A young Auckland couple's first few weeks of parenthood have been filled with stress, pain and anxiety after the new mum broke her leg while leaving the maternity ward - an injury she and her husband claim was caused by a medical staff decision.
Shina Ali, 27, told the Herald on Sunday she fell and fractured her right tibia after a nurse at Middlemore Hospital made her walk hours after having an epidural, despite Ali repeatedly telling the nurse her leg was still numb.
The hospital has launched a high-level investigation - a Serious Sentinel Event inquiry, which requires reporting to watchdog the Health Quality and Safety Commission.
Early on the morning of February 18, Ali, in labour, arrived at the hospital with her husband Zaoheb Mohammed, 30, and her mother.
She was given an epidural about midday, followed by a bolus top-up later that afternoon. At 5.53pm she gave birth to the couple's son Isaac without incident.
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Ali's midwife stayed with her until about 9.30pm when she handed over Ali's care to a staff nurse. Ali said the midwife told the nurse she could be transferred to a maternity care centre, but only after she regained feeling in her right leg which was still numb.
"Once the midwife left, the staff nurse, she started forcing me to walk," the new mum told the Herald on Sunday.
"She asked me to go and have my shower so I tried to get off the bed but I fell halfway. My family was over so they helped me. They were so angry they made me sit on the chair and sponged me."
She said the nurse kept trying to force her to walk throughout the night, but she was unable to without someone supporting her.
About 12.15am the nurse told the family they would have to leave because the ward was full, Ali said.
The couple said they asked the nurse for a wheelchair or to help them walk to the car, but she did not make one available.
"We made our way out of the labour ward - me, my mum and my husband. I took a few steps and I fell. I just sat on my right leg," Ali said.
"I could feel that it was broken because I couldn't lift it. But I couldn't feel any pain because it was still numb."
Mohammed said he knew his wife's leg was broken because her shin was bent at an angle.
"I was really angry."
A group of medical staff saw Ali fall, she said, and rushed over to help her.
She was taken back to the maternity ward, where a doctor examined her leg.
"I was trying to tell him that my leg was broken, because I could hear a noise, a clicking noise. We could see the shape was different," Ali said.
The couple claimed initial requests for an x-ray were declined.
Ali was allowed to stay overnight, but says she wasn't checked on until about 7am when another nurse noticed her leg was bruised.
She then went for an x-ray, which confirmed her right tibia was fractured.
On February 20, Ali underwent surgery to have a rod inserted.
"I was so stressed I couldn't sleep or eat for five days and my husband, he was the same," Ali said.
She was discharged from hospital on February 27 and is recovering at home.
Mohammed has returned to work as a mechanic and Ali's mother, who is visiting from Fiji, is due to go home in a couple of weeks. The couple don't have any relatives nearby who can help.
The Mangere house they rent has stairs and Ali said doctors had told her it will be at least another four weeks before she can walk again.
ACC has funded a homecare worker to help Ali for one hour per day, however, she is worried about how she will cope when her mum leaves.
"It's still so hard because there's so much to do at home - taking care of the baby, cooking and cleaning," she told the Herald on Sunday.
Ali said the first doctor who examined her, and the nurse who did not provide her with a wheelchair had apologised to her.
Ali's midwife had helped her lodge a complaint with the Health and Disability Commissioner over the incident.
Middlemore Hospital's clinical director obstetrics and gynaecology Dr Sarah Tout said a full Serious Sentinel Event (SSE) investigation had been launched.
It would seek to understand what happened, and identify any systems and processes improvements that could help prevent a similar occurrence.
"The nurse involved is very sorry that Mrs Ali has sustained this very unusual injury following an epidural and we are investigating the sequence of events," Tout said.
Hospital guidelines stated if a patient had an epidural during labour the woman should only be transferred after it had worn off and she was relatively mobile.
"[Ali] was mobilising in the unit, showering on her own prior to her transfer to a primary birthing unit. She had demonstrated an acceptable level of mobility for transfer to a primary birthing unit," Tout said.
The hospital was unable to confirm whether staff actions had caused Ali's injury until interviews had been completed as part of the investigation.