Subang Health Office Denies Reports Pregnant Woman Died Because Hospital Rejected

SUBANG - Subang District Health Office, West Java, conveyed clarification regarding a pregnant woman named Kurnaesih (39) who died due to difficulty accessing emergency services.

"There was a miscommunication, so the problem occurred. Maybe the delivery of information from the hospital staff was not complete, and the family misinterpreted it. If there is news that he (the patient) was rejected because there was no referral to the public health center, I will clarify that it is not like that", said the Head of the Subang Regency Health Office Dr. Maxi as reported by ANTARA, Wednesday, March 8.

Maxi explained that on 16 February 2023, Kurnaesih complained of heartburn and asked for help from a village midwife so she could receive treatment at the nearest health center.

However, he continued, about an hour after complaining of heartburn, the patient vomited, fainted and passed amniotic fluid so that the village midwife who assessed Kurnaesih had the potential to experience an abnormal delivery and took the initiative to call the public health center to send an ambulance.

"In a short time, the ambulance arrived and the patient was referred to the Basic Emergency Obstetrics and Neonatal Services (PONED). On the way, the patient vomited and fainted again, so that he arrived at the health center, about five minutes of assistance was carried out with infusions and catheters as well as initial aid efforts", he said.

Because dealing with conditions as experienced by Kurnaesih is beyond the authority of the public health center staff, he said, the public health center then refers the patient to the Ciereng Subang Regional General Hospital (RSUD) so they can get the emergency services they need.

In the integrated referral mechanism, Maxi explained, the public health center is required to notify the RSUD first to obtain service certainty based on the readiness of the equipment, room, and health workers.

"There is already a Permenkes regarding referrals, so if they are not ready, they will be referred to another hospital", he said.

After the public health center gave the notification to the RSUD, Maxi said, the midwife and Kurnaesih's family rushed to Ciereng Hospital while waiting for a response from the RSUD.

"Answers were delivered half an hour later when the patient's position was only five minutes away from the hospital. The answer was, according to the obstetrician, assistance had to be carried out with ICU facilities, because an operation was needed for his condition which was not fine", he said.

After receiving this answer, the midwife accompanying Kurnaesih took the initiative to contact the nearest hospital that has an intensive care unit, namely PTPN Hospital and Mutiara Hati Hospital. However, intensive care units at both hospitals are full.

"This referrer then contacted the Health Office for a consultation. Advice from the Health Office coordinating officer encouraged the patient to continue looking for referrals so they could be saved, so it was decided that Kurnaesih would still be taken to Ciereng Hospital", he said.

Maxi said Kurnaesih was well received at Ciereng Hospital, which is a type 2 hospital.

"It's not rejected, because if it's rejected, maybe the emergency room won't be accepted either. The patient's blood pressure is checked, and they can still talk", he said.

Maxi said the health officer then encouraged Kurnaesih to receive services at the Comprehensive Emergency Neonatal Obstetric Service Unit (PONEK) at the Hospital.

"When I entered the door, there was a midwife on duty talking. Where was this patient from? How come it was so fast, I just called five minutes and it arrived. The patient didn't wait for an answer, but on the way", said Maxi, imitating the words of the duty officer at Ciereng Hospital to the patient.

Maxi said that the duty officer at PONEK actually wanted to explain the results of the consultation with the obstetrician and the surgery needed by the patient.

"But the answer hasn't come out (from the duty officer), the patient is immediately pulled into the ambulance with a bit of a temper. There may be body gestures, expressions, and all kinds of things so that the language delivered doesn't quite match that answer, so the family and the referring midwife feel offended. he said.

The woman, who was nine months pregnant, died when her husband, Juju, tried to take her to another hospital in Bandung, West Java.

When questioned separately, the Head of the Communication and Public Services Bureau of the Ministry of Health Siti Nadia Tarmizi conveyed the importance of pregnant women accessing Antenatal Care (ANC) services six times and undergoing obstetrician examination twice.

The series of examinations, according to him, are needed to detect patient risks as well as the medical assistance needed so that the delivery process goes smoothly and safely.

Regarding access to services for pregnant women who need medical assistance.

"If the situation is full service, it cannot be forced, except for referrals, and the hospital has an obligation to provide first aid in emergency cases."