"Iron infusion - permanent staining"

I received an Iron Infusion at Armadale Health Service – Antenatal Clinic. This was due to losing approximately 2.5L of blood during labour the day before. The doctor recommended a slow-release iron infusion. At this time, I was still recovering from the birth of my child. I signed the waiver for the Iron Infusion without being in the right frame of mind (Due to blood lose, being bed bound, having minimal sleep in the past 48 hours and the overwhelming number of tests being conducted). I had advised my midwife of how overwhelmed I was and asked to be alone with my child and partner.

Approximately 1 hour later, the senior nurse inserted the IV into my right arm. The senior nurse looked confused when they tested the cannula as no blood was extracted. The senior nurse looked at my partner and I and said that this was strange but maybe there was a valve in the vessel at the location of the cannula. This did not fill us with confidence. The senior nurse then joked and said that they think it’s been inserted correctly and then quickly corrected themself and said that they were 100% sure the IV was inserted correctly. Shortly after, my midwife came into the ward. The midwife injected saline to flush the cannula in my arm as part of their procedure. I advised the midwife that a stinging sensation was occurring. The midwife advised that the senior nurse would have to return and attempt to correct the cannula as the saline should not cause a stinging sensation when injected.

Shortly after, the senior nurse returned and inserted a cannula into my other arm. The senior nurse finished the IV and again looked confused as no blood was extracted. The senior nurse commented again that this was strange, but they were confident it worked. The midwife returned to the ward and started the slow-release iron infusion without flushing the IV with saline first. The midwife asked if there was any pain when commencing the iron infusion. I advised them that I felt pressure in my arm. Despite this, the iron infusion was not stopped.

The iron infusion was connected for approximately 1 hour and 45 minutes. During this time, the midwife monitored the iron infusion for the first 15 minutes and then several times within the first hour. My midwife then took their lunch break, and no observations were completed for the remaining 45 minutes.

During the first hour of the iron infusion, I was asked to breastfeed my child. When breastfeeding my child, the midwives placed my child’s head to rest on the cannula in my arm where the iron infusion was connected. I commented to the midwives that this was quite painful and asked if I could breastfeed after the iron infusion was completed. I was advised that my child needed to feed every three hours and due to the iron infusion being slowly released that this would not be possible. If this was the case, why would a slow-release Iron Infusion be recommended? I believe the only difference is that a slow-release Iron Infusion is cheaper! Eventually, a midwife assisted by holding my child’s head above the cannula while they breastfed. After approximately 1 hour and 20 minutes of the iron infusion being released, I fell asleep. I awoke approximately 20 minutes later and noticed a slight bruise on my arm. I called for the nurse and the midwife came in. The midwife immediately called for the senior nurse and Doctor. The Doctor advised that the cannula had at some point failed and begun weeping into my tissue which has caused permanent iron infusion staining. The Doctor advised to remove the cannula immediately. The senior nurse advised that normally the doctor would insert the cannula and they, the senior nurse, will never insert a cannula again. This I found to be extremely concerning and unprofessional. Only the most highly trained medical professionals should be inserting a cannula if it can result in permanent disfigurement.

A couple of months later, I made a formal complaint to Armadale Health Services and requested an investigation and for the Iron Staining treatment through laser to be paid for by the hospital. I was advised that “In accordance with the WA Health Complaint Management Policy, this process should be completed within 30 working days. If there are any delays, you will be contacted and informed of the progress in 15-day intervals.” The 30 days ended very recently. I have still not received a response. I have contacted the complaints department multiple times. I have since been quoted $10,000.00 for the removal of the Iron Staining through laser treatment. I have also been informed that this procedure is extremely painful and will take 20 treatments, every 3 weeks. This will result in me having to take extended time off work, unpaid. Unfortunately, even after 20 treatments it is likely to only fade, and the stain will be permanent.

Details of why I am not satisfied:

• I had experienced significant trauma from the birth and I feel I was not in the right frame of mind to be signing the iron infusion waiver.

• The senior nurse failed to successfully put a cannula in, twice.

• The midwife seemingly failed to follow procedure and flush the cannula before proceeding with the iron infusion.

• The iron infusion was not stopped after I advised midwives of pressure.

• I believe a slow-release iron infusion should not have been recommended over a normal iron infusion which I recall only takes 20 minutes.

• Failure by midwives to provide observations throughout the iron infusion. I have been advised that the policy is to provide observations every 15 minutes throughout the iron infusion.

• I was asked to breastfeed during the iron infusion and my child’s head was placed on the cannula even after I voiced my concerns that this was painful.

• It seems my complaint has been ignored and the WA Health Complaints Management Policy has not been followed.

Treatment