Medics’ blunders that cost hospitals millions of shillings

 

The cost of negligence by a number of medics has left a trail of painful experiences among families.

Many patients have died due to doctors' negligence, with the affected hospitals slapped with awards running into millions of shillings.

Investigations by The Standard indicate more than 10 hospitals have since 2012 been ordered to pay Sh38 million for their doctors' blunders and negligence.

Sampled cases implicate both public and private hospitals following complaints by patients and their families.

Most of the cases leading to death and permanent injuries had patients left with operation materials after surgery and others being misdiagnosed.

Statistics indicate gynecologists have been hit with the highest number of complaints lodged before the Kenya Medical Practitioners and Dentists Board (KMPDB).

Of the 936 cases lodged with the KMPDB since 1997, those involving gynaecologists and obstetrics stand at 226 with most of them involving childbirth.

Latest data from the board shows the number of cases has, however, been reducing over the years with 2008, 2011 and 2013 recording the highest numbers at 85, 84 and 78 respectively.

So far this year, the board has received five cases. Last year there were 50 cases and 59 in 2015.

According to the data, internal medicine practitioners; where physicians and clinicians fall, were the second largest group of professionals after gynecologists with 150 malpractice cases followed by surgeons at 130.

The board has so far received 96 cases regarding over pricing of services, 86 on pediatricians, 83 on orthopaedic medicine and 46 that have been categorised as others.

"This includes but is not limited to failing to give medical reports, sexual harassment, absconding duty and attitude," reads the report in part.

Of all the reported cases, 895 have been determined through preliminary inquiry committee (866), tribunal at the national level (15) and 14 by the professional conduct committee, which has held hearings across the counties where Nairobi had the highest number of cases (four). Only 41 cases are pending.

On the board's disciplinary action taken, one doctor has been deregistered, four had their licences cancelled while six had their licences suspended for a period of six months and another 16 ordered to undergo supervised training for a period of six to 12 months.

However, a majority of the cases (141) were referred to the alternative dispute resolution or mediation; 106 were directed to undergo continuous professional development for 30-50 points while cases admonished or cautioned to either institutions or practitioners are 105.

Court rulings

Some 13 complainants did, however, withdraw their complaints while 11 cases were referred to the courts.

A scrutiny of the cases reveal that hospitals part with between Sh1 million and Sh8 million as punishment by courts after finding a doctor's slackness in how they handled the patient.

A case where the Nakuru Provincial Hospital was sued by a patient after the doctors allegedly left abdominal gauze pack is the most recent medical negligence case determined by the courts.

In the case, determined in April 2017 the patient narrated how she was diagnosed with blocked fallopian tubes and a surgery had to be done to unblock them. But the surgery ended up being a case in court with the Attorney General named as a respondent after doctors left an abdominal gauze pack in her stomach.

The woman named as JNG told the court that the pack damaged her intestines, her fallopian tubes and the ovaries. What the hospital did was to just give her painkillers despite her complaining of persistent pain.

The court heard that two doctors were to blame in the operation that cost her Sh 7,000. She complained to the KMPDB but never got a reply, forcing her to turn to the courts.

The court was told that a second opinion from a private hospital, Avenue Hospital, confirmed the blunders done in her previous operation. The judge was told that it cost her Sh1.4 million in treatment fees.

In addition, the woman testified that she had to part with Sh600,000 as treatment fees at Mariakani Hospital in a bid to repair her intestines.

The judge was told that the woman could not conceive after the blunder.

In reply, Joaquem Otieno for the hospital submitted that after assessing the woman, he made a diagnosis of tubal factor infertility and advised surgery.

He told the court that the team of doctors who operated on  her did not use the pack alleged to have been left in the stomach. Dr Otieno said the patient was discharged after showing recovery after seven days but never showed up for check up.

He testified that there was no way that the team that operated on the woman could have left anything inside her as all equipment were counted to verify if anything happened.

Another patient, Hellen Kiramana, was awarded Sh4 million after a wrong hip implant placed by PCEA Kikuyu Hospital doctors. The implant ate into her bones and caused severe back pains for eight years. The first hip implant was in 1999.

The court heard that one Dr Murila had initially told the patient of there being no metal for implantation. However, when she went back after one week, she met a white man who informed her the implants were available if she had money.

The case was determined by High Court judge Roslyn Aburili who noted that doctors did not explain why they placed the implant when it was clearly indicated in bold "Do not implant".

A witness in the case, a Nairobi Hospital doctor Fred Otsyeno, told the court he had in 2012 operated the woman and found she had a loose hip.

The surgeon further told the court the patient had a trial implant with the caution not to be used for the implant. He said the implant ought to be used in teaching and not for medical intervention.

The hospital responded by denying that its employees had acted in negligence. It argued that they were professionals in their work.

The judge was told that the patient was never guaranteed or assured that the implant would give her a life time cure from severe bilateral hip osteoarthritis free from further medical intervention.

Eight painful years

The judge ruled that the medical facility was to blame for pain Kiramana had undergone.

"In my humble view, what the plaintiff has shown by her uncontroverted evidence is gross negligence on the part of the defendant, its agents and servants in managing her health concern," she ruled.

"I find that the defendant hospital was vicariously liable for the negligent acts of its doctors who inserted a wrong implant in the plaintiff's hip, thereby, causing her a lot of pain and suffering. She stayed with the wrong implant for eight years and had to undergo a third operation to have it removed," she ruled.

In yet another case, Hilda Otieno sued Agha Khan Hospital, Kisumu and doctors P Reddy and G Ogutu after they operated her only to find she had constipation.

Judge Ali Aroni in the 2011 case was told that the doctors did radiology and found that she had some cystic mass in her ovary. They recommended an operation to remove it.

The court heard that the woman was complaining of stomach pains all along. On the operation table, doctors discovered that the diagnosis was wrong, as all along she had suffered from constipation, which would have been healed with laxatives.

The three defendants challenged Ms Otieno's allegation of professional negligence. They denied allegations of extreme negligence and that the woman ignored recommendations by Dr Reddy that she needed further consultations before anything was done.

The court heard the woman went for the surgery 'for the sake of it'.

"The doctors did not exercise diligence, care, knowledge or caution in the way they handled the plaintiff," ruled Justice Aroni. She awarded her Sh1.5 million.

In another case, against Mary Help of the Sick Mission Hospital in Thika, through its trustees Arch Diocese of Nairobi, the High Court awarded a child Sh4.7 million after it was discovered that he was injected on the wrong vein thus leading to his left hand rotting.

In the case, the court heard that on September 11, 2003 one JM gave birth to a son in the hospital but the doctors realised that he had a weak cry.

They decided to administer drip on the left hand but the injection made his hand to rot. The child had to have his hand amputated at Gertrude's Hospital.

The woman sued the hospital and one Kenneth Munene. Judge Ruth Sitati was told the child ended up losing his left hand because doctors had resuscitated him.