ThoseGeneva University Hospitals –
Conflicts and “climate of fear” in the Obstetric Service of the Hospital
A lack of communication would have led to two neonatal deaths. The HUGs want to dismiss the service chef from his post. His lawyers denounce a “cabal”.
The entry of the maternity of HUG (illustration image).
Lucien fortunate
- Two neonatal deaths reveal communication problems between teams, according to an expert.
- The HUGs plan to dismiss the Obstetrics manager following internal conflicts.
- Service lawyers denounce an “unjustified” decision.
The Obstetric Service of Geneva University Hospitals (HUG) lives a tormented period. The institution wants to dismiss the service manager from his post and reclassify it in another assignment. In question: two reports report conflicts, in particular between this official and part of his team as well as other services, likely to threaten the proper functioning of Obstetrics.
The chef has used the decision to open the reclassification procedure, then requested its suspensive effect, that the Administrative chamber of the Court of Justice has just rejected.
“Large sufferings”
The first alert signals date back to 2016, while the manager is not yet at the head of the obstetrics. A first audit is carried out following tensions in the delivery room.
A few years later, in 2024, the hospital mandated the KPMG company to assess the service as a result of staff complaints. The report is based on an anonymous satisfaction questionnaire of 334 employees of various services of the Maternityas well as 40 interviews of collaborators occupying different functions.
It emerges from “great sufferings” expressed by part of the respondents. Even if different executives are targeted, the Obstetric Service Chef is the representative of the hierarchy most often associated with the problems, underlines the room.
The main grievances about it report verbal aggressions, lack of respect, climate of fear. The judgment notes that some of these problems had been supported in 2020 already.
Accidental death
But there is more worrying: mid-December 2024, a second evaluation, led by a teacher in obstetrics from another large hospital, notes that “if the work is of quality, it seems to be done at the cost of fears, fears and stress”. According to him, “the conflicts and the cleavage between the chef and part of the team expose to medical accidents as well as to significant tensions”.
He cites three concrete cases. In 2018, “a major communication defect between the various trades in an urgent obstetric situation led to a neonatal death”. In 2021, a “interpretation conflict” between a doctor and a midwife also led to a death. Finally, an accident took place in 2023, without fatal exit. “These three cases, over six years, show the weakness of all teams in communication and transmissions.”
The two lawyers for the service of service, Me Nathalie Bornoz and Me Robert Assaël, come back to these cases: “Our client was shocked by the death of a newborn in 2021, which occurred while she was on vacation. This accident is all the more regrettable as a doctor on duty had identified a risk, but had not been able to access the room, because an employee – who was not under the responsibility of our mandate – had not allowed him, saying that everything was normal. “
They add that “despite all the measures taken, a second accident took place in 2023, as the medical team had only been called upon at the end of care. Fortunately, the baby could be saved. ”
Applied coercive measures
Asked about these accidental deaths, the director of communication at the hospital, Frédérique Tissandier, notes that the teacher – author of the end of 2024 evaluation – also said that “situations described are classic of a service with a significant volume of activity”.
“The HUG records nearly 4,000 births per year, and five to ten neonatal deaths, mainly due to genetic syndromes, very high prematurity or asphyxiation,” explains the director of communication. Each situation of neonatal mourning is accompanied by individualized and benevolent follow -up. The neonatal mortality rate at HUGs was 1.57 per 1000 births in 2023, much lower than that of Switzerland (4.2). ”
The professor notes, however, that it was the lack of dialogue that led to the deaths of the two infants. Have surveys been carried out? What measures have been taken? “The HUGs never comment on the subjects concerning patients and collaborators individually,” replies Frédérique Tissandier. In addition, the procedure (Editor’s note: reclassification of the service of service) Being in progress, we cannot make any other comments. ”
In general, she continues, all incidents are declared and followed by actions: “Each neonatal death is the subject of an internal investigation. The professor also noted that corrective measures had been implemented. ” And to add that “the quality of the medical services issued by the obstetric service, including by its supervision, is absolutely not called into question”.
In January 2025, during a service interview, the HUG announced, however, to the head that its role at the head of the obstetrics “is no longer compatible with its proper functioning” before sharing it, in April, with a new, subordinate assignment. In its judgment, the Chamber stresses that “it would be shocking that the HUGs are forced to maintain the appellant at the head of the service despite the serious reproaches”.
“Unfounded and arbitrary decision”
Today, the manager is on sick leave. For Me Nathalie Bornoz and Me Robert Assaël, the reclassification decision is “sudden and brutal, unfounded, unjust and arbitrary. For twenty-four years at the HUG, our client has provided skills with competence, dedication, empathy, which many collaborators and patients have confirmed. Suddenly, would she have become incompetent? It’s not serious. “
The two lawyers argue that none of the grievances is established “and that by bypassing the essential administrative investigation they should have ordered and that our mandant has requested, the HUG deprives it of the elementary right to defend themselves and to demonstrate the emptiness of the reproaches”.
In addition, according to them, the study produced by KPMG includes deficiencies. “The company, moreover, clearly said that its mandate consisted of a simple assessment on the working climate in general, that it could not guarantee that the information collected corresponds to reality and recommend any action without any in -depth analysis being done.”
“Some people want to dismiss it”
Me Nathalie Bornoz and Me Robert Assaël still recall that the manager has set up various protocols to ensure the quality of care: “It is not for nothing that maternity has become the largest in Switzerland and one of the best. In his report, the professor has also retained that the quality indicators were very good and that the difficulties inherent in interprofessional collaboration exist in all maternities. He also observed that the complaints and declarations of serious undesirable effects are few, given a denominator of around 4000 births per year. ” And to argue that their client is the victim of a cabal, “led by some people who want to dismiss it, for no real objective reason”.
Finally, the lawyers evoke a violation of the federal equality law, “because, to the HUG, no man, colleague or head of service, underwent what it endures when the facts which were accused were much more serious”.
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