The mother who bled to death III

Saturday January 11 2020

 

By Dr Sylvester Onzivua

The High Court of Uganda at Fort Portal delivered a landmark judgment, at least in terms of costs, on December 3, 2019, in a case involving a 35-year-old mother who bled to dead on March 23, 2011 in Fort Portal Regional Referral Hospital shortly after an emergency Caesarean Section.

The medical certificate of death dated August 30, 2011 indicated that the mother died of excessive bleeding subsequent to delivery when her uterus failed to contract adequately.

Cross examination
During cross-examination, the doctor who operated on the mother stated that he found that the mother’s uterus had ruptured, which he repaired.

The doctor, however, admitted that he was not aware of the post-operative care and treatment given to the mother. According to court, failure to transfuse the mother as she continued to bleed led to her death and the blame for this was squarely put on the doctors and other staff of the hospital.

No duty of care shown
Court did not believe the doctor who operated on the mother, when he claimed that he had repaired the ruptured uterus and that it had stopped bleeding.

According to court, the doctor failed to exercise such care and skill reasonably expected of a prudent and careful doctor of his status. Further, the doctor did not follow up to confirm whether the deceased received the blood transfusion he had ordered.

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Court, therefore, did not believe the doctor who claimed that the deceased reported late to the hospital, which was the cause of her death.

Negligence
To the judge, the doctors should have considered the mother’s situation as an emergency which they, unfortunately, did not. It was therefore the finding and holding of the court that in the circumstances, the doctors attending to the mother fell short of the professional standards as obstetricians and were therefore negligent, and the hospital vicariously liable.

Court agreed with the husband of the deceased that his wife’s death was caused by the negligence of the doctors who attended to his wife and other employees of the hospital as there was ultimately no proper medical attention towards the deceased, who was in labour.

Court also held that there was failure by the hospital staff to provide life-saving blood leaving the mother to bleed without rescue and resulting into her death.
The judge concluded, following the evidence of two doctors from the hospital, that there was lack of care and indifference towards patients and poor standards in the hospital that is moreover a regional referral hospital.

Compensation request
The husband of the deceased asked court to award him special damages to the tune of Shs16.3 million for medical and funeral expenses although the documentation was lost during the period of the funeral.

He also asked for general damages of Shs3 billion based on negligence, unlawful death, loss of life, loss of care, pain and suffering, mental and psychological torture, anguish, pain, the dependants being left motherless by loss of a parent and the husband being made a widower.

Court was asked to look at a case where general damages were awarded separately to each individual member of the family because the loss is individual as well as the resultant long-time effects.

Hospital responds
The hospital submitted that notwithstanding the fact the deceased contributed to her own death, the costs requested by the family of the deceased were exorbitant, exaggerated, inflated and in bad faith and bad in law. The hospital prayed to court to award the costs asked for at its discretion depending on the prevailing conditions and prior decisions of court.

Court usually awards special damages only when there is strict proof thereof; such as receipts are presented to court. In this particular case, court held that failure to attach receipts of expenditure in proof of funeral expenses is excusable because at the time of bereavement it may not be possible to attend to details such as asking for receipts.

Court therefore found that special damages were proved and awarded the Shs16.3 million requested by the family.
The family of the deceased asked court to award them Shs3 billion in general damages since life was permanently lost. However, it was the finding and holding of the court that Shs3 billion was on a higher scale. The judge reduced this amount by half and awarded the family Shs1.5 billion as general damages to be paid by the Attorney General.

Background

The evidence on record was to the effect that the deceased, a nursing assistant working in the same hospital was admitted in labour on March 23, 2011 and was taken to the operating theatre while still alive and not bleeding. She was operated on and the baby removed. The deceased left the operating table and the theatre alive.
The doctor who carried out the operation advised that the mother be transfused with blood which was never done.

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