Non-standard ultrasonography

Thursday, December 27, 2007

My wife was 6months pregnant at that time when we went to Kulunu Medical Services for a scan appointment. The sonologist on duty was Dr Fathmath Ali Didi. The scan was done. The only thing she said to us was that "baby was normal" and that "everything was fine". Two and a half months later when baby was delivered, he had gross multiple physical anomalies!
[Received by Email]

Dr Fathmath Ali Didi is the Director of Medical Administration at IGMH, an MBBS graduate who has risen through the ranks initially because of her influential family and now because of the ease with which she can be manipulated by policy makers.

We have been able to confirm that for the past many years she has been a practicing sonologist performing the "job" of PG Radiologists both at the government setup and in private practice. She is however, not a radiologist and has nothing more than the experience of attending a single certificate course on basic ultrasonography years ago. We have been told, and we believe too, that she has over the years acquired skills in operating the ultrasound scan machine and is able to do basic scans.

Nevertheless, lets us not be fooled into believing that she is at all qualified to do complex sonography. The scan referred to in the email had missed fairly gross physical anomalies that should have been seen by the sonographer. We wonder how many such errors had resulted from scans performed by herself and fellow wannabe-radiologist Dr Yaganegi.

We called IGMH to find out what post Dr Fathmath Ali Didi holds within the radiology department. The PRC girl said "she is a consultant". Our contact within the Personnel Department was able to confirm that she held no official post in the radiology department at IGMH. Her posts include Director of Medical Administration and Registrar in Internal Medicine. We have also learned that her qualification is listed as MBBS only. She is not a specialist physician and her post of Registrar in Internal Medicine came as a shock to us. We were made to understand that these types of extra posts were common for high level administrative staff and that it was a way of them earning a higher salary. Incidentally- Dr Yaganegi is also only an MBBS graduate.

One of staff at IGMH reported that Dr Fathmath Ali Didi only does scans when there is a shortage of Radiologists and that she is "usually quite Ok" with obstetric scans. The truth became apparent when we called CEOs office, where her office is. The person who answered said that she was on scan duty at the time and to call later!

This case highlights a serious breach of trust that should exist between service provider and patients. Individuals working in professional capacities well beyond their capabilities and medical qualifications is a serious issue. It could cause serious damage and grievances for patients. From the email, it is evident that it has already happened.


Maldiveshealth said...

Whether if it is Fathmath Ali didi or anyone else , if the patient safety is compromised , they should be kicked out.

justiceleague said...

Gross physical anomalies?

This is not enough to blame a person.

Please enumerate or mention which were the anomalies.

Otherwise I can't accept that what is written is all true. Where is the otherside of the story?

Anonymous said...

It is important to note that every test has it's limitations, regardless of who does it.. i.e there will be false positives and false negatives... In this particular case one needs to know the exact diagnosis and the sensivity and specificty of unltrasonogram for that paricular condition, before passing any judgement.. Anyway, if Dr Fathmath Ali Didi had said 'the baby is normal' her position cannot be defended..

Naaringu said...

If only she said no gross anomaly detected her position could be defended in a court...

Medical Investigator said...

There is no defense in any case. We have read readers comments but had initially withheld details of the baby's anomalies because describing them would almost certainly identify the patient and therefore the family.

We have been advised by the family to include the details even if it would reveal their own identity; something we discouraged but the parents insist that we do.

The bay had almost the entire content of its abdomen lying outside of the abdominal cavity {that is gross enough, the father said}, abnormally stiff limbs, misshapen head and heart defects (found on Echo as large VSD).

Child died on 2nd day of life!

Naaringu said...

What i meant that by saying "no anomalies detected" is that she means she did not detect any anomalies does mean that there were no a court case which would then try to dispute her claim as a doctor either way it would be a long and ugly Bamrungrad Hospital,Bangkok during an fetal USG the doctor missed a missing foot,he was successfully sued for 10 million baht..

justiceleague said...

Could you let us know at how many weeks of the pregnancy the ultrasound was taken?

Anonymous said...

Just some questions that come to my mind...Does this case absolve the concerned Obstetrician of any responsibility for the outcome? Were serial ultrasounds done? Were invasive tests indicated? Can invasive antenatal diagnostic tests be done in Maldives? Would qualified radiologist, have detected the abnormalities on a single ultrasound, at the same gestational age?

shareem said...

What you please let us know what a standard untrasonography is?
What is the relationship between radiography and ultrasonography?
A sonologist need not to be a radiologist.
Not all radiologists are trained in ultrasonography.
Even a nurse can undergo sonography training, offcourse the programme will be longer. An MBBS doctor is well qualified to undergo sonography training.
Sonography training is part of radioligy, it is a diagnostic imaging modality, it use ultrasound and not radiation.
As per previous doctors hierrachy an MBBS doctor can reach to the level of a registrar without a higher qualification, and looks like there is nothing wrong with that. But you said that she is a registrar in internal medicine- yes that is a problem, she should have been a registrar in radiology not in internal medicine as she does not practice internal medicine.
What is basic and advanced ultrasonography.Advanced sonography refers to vascular and cardiac etc sonography, I so not think fathima does those.
Looks like MMW is not ding any good to our healthcare system improvement. It appears that this is a means to vent out steam from the system of few, dejected, ambitious , yet unsuccessful individuals who are against fathima.

Anonymous said...

I happen to know details about this case myself. The anomaly was detected by Dr Fathimath. Not only so, she had also asked other radiologists to confirm the findings which was done so.
All this was much before birth. I think someone is deliberately fudging facts for some ulterior motive.

Anonymous said...

I happen to know details about this case myself. The anomaly was detected by Dr Fathimath. Not only so, she had also asked other radiologists to confirm the findings which was done so.
All this was much before birth. I think someone is deliberately fudging facts for some ulterior motive.