A Toronto hospital will undertake a review of its procedures after a newborn baby girl was declared dead and left under a sheet, despite the fact that the infant was actually alive.

The call for a review comes just a day after a Toronto mother went into labour and gave birth outdoors while walking to Humber River Regional Hospital on Sunday morning.

The baby girl was born just before 6 a.m. ET on Sunday near the intersection of Jane Street and Finch Avenue West. The temperature was –16 C, though it’s not known what role, if any, hypothermia played in the case.

Both baby and her mother — a woman in her 20s — were taken by ambulance to the hospital's Finch Avenue campus.

The baby was pronounced dead by medical staff and covered with a sheet. About 90 minutes later, two Toronto police officers assigned to guard the body while awaiting the coroner noticed the sheet moving and contacted hospital staff.

Mother and child are now recovering in hospital and are in stable condition. The identity of the mother has not been released.

Humber River Regional Hospital has released a statement saying it is "reviewing all procedures followed in the care" of the newborn infant.

"The review is looking at all aspects of care provided in this case, including the extensive resuscitation efforts by hospital physicians and staff beginning in the ambulance itself when it arrived at the hospital," said spokesman Gerard Power.

"The review will be conducted in consultation with all appropriate agencies, including Toronto police and EMS. The Ministry of Health has been informed as well."

The review is being led by Dr. Nalin Ahluwalia, Humber’s chief of emergency medicine, and Dr. Narendra Singh, Humber’s chief of pediatrics, Power added.  

Ontario Health Minister Deb Matthews told CBC News that she looks forward to the hospital review and wants to make sure something like this never happens again.

Caution needed when dealing with infants

Medical staff must be extra cautious before declaring that any child exposed to freezing temperatures is deceased, a veteran emergency room doctor said, the day after the girl was wrongly pronounced dead.

"When hypothermia is involved, then no one can be pronounced dead until they’re warm and dead, as opposed to being cold and dead," said Dr. Brian Goldman on Monday.

Although he did not have direct knowledge of this specific case, Dr. Goldman, who hosts the CBC Radio program White Coat, Black Art, said such incidents are well documented in medicine.

"There are plenty of stories in literature, scientifically, so-called miracle babies who have survived beyond a time when we would have considered them dead and usually it’s when they were hypothermic," he said.

Goldman said this is particularly a factor in small children, whose metabolism slows down when their body temperature falls, leading medical staff to pronounce them dead incorrectly.

"Infants and newborns are more likely to exhibit this," said Goldman. "So that the effective window of time to resuscitate that newborn is much longer than it would be with adults.

"I have certainly seen patients who looked like they were close to death, but they were cold and when they were warmed up, it was possible to restart their heart," he said.

Goldman said rather than changing how emergency room staff operate, the incident is a good reminder to all medical staff who treat patients exposed to the cold.

With files from CBC's Lorenda Reddekopp