Only one doctor has been found guilty of misconduct in 19 years

A doctor at Kenyatta National Hospital prepares to operate on a patient. In the rush to earn a fortune, doctors are increasingly spending as little time as possible on patients, their eyes fixed on volumes rather than quality. PHOTO | JEFF ANGOTE | NATION MEDIA GROUP

What you need to know:

  • In the past five years, the number of cases reported to KMPDB have dropped from 84 in 2011 to 59 last year.
  • In 2014, gynecological and cases related malpractice cases were the highest with 18 of the 55 complaints reported.
  • Last year, for instance, Nairobi Women’s Hospital was directed to pay the estate of the late Joyce Adema Sh3.6 million after Justice Rose Ougo found that its doctors failed to give a proper diagnosis.

Kenyan doctors easily get away with serious cases of professional negligence.

For example, only one doctor has been suspended for medical negligence in the past 19 years.

And that is one out of the 886 cases lodged since 1997.

While some medical doctors have been found guilty by courts of law over the years, they continue practising with the Kenya Medical Practitioners and Dentists Board failing to act — or having absolved some of them of blame.

Today, Dr William Omondi Oduor is the only medic struck off the register. KMPDB found him guilty of attending to a patient at Mwingi District Hospital in 2010 while drunk.

As a result, Mary Ndanu Titus, who was pregnant died, together with her child.

In the past five years, the number of cases reported to KMPDB have dropped from 84 in 2011 to 59 last year.

Whether this is as a result of better handling of patients or lack of confidence in KMPDB is not clear with the medics regulator maintaining an all-is-well facade.

Its Chief Executive Officer, Daniel Yumbya, says that the possibilities of medical negligence and mis-diagnosis “are not as high as people might think.”

But there is no shortage of frightening cases.

In September 2015, two children died in Kerio Valley, Elgeyo Marakwet County, after a measles vaccine was administered on them by a “cleaner” at Kapetwa Health Centre, according to then Director of Medical Services Dr Nicholas Muraguri.

Dr Muraguri is now the Principal Secretary for Health.

MALPRACTICE
With the board failing to follow up on such cases, the number of reported ones remains low and take too long to conclude.

In July last year, there was a national uproar after 30 children from Busia County were almost paralysed after getting the wrong injections.

The board only picked up the case after it was reported in the media and it is yet to make any head way though it has set up a committee to investigate.

Mr Yumbya says: “We cannot comment on it now”. With rules that prohibit the Board from discussing cases progress with the media, the KMPDB remains a closed house with such cases out of the limelight.

“Our rules prohibit us from discussing cases with the media, therefore, we discuss them at the end, where judgment is given in the open.”

The board notes between 1997 and 2013, most of the malpractice claims were linked to medical and surgical-related processes.

The second malpractice claims were behavioural, which comprised complaints by patients about inappropriate language and undue delays in providing care.

Alex Madaga’s fatal case is the latest.

Madaga is the patient who stayed in an ambulance for more than 18 hours waiting for an ICU bed by several hospitals in October last year.

“We have met with the family, we are going to constitute a Professional Conduct Committee by March, and we hope to conclude the case by then,” Mr Yumbya told the Nation early this month.

In 2014, gynecological and cases related malpractice cases were the highest with 18 of the 55 complaints reported.

SECOND OPINION

This was followed by surgery at 13 cases the least being dental with a single case.

Since the year began, six cases have been lodged with the board bringing to a total of 886 cases that are not concluded yet.

“You see, we get a [complaint] report but upon investigations we discover the case may not be as is said. So, some lodged cases are dismissed,” said Mr Yumbya.

He added patients should always seek a second opinion of their diagnosis or treatment.

“In the Patient Charter, a patient has the responsibility to seek second opinion when making a major health decision. Sometimes diseases have manifestations that present (themselves) in certain ways.

A doctor is a human being and may miss [something]. That is why it is important for another review to be certain.”

The cases, reported or not, keep piling up. Among them is that of Ms Ruth Wangui who, when she suffered a severe headache, was diagnosed with intramural fibroids, a condition that affects the uterus.

That diagnosis was not supported by any scans or proper medical investigation and Ms Wangui was placed on a 28-day treatment plan to “reverse” it.

A few days into the regimen, she noticed it had started interfering with her vision and she would occasionally convulse.

She visited another hospital for a second opinion and was informed she did not have any fibroids.

The doctor who misdiagnosed her condition kept his practice, probably damaging the lives of other unsuspecting patients, but Ms Wangui now lives with blurred vision and other complications.

Her case, like Ms Saidi’s, may never find its way into the board.

Dr Alice Musibi, an assistant professor of medical oncology at the Aga Khan University Hospital in Nairobi, agrees that medics sometimes fail their patients.

LAWSUIT

For instance, a patient with persistent abdominal pain might initially self-medicate but eventually seek treatment if their condition does not improve.

“The doctor might start by treating that patient for malaria, then typhoid, then worms, yet the patient could be having stomach cancer. By the time the patient goes to see another doctor, the cancer will have spread,” said Dr Musibi.

In the wake of a floundering complaints board and a medical community that, other than swearing the Hippocratic oath, seems to have sworn a pledge of silence and peer protection, patients often choose to litigate their cases in court.

That route, however, is fraught with challenges as lawsuits on medical negligence are some of the most complicated in the world.

The burden is always on the plaintiff to prove their case.

But even in this challenging environment, KPMDU has suffered embarrassments in court.

Last year, for instance, Nairobi Women’s Hospital was directed to pay the estate of the late Joyce Adema Sh3.6 million after Justice Rose Ougo found that its doctors failed to give a proper diagnosis.

The family argued that in 2007, Ms Adema went to Nairobi Women’s Hospital to be attended to as a referral, but was instead instructed to continue taking previous — and wrong — medication prescribed by an outsider doctor.

The family had initially lodged a complaint before the KPMDU, which, although it found that the doctors failed to properly assess the patient and hence did not recognise how seriously ill she was, still concluded that the doctors were not negligent in the management of the late Adema.

MONEY-ORIENTED
Some of the doctors who spoke to the Nation attributed the rising number of cases of misdiagnosis to the low doctor: patient ratio.

In the rush to earn a fortune, doctors are increasingly spending as little time as possible on patients, their eyes fixed on volumes rather than quality.

“They want to spend less time with you so that they treat more and earn more,” says Dr Ojwang Lusi, a senior health officer in Kisumu County.

Poor training, overcrowding in hospitals, and poor equipping of doctors are making the situation worse.

Training is proving particularly important as it touches on the preparation of doctors before they embark on the journey of saving lives.

In the past, says Dr Lusi, students would choose an area of specialisation and master it, but nowadays “they treat all illnesses, even the ones they are not familiar with” just to make money.

Critics of the medical training curriculum argue that the blot on the system only grew larger and more rancid with the introduction of parallel degree programmes, which watered down the quality of instruction in medical schools.

However, Mr Yumbya dismisses the claim, reasoning that “older doctors just take neater notes,” and that “they are not different from the younger ones”.