The Toronto Star, Sunday May 26, 1996
BY CAROLINE MALLAN, STAFF REPORTER
A coroner's jury probing the death of a Jehovah's Witness who died just hours after giving birth has called for the implementation of surgery without transfusions in Ontario hospitals.
The five-member jury deliberated for more than five hours Friday before releasing 11 recommendations that urge the Canadian Medical Association to follow the lead of U.S. hospitals and clinics that perform surgery without the use of blood products.
Bloodless surgery, as it's called, involves the recycling of a patient's blood on the operating table - a technique that originated because of the beliefs of Jehovah's Witnesses who refuse blood transfusions because of religious convictions.
MASSIVE LOSS
Cathy Grenci, 34, died last June 12 at York Central Hospital, less than 24 hours after giving birth, with the use of forceps, to a baby girl.
Grenci died of massive blood loss because of tearing during the birth. She refused a blood transfusion.
Her husband, Gerry Grenci, said he was pleased the jury did not dwell on his wife's refusal to accept the blood, but rather looked at ways hospitals can accommodate people who do not want to receive blood.
"It's not just Witnesses, nobody wants blood any more," Grenci said.
"It's not like 20 years ago when people got a blood transfusion and didn't even know it. People know what's happened, they know what can happen to them."
Grenci was referring to Canada's tainted blood tragedy, in which thousands were infected with the HIV virus or the potentially fatal hepatitis C.
Chuck Goodvin, of the Hospital Liaison Committee of the Jehovah's Witnesses, said the jury's recommendation about bloodless surgery is welcome.
Goodvin said the practice has been used extensively in the United States; in particular, he cited a hospital in Oregon and others in New York City.
A refusal to accept blood should also be clearly marked on the patient's chart on admittance and vital signs should be closely monitored to detect severe blood loss early on, the jury recommended.
The federal inquiry into the safety of Canada's blood supply, headed by Mr. Justice Horace Krever, heard evidence during hearings last year of research being done in Canada to determine the best method to implement bloodless surgery.
A leading Ottawa researcher told the inquiry that doctors have come to realize blood transfusions are not a risk-free solution for every patient during surgery.
But Paul Hebert, an epidemiologist at the University of Ottawa, also said there is not enough funding for research into the long-term effects of bloodless surgery, even though widespread implementation would save taxpayers millions of dollars now being spent on collecting, testing and storing blood.
The Krever inquiry also heard testimony from American doctors who use the bloodless method in most procedures.
An Oregon doctor testified studies at his hospital revealed patients who did not receive extra blood during surgery were discharged an average of one day earlier than patients who had received transfusions.
The Grenci inquest jury also called on York Central Hospital to revise their procedures to ensure that an operating room can be made available within 30 minutes of an emergency.
During the inquest, Dr. Allan Covens, the obstetrician who delivered Grenci's baby, said he waited 12 hours to begin operating on the bleeding woman because of delays due to various medical procedures.