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KKH: FATHER WAS GIVEN EXPLANATION

The swelling on baby Nur Farhana's right ankle was a "well-accepted complication" of an intravenous drip, said Associate Professor Victor Samuel Rajadurai, senior consultant and head of the department of neonatology at KK Women's and Children's Hospital.

Staff at KKH have reviewed the swelling area twice since the baby was discharged on Nov 15 and it is healing well.

Dr Rajadurai said the father was given a "detailed explanation", including how it occurs and the appropriate medical care.

He said the swelling was caused by what is known as extravasation. This is when the fluid or medication from the intravenous infusion leaks out of the vein into the surrounding tissue.

The doctor added that most cases of extravasation are mild and do not require treatment. In about 1 per cent of cases, it can result in tissue injury causing ulceration of the skin.

NO LACK OF CARE

"Most of these cases will heal with local dressing and antibiotics," said Dr Rajadurai. "The fact that extravasation occurs does not mean that there was any lack of care in the treatment."

Dr Rajadurai said the baby had to be admitted into its neonatal intensive care unitafter her birth as she had persistent pulmonary hypertension. This is a severe condition where the pressure in the lungs is high, causing problems in breathing and blood circulation.

She had to be fed via a drip and this had to be transferred to her right ankle after some complications. Within an hour, a swelling with a white patch developed on the right ankle as a result of extravasation.

Dr Rajadurai said the drip was removed immediately.

"There was no visible broken skin at that time," he said. "The site was later reviewed by a plastic surgeon and the affected area was dressed with non-adherent dressing."

Dr Rajadurai said that the baby's father was insistent on discharging the baby, saying that his wife was upset that she was unable to look after her own baby. But on the advice of the medical team, he agreed to let the baby stay in the hospital.

"The hospital is always open to discussing with the parents if they had any concerns or doubts about the care provided to their child," said Dr Rajadurai.