A death that remains shrouded in mystery

By Mochua Koinange

The circumstances of Esther Kagwiria’s death have remained shrouded in mystery.  But even worse, despite pleas to the hospital to provide more accurate information of events leading to her death, Letangule says the facility initially refused to co-operate after he confirmed his wife’s death.

The picture of the events at the hospital are murky. Letangule says he knows she arrived at the Family Health Care Medical Centre and Maternity at around 8:30am.

According to several documents obtained by The Standard On Sunday, the hospital admission papers state Esther was admitted at 9am with “swelling in the face and lower limbs and blurred vision,” noted as admission remarks.

The hospital documents show that after an abdominal examination the plan was to both “Admit and inform gynae”, comments scribbled on the admission papers. At 10:45am blood pressure was noted as 145/110, “Client very sleepy. In bed.”

Between 10-11am, she was given a cocktail of drugs. At 12:30pm she is noted as having delivered a baby weighing 1.5 kilos, even though the digits “: 30” are scribbled over in the report indicating somebody altered the time. The baby was taken to nursery and started on intravenous fluids.

“Dr Onzere” did a review of her condition at 12:45pm. The notes show that she was 34 weeks pregnant and in the second stage of labour.

At 3:30pm notes by a different person indicate she was admitted with preeclampsia and in active labour. Preeclampsia is a medical condition characterised by high blood pressure and significant amounts of protein in the urine of a pregnant woman. If untreated, medical experts say it can develop into eclampsia, the life-threatening occurrence of seizures during pregnancy.

She was then prescribed another cocktail of medication. At 4pm, the hospital notes state patient “still in coma with her BP at 160-100 with an additional notes that “husband not taking calls.”

At 4:30pm, the notes state “husband called back, informed of the need to refer and said we refer to Nairobi West. Nairobi West Hospital informed. A 5pm note shows “mother changed g/c. Dr. Sagwa informed, resuscitation done.” At 5:20, the last noted entry states: “Resuscitation unsuccessful, mother confirmed dead.”

According to Letangule, what he learnt later was that Esther was left in the hands of a male nurse from morning.

“This nurse would call and give her condition and he would get instructions on phone from somebody else. She had no doctor attending to her.”

Letangule filed a complaint with the Medical Practitioners and Dentists Board (MPDB), a government oversight board that receives and reviews all medical complaints filed by patients against their doctors or hospitals in Kenya.

The hospital produced its medical report and alluded to the comments made by a hospital visiting doctor (Dr Onzere).

“We found out at the hearing this was not a resident doctor but was one who just happened to be at the facility shopping for a medical place to have his wife who was expecting, deliver,” says Letangule. He had come to inspect the facility. When he arrived, a nurse rushed to him and told him they had an emergency and asked him to attend to her.”

Letangule says several issues raised by the hospital report puzzled him. Key among them was that the report indicated she had delivered at 12:30pm. “So we asked the hospital, if she delivered at 12:30pm, how do you just sit with someone who has gone into a coma from 12:30pm to 5pm?”

Letangule feels those precious six hours could have been better utilised to save her life.

On Friday, June 14, the MPDB sat and heard case No.18 of alleged mismanagement of Esther at the Family Health Options Kenya facility. “The board found that the hospital facility and doctor have a case to answer,” says Daniel Yumbya, the CEO of the MPDB.

In other words, the board had now confirmed the charges against the hospital. “That means the matter now goes to a full hearing where the hospital and doctor will put on their defence and probably be penalised in line with the board’s penalty system, which can be accessed through our website,” says Mr Yumbya.

A tribunal will be constituted for a full hearing soon. The facility and doctor will be pre-charged and can attend the tribunal hearing with their lawyers.

“I am pleased that the board found the hospital has a case to answer. I am doing this because I would not want anybody else to go through what I have,” says Letangule.