‘My surgeon failed to notice rotting flesh’

By EMMANUEL WERE

KENYA: For Nadira Gee, the operation that led to all the trouble was supposed to be a simple cosmetic surgery to remove excess skin and fat on her tummy.

The Tanzanian resident just wanted her lower abdomen to look firm.

After two consultations with Dr Cresceno D’Onofrio, an Italian plastic surgeon with a licence to operate in Kenya, Mrs Gee paid Sh240,000 and went to have the operation on August 3, 2007 at the Karen Hospital in Nairobi.

The abdominoplasty or ‘tummy tuck’ is a one-day procedure: The patient comes in the morning and leaves looking trimmer in the afternoon. D’Onofrio was experienced at these procedures. Gee was his 103rd patient at the hospital, according to the records at Karen Hospital.

All went well on the day of the operation and Gee was required to go back to the hospital after six days. On her return to the hospital, she had some complaints for the doctor about the way her abdomen looked.

“Nadira pointed out to D’Onofrio an area of black discolouration around her navel the size of the palm of my hand which she felt uncomfortable about. D’Onofrio said this was normal and prescribed an antibiotic in case it became infected,” reads a letter to Karen Hospital from Chris Gee, Nadira’ husband dated October 5, 2007.

“Nadira also pointed out her upper abdomen was very hard, but D’Onofrio also said this was nothing to be concerned with. He did not at any time offer to admit Nadira to hospital for further examination or treatment.”

What prompted that letter in October was a crisis two weeks after the operation in August 2007. Gee fell ill and, because D’Onofrio was away, her husband decided to rush her to Nairobi Hospital. There Nadira was seen by another plastic surgeon, Dr Stanley Khainga.

“After an examination Khainga said he thought the discoloured area was ‘wet gangrene’ (the most dangerous type of dead body tissue) and surgery should be performed at once,” Gee noted in his letter to Karen Hospital.

“Later in the day, after a long operation, I was told by both Khainga and the anaesthetist that on opening the wound, three quarters of a litre of old blood had flooded out. A palm-sized slab of flesh had been removed from Nadira’s belly area around her navel as the flesh was also suspected gangrenous. She almost lost her navel due to the loss of flesh,” he said.

Little progress

Mrs Gee went on to spend another nine days at the hospital. The cost came to Sh785,000, about three times the cost of the initial operation. With travel and accommodation costs for the couple, which resides in Tanzania, the Gees spent about Sh940,000 to deal with the complications from the ‘tummy tuck’.

Two months after the operation, in October 2007, the Gees filed a complaint with Karen Hospital about the conduct of Dr D’Onofrio.

There had been several meetings and communications between the Gees, Karen Hospital, D’Onofrio and Madison Insurance, the hospital’s insurer. But very little progress was made to resolve the matter.

This prompted the Gees to file a case with the Medical Practitioners and Dentists Board, according to letters of correspondence.

Ordinarily, the Board would have taken up the case to see if the hospital and the doctor had a case to answer on professional negligence. However, in unclear circumstances the board did not seem to take up action.

“We did not receive a letter from the medical board and we cannot go and ask them if they will send the letter,” said Dr Betty Gikonyo, the Chief Executive and Medical Director at Karen Hospital. “Our conclusion is that the matter did not go to the medical board.”

Right path

But according to documents availed by the Gees, they did send a letter dated April 28, 2008 to the medical board through their lawyer Kaplan and Stratton, raising a complaint against the Karen Hospital and D’Onofrio. The Board has also confirmed it has a ‘provisional file’ on the matter. But despite the complaint having been made five years ago, the matter has never been taken up with Karen Hospital.

Dr Gikonyo says the “right path” of filing a complaint had to be followed and that only by going through the Board could an objective process bring all the parties to the table.

D’Onofrio continues to operate in the country and at Karen Hospital, where the management says there have been no complaints against him.

Because more than three years have passed since the surgery went wrong, the Gees are time barred and cannot file a fresh case with the medical Board. In all respects, it looks to be one more file never processed, one more complaint never addressed or acted on.