The shocking truth on ‘killer doctors’

By EMMANUEL WERE and ALLY JAMAH
KENYA: One in every five Kenyans who walk into a hospital for treatment ends up dead or harmed due to mistakes made by those treating them, doctors say.
Figures put together by medical lawyers and independent pathologists show that three out of ten patients get the wrong diagnosis or medication. In some cases, patients undergo unnecessary and possibly life-threatening surgical procedures before the mistakes are discovered.
Many survive, however, because they go on to get a second opinion from another doctor or because diagnostic and medical errors are caught on second visits.

According to former Government Chief Pathologist Moses Njue, wrongful killings are happening across public and private hospitals and clinics. He says that up to half of the killings are not recorded because proper post-mortems are not conducted on people who die during medical care.
“The public do not pursue these matters because they are unaware or see it as an unnecessary pain,” Njue says.
Independent studies have confirmed a high error rate in Kenyan hospitals. Take malaria, for example, which is a leading cause of death and accounts for a fifth of hospital admissions. According to the National Hospital Sector Strategic Plan, as many as half of all ‘malaria’ in patients die during treatment. Many of these deaths, doctors now say, arise from a variety of fever cases that are wrongly diagnosed or treated as malaria.
The scale of the misdiagnosis and maiming has escalated the cost of insurance cover for doctors, as the number of court cases and settlements has surged. So high are the costs that some insurance companies are now opting to share costs on claims, because court awards have reached as high as Sh20 million in a single settlement. The result is that doctors are now more inclined to hide their mistakes rather than find ways to ensure they limit them.
Dr Njue, who served as the country’s chief pathologist for a decade until 2011, says that up to half of the wrongful killings are not being recorded because proper post-mortems are not being conducted on people who die in hospitals or during medical care. This means many cases never get to court.
Fear of litigation
“The public do not want to pursue these matters because they are unaware or perceive it as an unnecessary pain. You can imagine the mountain (of cases) that never leave the hospital,” said Njue. Few hospitals conduct reviews of the cases to help reduce their error rates, largely due to fear of litigation.
Medical lawyers estimate misdiagnosis at close to a third of cases. Doctors who spoke to The Standard On Saturday on condition of anonymity said the figures quoted by the medical lawyers and pathologists are largely accurate.
However, no public or private institution is willing to disclose the official figures on misdiagnosis and consequent deaths.
“The information is not readily available because those involved are hesitant and conceal the cases to protect their reputation,” said Dr Njue.
Kenya Medical Association chairman, Dr Nyaim Opot, disputes the validity of the figures quoted by the pathologists and medical lawyers, but says the data is fragmented due to lack of a central place for data collection, as each hospital compiles its own cases.
The Kenya Medical Practitioners and Dentists Board, which ought to track errors and negligence, has come in for criticism for failing to take up complaints made against hospitals and their doctors. In one case unearthed by this paper, a provisional file was opened and left inactive for five years until the three-year legal window for filing a complaint had passed.
With the Board claiming no information, and processing very few cases, medical lawyers are claiming a conspiracy of silence between doctors, hospitals, medical insurance companies, and the licensing body. They have called on the Medical Practitioners and Dentist Board to move to bring doctors to account and are launching a patient’s charter, to raise awareness among the public of their rights when they faced with negligence.
As things stand, cases where doctors have apparently been criminally negligent are going unpunished, with doctors leaving a trail of pain and suffering amongst Kenyans who have little or no recourse.
This patient safety series documents the case of Jane Waithira Kungu, who had her uterus removed in unclear circumstance after she checked into a Muranga hospital, Rahab Muthoni, who walked to Moi referral hospital only to walk out blind, and young Frankline Karani, who received a malaria injection in a Kakamega hospital only to become lame. But these are the lucky ones. Others are dead after doctors made costly mistakes.
Dr Kiama Wangai accuses the medical board of covering up negligence.
Need for reforms
“The medical board is involved in the cover up of some of the cases,” he says. “It is very difficult for the board to prosecute one of their own.”
The full board tribunal is composed of 15 doctors.
“How can some of the doctors charged appear before their own board? This is where the problem lies. You hear the doctors are suspended for only six months no matter how grave the offences are,” said Wangai.
The Board’s CEO, Yumbya says the institution has become more open and transparent. But he also acknowledges the need for reform. He admits the Board does not know where and how much negligence is occurring. Where an occasional case reaches the board, the principle penalty is a warning letter, probation or suspension for up to one year.
“(The changes we are making) will help us know which cases are common and in which hospital they occur more frequently,” he says.