Two axed from doctors’ roll over patient’s death in botched surgeries

Trans Nzoia County Director of Health Philip Mbithi (centre) with other members of the board’s committee during a  sitting in Kitale on Thursday. PHOTOS: OSINDE OBARE/STANDARD]

By HEZRON OCHIEL

Nyanza, Kenya: Two doctors found to have caused the death of a patient five years ago due to negligence have been fined Sh100,000 each.

The Kenya Medical Practitioners and Dentists Board also ordered the two doctors in Kisumu County to surrender their practising certificates.

Aggrey Akula and Francis Ayugi were penalised for allegedly removing the patient’s womb instead of fibroids.

The board cracked the whip on the two after finding they were negligent in performing their duties as doctors at the Kisumu East District Hospital. They were ordered to pay Sh100,000 each within 30 days as part of the sitting costs for the board’s committee.

The board, consisting of eight people and chaired by Kisumu County Director for Medical Services Ojwang Lusi, also ordered the district hospital to put in place an appropriate records management system within 30 days.

The decision followed a disciplinary committee constituted by the board to hear a complaint logged by Serphine Akinyi’s husband, Geoffrey Juma, over circumstances in which his wife died five years ago while undergoing medical treatment.

The two were admonished for failing to consult a surgeon on time, a move that allegedly led to a failed operation and consequently the death of Akinyi, 40.

The deceased is said to have suffered from fibroids and had four unsuccessful operations, leading to her death. Dr Lusi said the board held an inquiry at the Jaramogi Oginga Odinga Teaching and Referral Hospital on Wednesday after receiving the complaint from the widower.

In his testimony, Mr Juma told the committee that his wife was admitted at the Kisumu East District Hospital on July 24, 2009, and an operation was done the following day.

Juma said he noticed some discharge coming from his wife’s abdomen and managed to get Dr Akula’s telephone number. when Juma called, the clinical officer informed him that his wife’s womb had been removed.

Akula took Akinyi back to the theatre for a second operation and told Juma that after opening her up, they only did some cleaning.

The wound started discharging again and Juma approached an independent doctor and the patient was later taken to the radiography department of the provincial hospital.

Akula and Dr Ayugi performed a third operation without seeking a second opinion. Three or four days later, there was the wound was still  discharging and Akinyi developed a fever. She was moved to Moi Teaching and Referral Hospital in Eldoret.

Dr Philip Parklea, who handled the patient at the hospital, said she had an infection and he could not operate her. He said it was wrong that the referral letter mentioned two operations instead of three.

Akula, who graduated from the University of Nairobi in 1993, was working as an obstetrician/gynaecologist at the district hospital.

Recurrent bleeding

He claimed the patient had complained of recurrent vaginal bleeding and anaemia, and he prescribed some medicine to stop the bleeding.

When it did not stop, Akula said he advised Akinyi to have an operation and admitted her in the hospital.

During the first operation, Akula said he discovered multiple fibroids with intestines adherent to the uterus. Weighing the options (age and bleeding), he settled on a hysterectomy as the operation of choice.

In the second operation, he said the patient had to be taken back to the theatre for repair of a fistula but it gave away again. The operation took over an hour but the team of doctors did not see any fistula.

Ayugi told the committee in the third operation conducted on August 12, 2009, they repaired the identified site of leakage. The patient was moved to Eldoret and died three weeks later. Ayugi argued that the death certificate indicated the cause of death as cardiopulmonary arrest due to faecal fistula secondary to laparotomy.

Dr Parklea told the committee the cause of death indicated on the certificate by a clinical officer was not correct.

“The committee further finds that part of the patient’s record at the said facility show evidence of sepsis, high blood sugar and fever, but there was no clear indication on management steps taken by the team of practitioners at the institution, especially the physician, Dr Lameck Diero, whose documentation in the patient’s file were seriously wanting for his level of qualification,” the ruling stated.

The board reviewed documents relating to proceedings, witness statements and evidence to make the decision.