In March 2008, a female patient was admitted in a highly reputable hospital with a swelling in the neck that was diagnosed as a toxic thyroid goiter, for which she underwent surgery to remove it. After the operation, the patient showed all signs of recovery and was due to be discharged the following day.
However, the night prior to her discharge, the patient developed difficulty in breathing and efforts to resuscitate her failed. She was pronounced dead afterwards.
The doctor who operated on the patient confirmed that the patient had died due to lack of oxygen, as a blood clot (hematoma) kept on compressing her breathing system.
This was discovered after the surgical wound was opened during the postmortem examination. The doctor admitted that had the wound been opened up when the patient was still alive and the pressure released, the patient may have survived.
A senior nursing officer confirmed these findings and reported that the patient’s blood pressure, pulse and temperature were taken every four hours after the operation. The patient left theatre at 5pm and was seen at 6pm and at 10pm.
At 3am, the patient developed difficulty in breathing and was given oxygen and propped up, as is the procedure. The doctor on ground, an ear, nose and throat (ENT) specialist was called and came to see the patient at 4am.
It was discovered that some of the nursing notes were missing and that the patient’s blood pressure was actually not monitored for 10 straight hours. The health unit, however, denied any medical negligence and insisted that its staff exercised reasonable care and skill to ensure the safety of the patient.
A complaint was initially raised with the Medical Board and the members of the board, who were experts in the medical field, investigated the matter. The ruling of the board was dated October 24, 2013, five years after the patient died.
In its ruling, the board observed that the surgery was uneventful, although the period spent in the recovery room was rather long; from 1pm to 5pm. That the patient was returned to the ward when she was drowsy, but her blood pressure and pulse were stable. The blood pressure was actually taken at the time of the handover period.
The patient did not have another blood pressure measurement for the subsequent 10 hours, when she started deteriorating. The blood pressure as taken in the presence of the specialist doctor from the ENT department was low.
The Medical Board observed that neither the doctor, who operated on the patient nor the consultant in-charge of the ward, was informed of the patient’s changing condition. In fact, the surgeon who operated on the patient learnt of the patient’s death during the ward round the following day.
During postmortem examination, it was established that there was an accumulation of blood within the neck muscles and death of the patient was attributed to obstruction of the airways as a result of the hematoma.
The board directed that the hospital enter into arbitration with the family of the deceased and expected a feedback within 60 days. The board did not recommend referring the case to the full board for determination.
The board exonerated the surgeon who carried out the operation. The proposed arbitration did not take place and the family of the deceased, armed with the decision of the Medical Board, instituted a civil suit of medical negligence against the hospital.
The relatives of the patient in the civil suit against the hospital, stated that at the time of admission to the hospital, a duty of care and implied contractual obligation arose between the health-care providers and the deceased, that the health-care workers would exercise all reasonable skills and care ascribed to them to ensure safety and care of the deceased.
In the suit, the relatives attributed the death of the patient to negligence of the health-workers in a manner in which they handled and treated her when she was under their care.
The hospital denied the claims against them as incompetent, stale and an abuse of the court process. Court, however, found the hospital savagely liable for the death of the patient and awarded the following costs to the relatives of the deceased; general damages for pain and suffering, loss of expectation of life, loss of dependency and aggravated damages.
The hospital, aggrieved by the judgment, filed an appeal against the same on the grounds that
Inadequate particulars of negligence were provided in court to warrant the judgment. The case was filed out of time The trial court considered erroneous issues that were not before court The trial court relied on inadmissible evidence in passing judgment The trial court did not consider the evidence of the witnesses presented by the hospital The trial court did not consider and analyze the submissions of the hospital The judgment was contrary to the tendered weight of evidence and applicable legal principles
The appeal concluded that the trial court’s exercise of discretion was so ill-advised to occasion grave injustices to the hospital, bringing law into disrepute and invite anarchy and the law of the jungle into matters of medical negligence and disputes.
