Yellowknife (Sep 22/03) - The inquiry into the death of a Baker Lake infant has resulted in six recommendations being made to Nunavut's Department of Health.

The independent review panel forwarded the recommendations to Assistant Deputy Minister Dr. Keith Best earlier this month.

The review, co-ordinated by Dr. Alec Macaulay of the Northern Medical Unit, was conducted by Dr. Lynne Warda and nurse practitioner Kathleen deLeon-Demare.

Dr. Best ordered the external review into the death of the baby girl this past March.

The infant was reported to have suffered with chronic diarrhea for an extended period of time before her death.

Dr. Best said the panel's final report is still being reviewed by Nunavut Department of Health officials.

He said the report clearly reflects problem areas in the care regime.

"The problem areas are clearly indicated in the six recommendations the reviewers provided," said Best.

"We intend, through the Operations and Professional Practice Unit, to put a plan in place to implement those six recommendations as quickly as possible."

Although Gaela Stach, the nurse in charge of the Baker Lake Health Centre at the time of the infant's death, resigned from her position on Aug. 22, citing personal reasons, Dr. Best said he's confident the report shows Baker staff acted well in handling a complex level of care.

He said the review recommendations are consistent with the complexity of care involved in the case.

"I can't say too much about the autopsy report at this point.

"However, I'm sure after the departmental review is complete, we should be able to release the autopsy report or, at least, the its meaning.

"Our next step in the process is to wait until the department's review is complete and proceed with whatever recommendation or direction stems from that."

Editor's note: As of press time, review co-ordinator Dr. Alec Macaulay was attending a medical conference in Greenland and was unavailable for comment. Dr. Lynne Warda did not return calls to the News/North.

Panel recommendations:

(1) Improved requirements for charting.

(2) Follow approved guidelines for the management and treatment of diarrhoea illness and bronchiolitis.

(3) Ensure standards/quality assurance by reviewing the requirements for nursing qualifications and training to ensure health-centre nurses are competent in managing critically ill patients, particularly pediatric patients.

(4) Implement a system of routinely classifying health-centre patients by acuity, with certain minimum nursing staff and/or consultation guidelines.

(5) Nunavut should establish a multi-disciplinary Primary care Advisory Committee to regularly review issues of primary care standards and guidelines, morbidity and mortality, preventing medical errors, etc.

(6) The system of X-ray reading and reporting be reviewed to institute a system of more rapid reporting of significant pathology on X-rays.