KNH: We are not to blame for the botched operation

Kenyatta hospital has absolved itself of any blame in an alleged caesarean section that went wrong insisting that the patient’s intestines were already defective.

The hospital management has come out to clarify the events of January 26 and maintained that a section of Susan Nekesa’s small intestines had already herniated and their doctors did their best to correct the situation.

Herniation is when some organ in the body is squeezed out of its normal position which can cause obstruction of blood flow.

According to healthline.com, hernias are most common in the abdomen, but they can appear in other places in the body.

“Most hernias aren’t immediately life-threatening, but they don’t go away on their own. Sometimes they can require surgery to prevent potentially dangerous complications,” reads the site.

In Ms Nekesa’s case however, her case was life threatening according to Acting Director of Clinical Services at Kenyatta National Hospital Dr Peter Masinde.

Masinde said the section of Nekesa’s intestines had been trapped in her abdomen impending not only blood flow nut had also become infectious and part of it was rotting away.

This part, he said, was removed through surgery and an artificial passage created on her abdomen(ileostomy) to assist her pass waste.

“This was to allow for healing and recovery of the intestines,” he said.

The 36-year-old defective intestines, Masinde said, were discovered when she started complaining of abdominal pains, swelling and vomiting four days after her C section. A team of surgeons had her reviewed and diagnosed her with intestinal obstruction.

Such was an emergency and needed surgical intervention.

“During this surgery, no injury to intestines or other internal organ was observed,” said Masinde.

He added: “However, it was found that a section of her small intestines had herniated through a defect of rectus sheath that was not in any way linked to the caesarean section.”

The family of Nekesa, her husband Robert Sitati and sister Evelyn Anindo had complained of doctor negligence which had not only led to the wrongly perfumed C section but also the death of one of the twins that she delivered at the hospital January 26.

The child, as claimed by the father, died after chocking on milk while being fed by a nurse.

It was further alleged that Nekesa was left to fix and dispose the ileostomy bag (containing her waste) by herself without the help of nurse despite the immense pain she is in.

This is even after the family being forced to buy the ileostomy bags from Nairobi Hospital after they ran out at KNH which begs the questions on the actual standards of the facility as the country’s largest referral hospital.

“Sometimes we run out of them. We do not deny. These things deal with supplies. We cannoy let a patient leak waste yet they can get the bags from a private facility,” said Masinde.

Masinde argued that Nekesa situation was unique as the bags she needed were to dispose waste that is still in his raw form with so much acidic content from the stomach hence the bags kept on being replaced time after time.

These allegations were denied by the hospital management. Dr Peter Muchoma. Neonatal consultant Dr Gacheru Nyamu said the family was kept abreast with every progress of both the twins, who were born prematurely, and the mother.

“It is only that the hospital policy demands we inform the next of kin so the nurses or doctors cannot go telling every inquisitive relative of how the patient is doing,” she said.

On admission on January 24, Nekesa was observed to have several pre-existing conditions among them high blood pressure, abdominal pains and a scar that showed she had delivered her first child through C section.

She later developed convulsions (epileptic like symptoms) two days later and a diagnosis of eclampsia was made. This meant she cannot deliver naturally hence the C section. On a pregnant woman, such a condition can drive her into a comma and possible death of both the patient and the unborn.

Nekesa later delivered twins(girls) 33 weeks’ old weighing 1.9 kilograms, which meant they needed life support and were put in incubators.

While one of the twin’s health picked up, the other was found to have a systolic murmur, an abnormal heart sound. She also developed jaundice, as her liver broke down, and she was put on antibiotics and fed on formula.

“On March 20, the baby’s condition deteriorated requiring resuscitation but was not6 successful and succumbed the same morning at 3:17am,” said Masinde.

The other twin was discharged on Thursday after full recovery. However, her mother will stay in the hospital for more days as she is required to undergo a corrective surgery on Monday to enable her pass waste naturally.