State paid over $16M in 61 medical negligence settlements

Joshua Seemu­n­gal

Se­nior In­ves­tiga­tive Jour­nal­ist

joshua.seemu­n­[email protected]

The State, through the Re­gion­al Health Au­thor­i­ties (RHAs), which man­age lo­cal health­care, paid out more than $16 mil­lion on 61 med­ical neg­li­gence set­tle­ments be­tween 2015 and 2024, ac­cord­ing to Free­dom of In­for­ma­tion Act (FOIA) re­quest doc­u­ments ob­tained from the Min­istry of Health by Guardian Me­dia.

And while the set­tle­ments for med­ical neg­li­gence cas­es have amount­ed to more than $16 mil­lion be­tween 2015 and 2024, a 2022 Guardian Me­dia in­ves­ti­ga­tion re­vealed that be­tween 2015 and 2021, more than $37 mil­lion of tax­pay­ers’ mon­ey was spent on le­gal fees by RHAs to de­fend claims filed by vic­tims of med­ical neg­li­gence.

The RHAs, which are fund­ed by the State, paid the set­tle­ment fees.

Un­der ex­ist­ing pub­lic sec­tor con­trac­tu­al arrange­ments, fi­nan­cial li­a­bil­i­ty for med­ical neg­li­gence claims rests with the rel­e­vant RHA rather than in­di­vid­ual doc­tors.

Set­tle­ments, ac­cord­ing to le­gal sources, do not con­sti­tute an ad­mis­sion of li­a­bil­i­ty and, in many cas­es, are reached to avoid pro­longed lit­i­ga­tion.

Pa­tient names and oth­er case de­tails were not list­ed, as they were sub­ject to pa­tient con­fi­den­tial­i­ty.

How­ev­er, in­for­ma­tion about some med­ical neg­li­gence cas­es that ini­tial­ly went be­fore the courts in re­cent years has been made pub­lic.

In May 2024, the South West Re­gion­al Health Au­thor­i­ty (SWRHA) set­tled with a woman whose sev­en-year-old child suf­fered a per­ma­nent neu­ro­log­i­cal in­jury dur­ing her birth at the San Fer­nan­do Gen­er­al Hos­pi­tal in 2018.

Be­fore that, in No­vem­ber 2022, the North Cen­tral Re­gion­al Health Au­thor­i­ty (NCRHA) paid $150,000 to a 30-year-old woman whose ba­by died while she gave birth at the Mt Hope Women’s Hos­pi­tal in 2017.

Jus­tice Frank Seep­er­sad com­mend­ed the NCRHA for its de­ci­sion to set­tle, say­ing, “In a so­ci­ety where the right course of ac­tion is rarely adopt­ed, the po­si­tion adopt­ed by the De­fen­dant is as wel­come as it is re­fresh­ing.”

In Feb­ru­ary 2022, the East­ern Re­gion­al Health Au­thor­i­ty (ER­HA) was or­dered to pay Clar­isia James near­ly $100,000 in dam­ages af­ter she was in­jured dur­ing an op­er­a­tion. While she was un­der anaes­the­sia, a med­ical in­stru­ment sparked and ig­nit­ed the op­er­at­ing the­atre’s drapes, re­sult­ing in burns to her up­per body.

There are al­so sev­er­al med­ical neg­li­gence claims cur­rent­ly be­fore the courts, which have not yet been de­ter­mined.

For ex­am­ple, ear­li­er last year, the fam­i­ly of a 55-year-old woman filed a med­ical neg­li­gence law­suit against the South West Re­gion­al Health Au­thor­i­ty. The claim al­leged that she died from post-surgery com­pli­ca­tions fol­low­ing an op­er­a­tion at the San Fer­nan­do Gen­er­al Hos­pi­tal.

Ac­cord­ing to the doc­u­ment, filed with the San Fer­nan­do High Court, Ann Agard died on Oc­to­ber 29, 2019.

Le­gal de­f­i­n­i­tions state that med­ical neg­li­gence oc­curs when a health­care provider is de­ter­mined to have failed to pro­vide care of an ac­cept­able pro­fes­sion­al stan­dard, lead­ing to harm, in­jury or death.

Ex­am­ples of med­ical­ly neg­li­gent acts in­clude sur­gi­cal er­rors, in­cor­rect or un­nec­es­sary treat­ment, fail­ure to pro­vide prop­er fol­low-up care and mis­di­ag­no­sis.

Of the five re­gion­al health au­thor­i­ties, on­ly the To­ba­go Re­gion­al Health Au­thor­i­ty (TRHA) was not list­ed. The TRHA falls un­der the To­ba­go House of As­sem­bly’s ju­ris­dic­tion. The oth­er four RHAs fall un­der the ju­ris­dic­tion of the Cen­tral Gov­ern­ment.

In 2018, for­mer sec­re­tary of Wealth, Well­ness and Fam­i­ly De­vel­op­ment, Dr Agatha Car­ring­ton, re­vealed that the TRHA paid out $1.84 mil­lion to set­tle four law­suits be­tween 2013 and Ju­ly 2018.

Of the four RHAs un­der the Health Min­istry, the re­gion­al health au­thor­i­ty with the high­est set­tle­ment pay­out over the ten years was the North Cen­tral Re­gion­al Health Au­thor­i­ty.

Be­tween 2015 and 2022, the NCRHA set­tled on 18 med­ical neg­li­gence claims, to­talling around $10 mil­lion.

• ↓2015: Two cas­es for ap­prox­i­mate­ly $829,700.

• ↓2016: Two cas­es for around $1.6 mil­lion.

• ↓2017: Two ad­di­tion­al cas­es were re­port­ed for $269,600.

• ↓2018: Three mat­ters for $3.1 mil­lion.

• ↓2019: Three mat­ters for $2.4 mil­lion.

• ↓2020: Two mat­ters for $1.5 mil­lion.

• ↓2021: One mat­ter for $741,500.

• ↓2022: Three set­tle­ments for $233,400.

The NCRHA cov­ers a pop­u­la­tion of more than 351,000 peo­ple.

The au­thor­i­ty gov­erns the pri­ma­ry health­care clus­ters of Ari­ma, Ch­agua­nas and St Joseph. It is re­spon­si­ble for the Er­ic Williams Med­ical Sci­ences Com­plex, the Mt Hope Women’s Hos­pi­tal, the Cau­ra Hos­pi­tal, and the Cou­va Hos­pi­tal and Mul­ti-Train­ing Fa­cil­i­ty. It al­so gov­erns around an­oth­er 13 health cen­tres and ex­tend­ed care fa­cil­i­ties.

The South West Re­gion­al Health Au­thor­i­ty (SWRHA), be­tween 2015 and 2024, set­tled on 37 mat­ters, to­talling ap­prox­i­mate­ly $5 mil­lion. Thir­ty-six were de­scribed by the FOIA doc­u­ment as be­ing High Court mat­ters.

Here’s a look at some of the set­tle­ments:

• ↓2015: One mat­ter was set­tled for $30,000.

• ↓2016: Three mat­ters were set­tled for $275,000.

• ↓2017: Three mat­ters were set­tled for an­oth­er $275,000.

• ↓2018: Eight mat­ters for $642,000.

• ↓2019: Three mat­ters for $126,300.

• ↓2021: Three cas­es for $133,000.

• ↓2023: Two cas­es for $135,000.

• ↓2024: One case for $75,000.

Pro­vid­ing health­care for a pop­u­la­tion of more than 600,000 peo­ple, the SWRHA is re­spon­si­ble for the San Fer­nan­do Gen­er­al and Teach­ing Hos­pi­tal and the Can­cer Cen­tre of T&T-South, as well as the Point Fortin Hos­pi­tal. It al­so gov­erns the Cou­va, Princes Town and Siparia Dis­trict Health Fa­cil­i­ties, an­oth­er 31 health cen­tres and two ex­tend­ed care cen­tres across Coun­ty Vic­to­ria, Coun­ty Ca­roni and Coun­ty St Patrick.

Ac­cord­ing to FOIA re­quest doc­u­ments, the East­ern Re­gion­al Health Au­thor­i­ty set­tled four med­ical neg­li­gence mat­ters be­tween 2015 and 2019, for ap­prox­i­mate­ly $900,000.

• ↓2015: Two set­tle­ments were agreed up­on for $221,700.

• ↓2016: A set­tle­ment was agreed for $500,000.

• ↓2019: A fi­nal set­tle­ment for the pe­ri­od for $173,600.

The ER­HA pro­vides health­care for a pop­u­la­tion of at least 157,000 peo­ple. It is re­spon­si­ble for the San­gre Grande Hos­pi­tal Cam­pus, as well as 16 out­reach cen­tres and health cen­tres, in­clud­ing in Biche, Grande Riv­iere, Guayagua­yare, Rio Claro, To­co, and Va­len­cia.

Ac­cord­ing to the FOIA doc­u­ments pro­vid­ed by the Min­istry of Health, the North West Re­gion­al Health Au­thor­i­ty set­tled on two mat­ters in the pe­ri­od. The first was in 2015, and the sec­ond was in 2020. How­ev­er, fig­ures were not pro­vid­ed for the set­tle­ments agreed up­on af­ter le­gal ad­vice. Sources in­di­cat­ed to Guardian Me­dia, how­ev­er, that one set­tle­ment was around $130,000 for a mat­ter at St James Med­ical Com­plex.

The NWRHA serves a pop­u­la­tion of more than 500,000 peo­ple. It is re­spon­si­ble for the Port-of-Spain Gen­er­al Hos­pi­tal, St Ann’s Hos­pi­tal, and the St James Med­ical Com­plex. It al­so gov­erns an­oth­er 25 health cen­tres and dis­trict health fa­cil­i­ties, in­clud­ing in San­ta Cruz, Barataria, Aranguez, Care­nage, Diego Mar­tin, Pe­tit Val­ley, Las Cuevas and Mara­cas.