Tragedy and alleged neglect at Al-Saba’een Hospital [Archives:2008/1134/Reportage]
March 3 2008
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Mohammed Al-Ansi stopped in the middle of his story to keep from crying while he recounted his daughter Shorouq's tragic story.
Eighteen-month-old Shorouq died last fall at the Sana'a-based Al-Saba'een Hospital possibly due to medical malpractice.
The Al-Ansi family's story began Sept. 17, 2007, when Shorouq was admitted to Al-Saba'een hospital complaining of a bloated stomach.
Dr. Issam Al-Mu'alim was assigned to Shorouq's case and requested that she remain in the hospital overnight to prepare for surgery the next day, as she was suffering an intestinal blockage and required a barium X-ray.
Al-Mu'alim alleges that her parents went to do the X-ray in a private clinic and only returned to the hospital two days later, whereas they maintain that they did the X-ray that same night, returning to the hospital immediately.
As is common before surgery, Al-Mu'alim, as the supervisor of Shorouq's case, ordered her to remain at the hospital in a private room because she required surgery.
However, the next day, instead of performing the scheduled surgery, Al-Mu'alim phoned in his instructions regarding Shorouq's medical needs to nurses and the other doctors on duty because another doctor was covering that day's shift.
According to Al-Ansi, on-duty nurse Sawsen Al-Wajih withheld food from the infant for two days as preparation for the surgery, in accordance with Al-Mu'alim's instructions.
“We told her that Shorouq should only fast the day before surgery, but she replied that it wasn't our business, telling us that if she eats or drinks anything, she'll end up with food poisoning,” Al-Ansi recalled.
He and his family then suggested Al-Wajih give Shorouq nutrients intravenously, but she again refused.
During those two days, Shorouq didn't have even a drop of water, according to her father, who added that the child complained and cried due to her extreme thirst and hunger. Throughout this ordeal, the Al-Ansi family never once saw Al-Mu'alim.
After two days, Shorouq's family noticed that her brain had atrophied, at which point they called another doctor on the hospital's staff, Majed Mughalis, to examine her, discovering that she was dehydrated from the fasting.
Al-Ansi telephoned Al-Mu'alim, complaining about the neglectful care his daughter was receiving and warning him that the family would file a complaint against the nurses with the hospital's Legal Affairs Department.
Al-Mu'alim came to the hospital an hour later, at which point he and the Al-Ansi family filed complaints against the nurses with the Legal Affairs Department; however, the department completely neglected the two complaints. The Yemen Times attempted to determine the reason, but in vain.
After lodging the two complaints to the hospital's administration, staff member Dr. Riyadh Mansour gave Shorouq an IV with nutrients for half an hour. Additionally, he inserted a tube into her rectum in order to extract waste.
In total, Shorouq remained at the hospital for five days, during which she received no food or water, by order of Al-Mu'alim, according to Al-Ansi.
On the fifth and final day of her life at the hospital, two nurses gave Shorouq sequential doses of an unknown medication. Al-Ansi said that when he told the second nurse that the first nurse already had given his child a dose of medicine, the nurse turned to him with an alarmed look and asked why he didn't tell her before.
A few minutes later, Shorouq experienced a strong muscle spasm and bit her own tongue. Attempting to pry open her jaws with his own hands, her father ran into the corridor and started shouting for help.
A doctor came to resuscitate her, but to no avail, as Shorouq died shortly afterward.
After her death, Shorouq's parents filed another complaint with the hospital's general manager, Dr. Amat Al-Karim Al-Houri, against Al-Mu'alim and the three nurses.
She suspended Al-Mu'alim and the nurses for two months. She then allowed Al-Mu'alim to work for half a day before suspending him for another month.
Al-Houri maintained that she could neither condemn the doctor and nurses nor acquit them of wrongdoing unless she reviewed Shorouq's original case (treatment) file.
Once the hospital received the original file – under orders from the public prosecutor – it issued a report on the infant's cause of death.
Al-Saba'een Hospital refused to give a copy of its report to Al-Anisi, but Al-Houri said Shorouq's death resulted from her infection, brain atrophy.
Fallout
Al-Ansi came with his story to the Yemen Times, carrying a large bag of documents full of investigations, complaints and newspapers that had dealt with this situation. Although he's gone to the Southwest Prosecution, Attorney General Abdullah Al-Ulfi, Prime Minister Ali Mujawar and filed complaints against the hospital, he doesn't feel that justice has been served yet.
Al-Ansi says his main priority in all of these actions is to disclose those cases similar to his daughter's, as well as holding the hospital staff accountable for what he believes was gross negligence.
Additionally, instead of handing it over to the hospital's administration, he has decided to keep Shorouq's case file in order to use it as evidence at a later trial. He has decided to turn to the prosecution and then to the courts because he's convinced his daughter died due to negligence and that the case will reach the court system.
The investigation begins
According to reports by Al-Saba'een Hospital's criminal investigations office, Al-Mu'alim has confessed that nine of his patients died within one month, September 2007, as the result of negligence, but he then later withdrew that statement.
However, the Yemen Times did uncover a document at the hospital stating that Al-Mu'alim had nine patients – all children – who died in September 2007.
When presented with the documents, Al-Mu'alim alleges that the officer of the hospital's Criminal Investigation's Office wrote the document himself and he just signed it based on his trust in the officer.
The documents regard investigations by that office.
When asked, Al-Mu'alim replied that he wasn't present on the day and doesn't know what type of medication the two nurses gave Shorouq or even if she died due to the double dose. He further stated that he thought that if the nurses had given her two doses of antibiotics, it wouldn't have been enough to kill her.
However, neither the medicine Shorouq received before her last seizure, nor the dosage, was written in her case file.
Regarding his complaint filed with the hospital manager against the two nurses, Al-Mu'alim commented, “When the girl's mother complained to me about the bad treatment of the nurses toward her, I filed that complaint against them, but not because of their being remiss in their duties.”
When told that Shorouq was forced to fast for five days, he denied that she had fasted at all, although the hospital's general manager did admit that she had fasted in preparation for surgery.
Al-Mu'alim declined to comment on the hospital's overall performance in Shorouq's case.
The Southwest Prosecution got involved in the case for further investigation. Its member, Abdulmanan Al-Dubaie, said, “According to Al-Mu'alim, there was significant negligence in the qualifying nurses, lack of mechanisms and elements of remiss in their performance. Additionally, there were nine instances of deaths during September 2007 without investigation.”
However, Al-Mu'alim maintains that when Shorouq entered the hospital experiencing intussusception (intestinal blockage), she arrived in the late stage of her disease. “The infant was infected with such disease during the mother's pregnancy and following delivery, she couldn't get rid of waste,” he explained.
The prosecution later issued a final statement explaining that Shorouq's death was normal and the file was closed as a result.
Insisting that his daughter's death resulted from hospital staff negligence.
Al-Ansi is attempting to file a new complaint against Al-Saba'een Hospital, which he says is responsible for the shortage of medicine and oxygen during Shorouq's treatment.
He adds that the new complaint will include Al-Mu'alim and the nurses in particular because they are who were responsible for handling her case at the hospital.
Al-Ansi recently brought his case to President Ali Abdullah Saleh, who ordered the case file reopened. Likewise, Al-Ansi now is attempting to pressure the Southwest Prosecution to reopen the investigation and he is insisting that they reveal similar cases.
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[archive-e:1134-v:15-y:2008-d:2008-03-03-p:report]
