500 Kenyan doctors in work boycott after brain surgery debacle

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More than 500 senior doctors in Kenya’s biggest referral hospital have boycotted work, demanding the reinstatement of their colleague who was suspended for performing brain surgery on the wrong patient. Sammy Oroko, the chair of the doctors’ union, said in a BBC News report that suspending the Kenyatta National Hospital (KNH) neurosurgeon was a knee jerk reaction which will not solve the underlying problems at the hospital.

Three other staff – the ward nurse, theatre receiving nurse and anaesthetist – were also suspended.

The report says the union wants an overhaul of the hospital operations, including digitisation of the hospital’s booking systems and setting up more theatres. Oroko defended the boycott saying this was the opportunity to re-examine the entire system at the Kenyatta Hospital. The doctors are also demanding outstanding allowances for senior doctors, which they say have not been paid as agreed with the state last year.

The report says it emerged last week that a neurosurgeon had performed brain surgery on the wrong patient. The hospital has denied reports the patient had since died.

 

The scandal, which prompted an outpouring of horror on social media, is the latest drama to hit the KNH in recent weeks, after allegations of staff sexually assaulting patients, and the theft of a baby, reports The Guardian. Health Minister Sicily Kariuki also suspended the CEO of the hospital over the blunder.

“The hospital deeply regrets this event and has done all it can to ensure the safety and wellbeing of the patient in question,” read the statement from the hospital, adding the patient was “in recovery and progressing well”.

The report says KNH is Kenya’s oldest and largest hospital, and also serves as a teaching hospital.

 

Two men had been wheeled into the hospital last weekend – one needed a surgery to remove a blood clot in his brain “while the other only required nursing and medication to heal a trauma swelling in his head”. According to a Daily Nation report, the patients were both admitted in the hospital’s Ward 5A, which houses general surgery and trauma patients without fractures.

Patients wear name tags on their hospital gowns in this ward and investigations will look into how the two were given the wrong tags – the patient’s only method of identification.

The report says it appears in this system, the surgeon will have no contact with the patient, waits in the theatre, and follows the information in the files to carry out critical surgery. “The staff in theatre had no way of telling they were operating on the wrong patient because he was unconscious,” a source, who requested anonymity because of the sensitivity of the matter, said. “Besides, the file details and patient label tallied.”

The report says the team only realised the mistake more than two hours into the operation after opening the head of the wrong patient, only to find a swollen brain but no blood clot. After consulting a senior neurosurgeon on call, the operating doctor was instructed to proceed no further, clean up the area and close the head.

The doctor examined a CT scan of the patient and his file before recommending surgery. Both showed that there, indeed, was a blood clot in his head. However, the scan was from the wrong patient.

The report says few medical errors are as terrifying as those that involve patients who have undergone surgery on the wrong body part, undergone the incorrect procedure, or had a procedure intended for another patient. It says these “wrong-site, wrong-procedure, wrong-patient errors” (WSPEs) are rightly termed “never events” – errors that should never occur.

 

Doctors have defended their KNH colleague – they are quoted in The Star as saying that the nurses who prepared the patient for surgery are the ones at fault. The hospital has suspended the admission rights of the registrar and issued him with a show-cause letter. KNH CEO Lily Koros said that they took action following the incident, in line with the hospital’s procedures.

“As unit colleagues, we believe that while our friend may have exhibited some procedural shortcomings, the surgery was done on the wrong patient mainly because of wrong patient labelling by the ward staff,” the doctors said.

The doctor said Koros was not just in suspending the neurosurgeon. “Slapping a suspension on our colleague is totally erroneous, victimising in nature and unwarranted,” they said.
“…KNH should sort out the system failure on their part. Today it is him, we don’t know who the failed system will nab tomorrow,” they said.

Koros said: “The seven-day show-cause period comes to an end on 2 March, 2018, after which the clinical services director will immediately convene the Medical Advisory Committee to deal with the issue.”

BBC News report
The Guardian report
The Nation report
The Star report


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