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Private hospitals fault counties over medical negligence probes

Tuesday May 14 2019

Suspects in baby Ethan death

Vincent Njau, Irene Katete and Kennedy Odhiambo at the Machakos Law Courts on May 9, 2019, when they were charged with causing the death of baby Ethan Muendo at Shalom Community Hospital. PHOTO | STEPHEN MUTHINI | NATION | MEDIA GROUP 

 AGGREY OMBOKI
By AGGREY OMBOKI
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Private hospital owners have accused counties and government authorities of harassment and interference with investigations into cases of medical negligence.

Dr Timothy Olweny, Secretary-General of the Kenya Association of Private Hospitals, said on Tuesday that processes of addressing negligence were being overtaken by interference by counties and state bodies.

Dr Olweny also said the probes were being overtaken by “roadside declarations and procedures outside the medical board's standards and regulations”.

He further decried the “arbitrary and hasty arrest of health workers and hospital management and interference by counties, "a worrying trend for the health sector".

“The separation of the responsibilities of statutory bodies tasked with regulation and oversight of private healthcare institutions seems to have been distorted by these incidents, with apparent abdication of these roles to the county government and other government agencies,” said Dr Olweny.

“We are deeply concerned by the extent to which county governments can disrupt or allege to terminate the operations of private facilities within their administrative jurisdiction under the presumption of safeguarding public interest."

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SHALOM HOSPITAL

Amid public outcry, Shalom Community Hospital was closed last week and its license suspended following the death of baby Ethan Muendo after a morphine overdose.

As a result, three staff members were arrested and charged in a Machakos court last Thursday.

Shalom had previously hit the headlines after a video went viral, of a woman giving birth unattended, on the floor of a ward, as a staff member watched. A nurse’s aide was arrested.

Addressing the press in Nairobi on Tuesday, however, Dr Olweny said the association was concerned about the arrests of Shalom managers following baby Ethan's death.

“We have noted the announced closure of the hospital and the arrest of staff, management and directors. This followed the closure of St Teresa Maternity & Nursing Home in Kikuyu a week earlier,” he said.

FAIRNESS

Dr Olweny observed that actions against the level four hospital were widened to include closure and withdrawal of licences yet the offences were committed by individuals.

“We were hopeful that the [relevant] bodies would expeditiously and fairly adjudicate these matters but we now have grave concerns regarding the administrative and legal actions that have been taken,” he said..

The official said the government should respond similarly to cases of malpractices at all hospitals, whether public or private.

He said the association expected the state to crack the whip on Kerugoya Hospital with the same severity as Shalom, which is run by a faith-based organisation.

“Regardless of the highly emotionally charged environment within which these events occur, organs must be sensitive to aggrieved parties, ensure procedural justice for the medical professionals and institutions involved and ensure any actions taken are within the strict confines of the law,” said Dr Olweny.

“The same performance yardsticks must also be used for all medical facilities, regardless of their ownership structure, size, or affiliation."

THE FINDINGS

In the case of baby Ethan's death, Machakos Governor Alfred Mutua called for the arrest of implicated health workers but did not provide any information on whether the county health department had carried out inspections to protect patients and prevents similar cases.

After the investigation, a May 8 letter by the Kenya Medical Practitioners and Dentists Board (KMPDB) said Shalom had flouted several patient care procedures including failure to hire senior doctors for specialised care.

The task force that looked into the matter found that the nurse in charge – often referred in hospital setups as 'matron’— does not know of the rotation rota, which has information on who is supposed to be on duty and covering what wards.

A patient attendant, the report reveals, mans the treatment area and handles medication but is not trained to prescribe or administer it.

The two-page document, that lists Health Cabinet Secretary Sicily Kariuki as part of the board’s decision, also noted a series of breaches of patient care guidelines that may have put them at risk

However, the task force did not mention regulatory bodies that have taken responsibility for situations at hospitals such as Shalom.

In addition, the Pharmacy and Poisons Board, which was part of the task force, did not comment on why the hospital had morphine but did not know who would handle the dangerous pain medication.

Under the Dangerous Drugs Act that governs the prescription, handling and administration of controlled medicines and substances, morphine is classified as a restricted drug that is only stocked in hospitals with proof of the existence of personnel with knowledge on how to use it.

WHAT HAPPENS

Dr John Nyauma, who runs St Leonard’s Hospital and is a former member of the KMPDB, noted it has procedures for the investigation of cases of medical negligence.

The board registers and licenses all medical doctors, dentists and healthcare facilities in the country, and regulates the medical practice.

Other healthcare professionals are licensed and regulated by similar statutory bodies.

Dr Nyauma further said that disciplinary measures should be taken in line with the law.

“The KPMDB has laid down procedures for adverse incidents relating to patient care that may constitute professional negligence or malpractice, as well as remedies to prevent recurrence, the overriding objective being to safeguard the interests and safety of the public,” he said.

“While these remedial measures may involve the suspension or revocation of the registration of licenses of professionals and or institutions found culpable, due process must be adhered to in strict compliance with the law."

Regarding performance standard, Dr Olweny said the association was ready for scrutiny by the government.

He added, however, that they had not been informed of Ms Kariuki's May 11 directive for a 90-day operation to rid the country of quacks.