A review is under way into the deaths of four babies within a month at Adelaide's Women's and Children's Hospital amid concerns a lack of cardiac surgery facilities may have contributed, something doctors warned about more than a year ago.
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Deputy Chief Public Health Officer Mike Cusack said such a cluster of cases over a short period of time is concerning.
The hospital would expect to report only six to 10 such cases, of very young infants with serious heart problems, each year.
"Where we see four babies in a cluster, that is a cause for further investigation," Dr Cusack said.
"As a parent, whenever you read about adverse events in children, it's always hard. So my heart really does go out to each of the parents and families that have been affected by this.
"When you see these tragic events there's a great need and desire in the health system to want to analyse and really understand what happened."
Dr Cusack said investigations already conducted by the hospital had not identified any particular problems or mistakes with the treatment of the babies.
His review would focus on whether the best care for such cases was available in SA.
"Is there anything, that if a child were to present with similar circumstances in the future, that we may be able to do differently next time," Dr Cusack said.
Health Minister Steven Wade said a recent report to the board of the Women's and Children's Hospital had ruled against establishing a full cardiac surgery unit in Adelaide as it could increase the risk to seriously ill infants because of low case numbers.
But he said the hospital's board was seeking further information and input from other senior clinicians on that issue.
The hospital was working to establish an Extra Corporeal Membrane Oxygenation (ECMO) support service, which replaces the function of the heart and lungs, the minister said.
It was also revealed on Wednesday that senior doctors at the Women's and Children's had raised concerns over the lack of cardiac services as far back as July last year.
Opposition health spokesman Chris Picton said given the earlier warnings the government must act to prevent further tragedy.
"This hospital which all of us parents rely on must have the resources doctors are calling for," he said.
Under current arrangements, young infants needing complex cardiac surgery are flown to Melbourne, although COVID-19 restrictions have resulted in patients being sent to Sydney in recent months.
Victorian Premier Daniel Andrews described the recent deaths as a "terrible tragedy".
But he said any decision to send babies to Sydney for treatment instead of Melbourne was taken by South Australia.
"I don't know that it is correct that COVID-19 restrictions were the cause of them not travelling," he said.
Revealing details of the deaths, obstetrician John Svigos told an SA parliamentary committee on Wednesday that Adelaide was the only mainland capital that did not perform paediatric cardiac surgery.
He said he was aware of three deaths in the past four weeks, while Salaried Medical Officers Association industrial officer Bernadette Mulholland said there had been a further death last week.
Australian Associated Press
