How KMPDC handles cases of malpractice and negligence

When KMPDC CEO Dr David Kariuki appeared before the National Assembly's Health committee on February 15, 2024. [Elvis Ogina, Standard] Could you, as a patient, seek recourse when you feel mishandled or your rights violated by a medical doctor? For years, reports of patients getting maimed, or even dying in the hands of medics and hospitals under questionable circumstances, have paced news outlets, with incidents being reported as accidents, yet leaving many people's blood running cold. Whenever such cases emerge, the Kenya Medical Practitioners and Dentists Council (KMPDC) promises radical investigations. Yet the trail turns cold as each case is pushed to the darkest part of the nation's collective memory. Yet some cases remain unreported. Whispers of patients, especially women who undergo cesarean-section operations ending up with bandages, cotton wools, needles and other surgical accessories inadvertently retained in their bodies after delivery abound. The Standard reached out to KMPDC's chief executive officer David Kariuki to shed light on what should be done to lessen of possibly eliminate the cases. The council, among other roles, is mandated with litigating complaints that address discipline and ethics within the medical practice. To achieve this, the council has various procedures of ascertaining whether what the doctor or health facility is accused of falls within the accepted standards, and if the deed has affected the outcome of the patient they are attending to. "The Medical Practitioners and Dentists Act gives us the power to form a committee that would listen to cases on discipline and ethics. The committee would conduct inquiries into any complaints supplied to it. The complainant may be a patient, a relative, or even a doctor against another doctor," says Dr Kariuki adding that a complaint may be made against a doctor or a hospital. As the body tasked with regulating professional conduct, KMPDC ensures the fitness to practice of doctors. According to Kariuki, the committee in charge is a quasi-judicial body that operates within legal powers and boundaries of a conventional magistrate's court. At the end of the judicial process, which takes the shape of court proceedings, with investigations being conducted and empirical evidence collected and adduced, the committee makes a decision that could go either direction. "If any party is not satisfied with the committee's ruling, the law allows them to ask for a review of the matter at the High Court," Kariuki explains. In about 98 per cent of cases determined by the council, the upper court has upheld the council's determination. The committee is composed of a chairperson (a medical doctor), a member of the Kenyan National Commission on Human Rights (KNCHR), and another member who is also a medical doctor. The committee also has five other adjunct members, who, depending on the case being handled, would-be professionals acquainted to the specific infraction being addressed. The complainant is also allowed to come with legal representation, an advocate of the High Court, so is the party being complained against. At any given moment, there would be at least eight committee members who would be following the proceedings of each case. A Kenyan can lodge a case with the council by simply making a phone call to the number 0727666444. For a successful prosecution, it would be imperative that a complainant provides as much evidence as possible. "Evidence could be admission forms, X-ray images, prescription slips, and so on," Kariuki says. The process of blood donation. [File, Standard] On average, Kariuki says, it takes about 9 months to run a case to completion. Based on data provided to The Standard by the council, the rate and duration of determining cases has noticeably reduced over the years. By the end of 2019, about 9 per cent of cases that had been lodged with the council were yet to be finalised. By the end of 2023, that rate had jumped to 90 per cent. Previously, the council has been accused of protecting its own (read doctors) from whom they collect fees. "That accusation is false. In fact, our work is about serving Kenyans, and making sure that they receive proper care. The only money the council collects from doctors is license fees to enable them to practice," Kariuki says in defense of the council. "Whenever a case is brought to us, it is handled properly. The majority of the last cases we have closed on have ended in favour of the complainant. Some have also been referred for arbitration," he says. We sought the most recent data on how the cases were determined in the last few years but we could not get that data to verify the CEO's claims. Cases already with the council show that Kenyans have complained about many services offered by medical doctors, pharmacists and dentists. Among the cases lodged from 2019 to 2023, obstetrics and gynecologists lead, accounting for 26 per cent of the total cases. It was the only service that shot past 15 per cent. Kenyans also complained about financial impropriety by clinical service providers. "Yes, one can complain against being overcharged or being charged unfairly. However, the council has developed guidelines on fees chargeable and the guidelines are on our website. A decision on a financial case is limited to the guidelines," Kariuki says. This notwithstanding, Kariuki adds that whenever anyone has the feeling that their rights have been infringed on in the hands of medical practitioners, they are free to seek legal recourse with the council. "As a patient, you have the right to know what you have been diagnosed with, how the doctor is planning to handle your case, why the amount they will charge you for the service, the treatment options available, and so on," Kariuki says. Apart from calling the council's number to lodge a complaint, one could also send an email to legal@kmpdc.go.ke.

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