The incident happened on 24th June when I brought my daughter to KKH’s A&E department. My daughter had puffy eyes since 19th June and I was concerned that it could be attributable to an earlier accident on 3rd June in which my family called an ambulance when she fell from her cot bed face-down and suffered bleeding from her mouth, bruises to the sides of her nose bridge and inner corner of her left eye.
The doctor-in-charge ruled out the possibility of the linkage to the earlier event on 3rd June as the incident took place a while ago and suspected the eye puffiness could be due to viral infection, allergy or kidney problems. To ascertain if my daughter had kidney problems, the doctor suggested to place a urinary bag to collect the urine. Based on previous visits to KKH, I told her that we usually collect mid-stream urine as it gives a more accurate result. She agreed and questioned if my daughter will be peeing in the washroom. I was surprised at her question as we were usually allocated a bed for the mid-stream urine collection of my child. After communicating with her, she arranged my daughter and I to the bed section.
Till then, my daughter’s diaper was filled with urine when we took off her diaper for cleaning purposes. I was feeding her with water and hope that she manages to urinate. However, my child refused to urinate and kept saying she wanted to go home. I continued to persuade my daughter but she kept insisting that she wanted to go home.
I then suggested to the nurse that since my daughter refused to urinate, it would be easier for her to pee at home as she is a shy girl and does not allow strangers to remove her pants or change her diaper. We were offered this option previously at KKH with 2 sterile bottles for urine collection at home. However, the doctor told us that the mid-stream urine collection cannot be done at home as the test of protein in urine and the test of urinary tract infection (UTI) are different. I have previously worked in a private research organization of renal disease and personally find this explanation absurd.
I explained to the doctor that I needed to bring my daughter, wife and helper to lunch. Only one child patient and accompanying adult are allowed to enter the F&B premises. Although my wife was 37 weeks pregnant, she was still declined entry along with my helper due to possible safe distancing procedures enforced by the hospital. I highlighted to the doctor that my wife and helper could not have lunch in the hospital and then she suggested to attach an urinary bag on my daughter’s bottom and told me to bring them to go lunch and come back after the urine is collected. Since I have previously mentioned to her that my wife and helper were unable to enter the F&B premises, I interpreted that we were allowed to go out to have lunch with the urinary bag placement and come back to KKH afterwards.
As the nurse on duty adheres the urinary bag on my daughter, I asked the nurse on the time that I needed to be back to KKH. She answered that we can come back any time after she urinates in the bag. She then instructed me to remove the bag after urine collection and pour the urine into the sterile bottle provided. She also mentioned that if I find it difficult to pour the urine from the bag to the sterile bottle, I could always approach the nurses for assistance.
In view of the above, I went back to my house which is just around 10 mins drive from the hospital. About 10 mins after my family and I reached home, we noticed that my daughter had urinated but her urine was not collected in the bag. Instead, the urinary bag was detached and the diaper was soaked with her urine.
In response to this, we planned to call the hospital to check on the next course of actions, whether we are able to collect her mid-stream urine directly or if we need to drive back to the hospital for the reattachment of the urinary bag. At this time, the doctor then called to check on the status of urine collection of my daughter. I told the doctor that the attached bag had failed to collect the urine and my daughter’s diaper was soaked. She then asked me on my location and I told her that I was at home. She mentioned she will call me back later.
The second call came few minutes later and the same doctor told me she needed to close the case and we need re-register at the hospital again if we are sending our daughter back. I was shocked and asked if we can collect the mid-stream urine and send back to the hospital. She said we can do so but she might want to re-collect the urine again as it might be inaccurate because this urine collection is to test for protein but not for urinary tract infection. I asked for the difference between the methods of urine collection of protein test versus UTI test. She didn’t address my question and told me that the environment is different at home and in hospital. I expressed again that this was not the first time that we could collect mid-stream urine at home. We have tried once in KKH and another time in Queenstown polyclinic.
I also reiterated to the doctor that I was not informed that I can’t leave the hospital. If I could not leave the hospital, how can my pregnant wife, helper and daughter have lunch when two of them are refused entry into the F&B premise? The doctor claimed that she has explicitly told me that we are not able to exit the hospital premise but I seriously did not receive the message from her. If I know that I cannot leave the hospital, I would not have informed the doctor that I was at home as the distance from my home to hospital is just a 10 mins drive. I could have alternatively told her that I am somewhere in the hospital and I am going back to the A&E department when she called me. However, she still insisted that she has communicated to me explicitly when I seriously did not receive her message.
The doctor then insisted we have to collect my daughter’s urine within the hospital premises and emphasized that she needed to close the case and we need to register again even if we choose to forgo lunch and send our daughter back to KKH immediately. I was utterly displeased with her answer and asked her what’s the reason of re-registering our child if we manage drive back to the hospital immediately. She then mentioned it was the practice of the hospital and it was the emergency department.
I was utterly disappointed in her answer and do not want to probe further. I do not understand why there were inconsistencies in the practices of KKH on urine collection and the need for re-registration when we said we could drive back to the hospital immediately within 10 mins. The nurse on duty also advised we could come back any time my daughter urinates in the bag. No one has mentioned the need for re-registration and the incurrence of double A&E fees. And what is disappointing is that previously we were given sterile bottles for urine collection from KKH as well but this time, we were told we needed to re-register.
After the unpleasant event, my family and I decided to bring my daughter to another hospital for a second opinion. We hope that you could look in this matter and provide us a refund in KKH’s A&E fees as the investigation and diagnosis was not completed.
Lee Xing Yan, Stella
Lee Chee Chow
Tel: +65 [protected]
Singapore – 229899