An inquest into the September 2010 death of Tanya Welcome Joseph, 31, was scheduled to continue Tuesday after jurors heard evidence over four days last week.
Mrs. Joseph died at Chrissie Tomlinson Memorial Hospital hours after she underwent what was described as routine gall bladder surgery. Several witnesses have commented about the records kept on the patient after her surgery was completed.
Attorney Michael Wingrave, who represents the hospital, told one witness, “I don’t disagree that observations should have been more frequent.”
He was speaking via video link with Sue Williams, a registered nurse and nursing instructor, who was asked for her written opinion on what had happened before Mrs. Joseph was found unresponsive.
Ms. Williams said the record showed that the patient had received the pain medication Pethidine at 1 a.m. She would have expected more frequent observations, which would have shown any change in the patient’s respiratory rate. A registered nurse would know to observe more closely when the drug is administered, she stated.
At 2 a.m. Mrs. Joseph was sleeping. At 3 a.m. a nursing assistant reported that the patient was asleep, breathing spontaneously and snoring. “That is quite significant to me,” Ms. Williams said. The noisy breathing “might be an indication she was retaining fluid in her lungs.” She wondered why the respiratory rate was not recorded at that time.
Earlier in the week, Julie-anne Dowie gave evidence, also via video link. She said she was director of nursing at Chrissie Tomlinson in 2010, but was off-island when Mrs. Joseph was admitted. She resigned in 2011.
Attorney Anthony Akiwumi, who represents Mrs. Joseph’s family, asked if she would have wanted to investigate Mrs. Joseph’s snoring. Ms. Dowie said would, because it could be a sign of struggling to breathe. She explained that Pethidine is a respiratory depressant.
Questioned by Queen’s Coroner Angelyn Hernandez, she said in such a situation she might require someone to sit with the patient because conditions can change very quickly.
One registered nurse and two nursing assistants were on duty when Mrs. Joseph died. Ms. Dowie said the person accountable is the registered nurse.
Dr. Steve Tomlinson, who was the owner and chief executive of the hospital at the time, has told the court that he terminated the registered nurse on duty at the time.
That nurse, Sharna Clarke, provided a statement, which the coroner read to the jury. The statement set out times for events during her shift: She noted that at 3 a.m. a nursing assistant checked Mrs. Joseph, who was sleeping and snoring. The assistant returned to the nursing station where Ms. Clarke was. Her next note is for 5:35 a.m., when the patient was found unresponsive and efforts were made to revive her.
Police Constable Manley Berry, who investigated the death, testified on Thursday that he had requested statements from the nursing staff on duty and subsequently received them from the hospital administrator. He later tried to find Ms. Clarke, but discovered through the Immigration Department that she had left the island on Jan. 3, 2011. He said he followed up on contact numbers and emails, both in Jamaica and the U.S., but got no response.