of Fuchu’s legal team at Lubin & Meyer in Boston. “It was concern for the baby, not the mother.’’
Seveny Fuchu was born in the Dominican Republic. She and her husband met at Beulah Christian Church in Bronx, N.Y. They were married in 2005 and moved to Woonsocket, R.I., when Kenny Fuchu found a better job nearby.
She became a case manager at BayPath Elder Services in Marlborough, and her online obituary includes testimonials from co-workers about her warmth toward clients, for whom she tracked down wheelchairs, medication, and other necessities. Her husband said she decided on MetroWest because it was convenient to her work.
As nurses wheeled her into the delivery room, Fuchu said, he kissed his wife and promised to take her and the baby on a vacation to Punta Cana, a beach town in the Dominican Republic, as a way to distract her from the painful and exhausting labor. After her death, he was carrying their son, Kenneth, out of the hospital when he spotted another family leaving with a newborn, the mother in a wheelchair and carrying flowers. “That was the way it was supposed to be,’’ he thought.
His son is doing well now, and a good friend of his wife is caring for him during the day so Fuchu can keep his job as a machine operator at Textron Systems Corp. in Massachusetts.
Labor and delivery staff have lost mothers at other hospitals in recent years, sometimes because they have not been fully prepared for an emergency.
When Pamela Sampson arrived at Cooley Dickinson Hospital in Northampton in December 2013, she was incoherent and her blood pressure was soaring, according to state reports. Doctors performed an emergency caesarean section, but did not treat her high blood pressure until two hours later, the state concluded. She suffered a massive stroke and died.
Two newborns also died there around the same time, and the Northampton hospital brought in experts from Massachusetts General Hospital to help overhaul its maternity care. As a result, a senior Mass. General physician joined the Cooley Dickinson perinatal safety committee, the hospital adopted a plan to better monitor high-risk cases, and staff were trained on fetal heart monitoring.
Also that winter, two expectant mothers died shortly after giving birth at South Shore Hospital in Weymouth, though state investigators said they did not uncover problems with their medical care.
In 2015, the state public health department and the Board of Registration in Medicine, which licenses doctors, issued a statewide advisory on how to identify high-risk obstetrical patients and manage emergencies. They cited 20 deaths over the previous four years, including nine women who were low-risk. They said poor communication among staff often played a role, and that special team training can help.
Eugene Declercq, a professor at the Boston University School of Public Health, said that “a small hospital might not see a maternal death for years. So being ready to deal with that potentially fatal emergency is a challenge.”
And public health officials sometimes do not know a hospital has gaps in its care plan until a serious problem occurs.
Dr. Mark Manning, an obstetrician at UMass Memorial Health Care, said the surest way to avoid mistakes is to adopt standard procedures: who is called in an emergency, how they are called, what drugs are given. “Things do not get missed and they get done more quickly,’’ he said.
Dr. Hafsatou Diop, a state epidemiologist who directs efforts on maternal health, said that while patient mortality is a serious problem, many more women survive but suffer complications, such as excessive blood loss and transfusions, related to pregnancy. The state plans to publish a report soon on the prevalence of these types of complications and injuries.
“Mortality is just the tip of the iceberg,’’ she said.