Caribbean tertiary care hospital continues transformation of health care with another year of pioneering procedures
As Health City Cayman Islands celebrates its fourth anniversary this month, hospital doctors, management and staff at the Caribbean tertiary care hospital are looking back at a busy 12 months of life-saving emergency procedures, groundbreaking regional firsts, and increased visits by international patients.
The Joint Commission International (JCI)-accredited hospital, positioned as a model for global healthcare transformation by its founder Dr. Devi Shetty, has recorded more than 55,000 patient visits since opening its doors in April 2014.
During its fourth year of operations, the list of Health City’s innovations and critical high-level care services grew at a rapid pace. In 2017, the hospital became the Caribbean’s only regional center for an advanced form of life support called Extracorporeal Membrane Oxygenation (ECMO.) The ECMO system acts as an artificial heart or pair of lungs during therapy, allowing the patient’s organs to rest while natural healing of the affected area takes place. Health City’s ECMO capabilities saved the lives of several local and international patients during the year, and have become an integral aspect of the hospital’s critical care facilities.
Several technically difficult and rarely performed cardiothoracic surgeries were performed, including a pulmonary thrombo endarterectomy to correct chronic high blood pressure in the pulmonary arteries of a senior citizen, and a pulmonary endarterectomy to remove blood clots in the lungs of a young father. Both dramatic surgeries were performed by Dr. Binoy Chattuparambil, Clinical Director and Chief Cardiothoracic and Vascular Surgeon at Health City.
Caymanian Zoe Bodden, age 80, had difficulty breathing and couldn’t walk, but after her surgery she was back to fighting form. “Dr. Binoy saved my life. After the surgery he would come to visit me at least four times a day, and then shortly after I got out of hospital, he went on vacation to India and every day he would text Minerva [my nurse] and ask her how I was doing,” she said.
Thirty-three year old Bjorn Ebanks’ lungs were clogged with blood clots, and his heart arrested twice before being put on ECMO and undergoing surgery. He was grateful to be alive after his ordeal, and credited Dr. Binoy, as he is affectionately known, with saving his life. “Dr. Binoy is one of the best I would say. Most doctors would probably have given up on me. I’m grateful that I am here and I can have another chance to see my family,” the young Caymanian said.
Further advances were seen in the areas of cardiology and cardiac electrophysiology. New services and procedures were introduced, the first being cryoablation to treat atrial fibrillation. Health City’s Chief Interventional Cardiologist and Electrophysiologist Dr. Ravi Kishore was the first in the Caribbean to perform the procedure, which introduces a deflated cryoballoon into the heart. “Through this balloon we can introduce a liquid, which cools and dilates the balloon, and then freezes whichever structure it is put into,” explained Dr. Kishore. Jamaica-based English patient Peter Tuckey was thrilled with the result: “It’s an excellent facility and I’m so happy that it’s close to Jamaica…I’ll be back to exercising, back to golf…so everything’s on the up.”
Later in the year, Health City became the only facility in the Americas to offer Cardiac Contractility Modulation (CCM) device implantation for the treatment of heart failure. Currently offered in the U.S. on a clinical trial basis only, CCM does not affect the cardiac rhythm directly. Rather, the aim is to enhance the heart’s natural contraction sustainably over long periods of time. Both local and international patients successfully received CCM devices during the year.
Dr. Kishore explained: “What we are proud of is, this is the first time we have introduced this device in the entire Caribbean, and even in the U.S. it’s an investigational device so it’s not routinely implanted in patients in the U.S. and none has been implanted in Central America and South America. In that sense, I think we have introduced yet another novel therapy in the region.”
The first patient to receive a CCM device at Health City was also pleased with the outcome.
Caymanian Howard Vernon said: “Dr. Ravi is very easy to understand, he gets to the point and he believes in showing you what can be done. I would definitely recommend Health City to anyone, anytime.”
In the neurosciences, the first awake craniotomy in the English-speaking Caribbean was performed at Health City in 2017. In an awake craniotomy, the skull is opened and brain surgery is performed while the patient is conscious. In this case, there was a tumor in a crucial part of the patient’s brain, which controls fine motor movements. The surgeons needed to be able to speak with the patient to ensure the removal of the tumor did not damage his speech and hand movements. This was especially important as the patient is a watchmaker by profession. He fully recovered within three months.
The patient, a resident of the Cayman Islands, was referred by his primary care physician to Dr. Romnesh de Souza, Interventional Neurologist at Health City Cayman Islands, on suspicion of a stroke. Dr. de Souza explained that the patient’s occupation involved working with fine instruments requiring a great degree of precision and dexterity. This therefore presented a challenge to the neurosurgical team, led by neuro surgeon Dr. Susheel Wadhwa, who was keen not to damage surrounding parts of the brain that control motor skills and other functions, such as language, during the surgery.
“This is the first operation of this nature at Health City. But fortunately for us, we had the entire team. Right from the technicians to the nurses to the anesthetists to the surgical team, it was the same team which was performing these surgeries in India and so the surgery could be carried out smoothly,” Dr. Wadhwa said.
Another big development in the hospital’s fourth year was in the area of orthopedics, with the introduction of limb lengthening surgery. Health City is the first hospital in the region to use a minimally invasive technique utilizing a device known as a “magnetic nail.” The hospital’s first limb lengthening case was a complicated one, involving a 10-year-old boy from the Turks & Caicos Islands.
Chief Orthopedic Surgeon, Alwin Almeida explained the benefits of the new technique and device being used by Health City in its limb lengthening procedures. “The concept of limb lengthening means we can actually make people taller by expanding their bones, especially those of the lower limbs. One of the biggest advantages of limb lengthening using the precise nail is that a painful and difficult procedure has been simplified and been made painless, not to mention minimally invasive,” he said.
Overall, these advances and firsts were part of a busy year, which saw increasing numbers of air ambulances coming to Health City from all over the region. The various medical and surgical teams saw a steady flow of patients coming from new markets in Latin America and the English-speaking Caribbean.
The ongoing growth was also accompanied by ownership changes. The Narayana Health Group, one of India’s largest private health care organizations and founded by Dr. Devi Shetty, purchased the majority share in Health City Cayman Islands from the U.S.-based Ascension. The purchase, finalized in January 2018, makes the hospital wholly owned by Narayana Health, and underscores the confidence Dr. Shetty has in Health City’s model.
Speaking at the GREAT Festival of Innovation in Hong Kong in March, Dr. Shetty lauded Health City as an example for the rest of the world to follow. “We built Health City with the idea of transforming health care of the Caribbean region and the Western Hemisphere – and perhaps the rest of the world. We have a phenomenal opportunity to use technology and make health care safer, (accessible and affordable) for the patient,” he said.
Closer to home, Dr. Binoy Chattuparambil underscored the hospital’s ethos as the fourth anniversary milestone was reached. “Health City Cayman Islands continues to follow our mission to transform the delivery of health care in the Caribbean and beyond. We have seen our patient numbers from several international markets rise over the past year, adding to the growth seen in prior years. As we continue to add to the range of specialties that we offer and remain on the forefront of medical innovation, we always maintain our patient-centric focus on providing high quality, compassionate and affordable care. We believe this is demonstrated by the glowing testimonials of our patients, who entrust their health to us. We are dedicated to honoring their trust, and grateful for their faith and confidence in us,” he stated.
May 3, 2018 – Kiari FM
May 2, 2018 – Caribbean 360
