Another baby and mother in critical condition at IGMH

Thursday, February 7, 2008

For the second time in a week, a baby and mother are in critical condition at IGMH. This comes to us as no surprise because the IGMH administration has successfully swept all cases of neglect and maltreatment under the carpet ever since its inception. The perpetrators of these criminal dealings are high and mighty, well protected by the senior administrator.

On 5th of February a mother with 4 previous kids was admitted to IGMH because of premature contractions and signs of early labor. It was still a couple of weeks till the declared expected date of delivery. She was kept in hospital with apparently no monitoring or treatment other than a few routine jabs and pokes by doctors and nurses on "rounds".

On the night of the 6th of February 2008, she started to have severe bleeding from her birth canal. After several attempts at getting the attention of the nursing staff in the ward, finally after nearly an hour of waiting the on duty junior doctor came, saw the patient and advised her to be transfered to delivery room. A scan was done which reportedly showed that the placenta was low lying. After the unusually long delay of about 3 hour, the mother was shifted to the operation theater for emergency C section. Our source confirms that the baby's heart rate had dropped to dangerously low levels during this time.

The obstetrician struggled at C section in getting the baby out of the unusually small incision that was given. After much struggling and wasting precious few minutes for the baby, the incision was extended and baby forced out. The attending pediatric doctor was able to revive the baby after about 15 minutes of resuscitation but baby had trouble breathing well by itself. Baby was transfered to the newborn ICU and connected to an artificial breathing apparatus (ventilator). The baby reportedly is in a critical condition, still requiring assistance with breathing, but the pediatric doctors are apparently confident that the baby would recover enough to come off respiratory support in a few days time. The family was however warned that baby could have significant brain damage caused by lack of oxygen during labor and because of the delay in extracting the baby at C section. It was informed to family that baby was likely to have fits too.

The C section was more eventful than described above. After the baby was forced out of the womb, due to an unreported reason (most probably an injury concealed by doctors) the mother started bleeding heavily from the uterus. The obstetric surgeon struggled to stop the bleeding. Over on hour passed with the mother bleeding heavily on the operating table. Finally after a back-up obstetrician arrived to assist with the surgery, the bleeding was stopped. By then the mothers condition had severely deteriorated. Mother continues to fight for her life in the ICU on artificial breathing by a ventilator.

A huge commotion was reported at IGMH overnight apparently relating to some minor detail in arranging blood for the mother, who obviously needed urgent transfusion.

The damage-control and cover-up apparatus at IGMH headed by Dr Fathmath Ali Didi is reportedly in hyper-drive coming up with stories to hide the details of the negligent acts committed in this case.

With this second obstetric bungle the publics confidence in IGMH in effectively managing safe birthing is lost. The authorities are still doing everything they can to hide facts rather than review the processes to make health care safer.

Dr Solih, your staff are killing and maiming our people. Act to save us.

35 comments:

kee said...

Dr Fathmath Ali Didi (FA) along with Dr Firdhous and Dr Naila are the main obstacles for a better health system in Maldives.

As for Dr Solih; probably he has joined them cos he was unable to change much. But thats no reason to stab in the back of the staffs who put u up there with much expectation. If I were u, would have resigned with dignity instead of getting my hands dirty with them.

Anonymous said...

"A scan was done which reportedly showed that the placenta was low lying"

Didn't they know that from previous scans? Geez. this is 100 percent negligence. This is murder.

Anonymous said...

There is only one way to handle this. Mass protest by all those doctors who care. regardless of losing their jobs, regardless of anything to happen all and in numbers must strike to bring an end to this killing.

Anonymous said...

"A scan was done which reportedly showed that the placenta was low lying"...???? The scan was done at the time she presented with bleeding?...this is not possible! Did she not attend for antenatal checkups monthly??? This would have detected Placenta praevia & the docs wud have known about it beforehand. No doc hu knows the patient is a case of low lying placenta is stupid enuf to take any chances.

'jabs n pokes n "rounds" '???..is this how it is seen by the public?..ru aware of any further investigations? shud she have been kept inside an MRI machine through out her pregnancy?

something doesn't add up in this story

also,what is the Maternal mortality rate and Perinatal/postnatal mortality rate in the maldives?..and how does that tally with regional and international figures?

And is it a conceivable reality to expect ALL deliveries- in the safe OR high risk category, to be event free and without complications?


IGMH admin needs to communicate with the public better, n make statements stating the facts where they stand! ofcos, whatever they may say, it will be "lies, cover-up" anyway...so..

virion said...

I am not doubting your intention or the truth of ur stories, but the credibility of yr stories is lost due to lack of names. An obstetrician, a back up obstetrician, a pediatrician etc. For Gods sake werent they named when they were born?

Some high risk pregnany are admitted to give them forced rest, which in itself is a treatment and the 'jabs n pokes n "rounds" 'which you talk about are a good way of monitoring in experienced hands. She doesnt need to be inside a MRI machine,hooked to a cardiac monitor and under constant USG scan.

Yes, our MMR compares very favourably with the neighbouring countries. We have to accept that and not with standing these negligence we have to appreicate all the doctors who are doing a worthy job. So name the negligent doctors so the other names get cleared and we know to avoid them.

Looks like Solih, FA and Firdous are the only names you guys know in IGMH. Grow, dont be afraid to call a apade a spade.

Anonymous said...

Fear is what is maldives. Fear is what will be maldives. Every where religious freaks present ...fear will be present.

Anonymous said...

I'd like to shed light on the double standard of ADK hospital. The 'Ward' gets second class service. Once a patient asked a nurse if she could be accompanied to the toilet as she was advised so. The indian nurse refused and asked her to go by herself.

Nurse said...

I doubt that mmw knows the names of the people involved. We, do. The obstetricians with blood on their hands are Dr Cherian and Dr Aseel.

It is not mmw that needs to grow. it is the rest of us who sit by idle when all this happen. This group is actually doing something about it; getting the word out.

There is no denying that these events did take place. There is no denying that there is negligence.

The reported MMR and IMR in maldives is better than that in the region. It is commendable. These cases are not simply obstetric complications. These were cases where patients were managed in ways and procedures outside of acceptable norm. That is why these cases are singled out and written about.

Antenatal scans were done. PP was seen on the scans. It was not a new finding. THAT is why we are outraged.

It is not the story that doesn't add up, it is the way the case was handled that doesn't add up. THAT is also why we are outraged.

It is inconceivable that cases could be mishandled like this to result in tragic results. These are not routine, by the book managed cases that result in expected complications. These were misadventures, negligence, criminal mismanagement......

Anonymous said...

i agree that IGMH needs to communicate. if they dont it leaves the door open for all others to have their say whether true or not. for one thing placenta previa doesnt need C section unless patient in labour or bleeding or full term. my guess is the doctors might have kept her in observation trying to give the baby the maximum time to mature inside as if i am not wrong u say it was premature contractions.yes i agree that there was a delay in seeing the patient and getting the patient to OT. usually there are things many dont see.. for example there might already be cases going in theater.and i believe that bleeding is a risk of the operation even in the best of hands and can lead to serious consequences. good luck to IGMH in explaining to cynical ppl who already have decided its gonna be a coverup. an optimist might think it was a meeting to find out what exactly happened

Anonymous said...

this site is posting cooked up stories with a sole pourpose of defaming igmh (probably a incompetant & disgruntled doctor who got sidelined from igmh hierarchy - and rightfully so!)
the public needs to be warned against these untrue rantings of a psychopath!
the patient and her baby are alive today due to the timely intervention of the very doctors labeled to have blood on their hands!
if you can't trust these doctors then go and deliver under the care of phoolamas like 15 years back and pretty soon half of the population of maldives will be wiped out.
igmh is the only tertiary care hospital in this small country and if the people loose trust in it because of lies posted by a mentally deranged person, then god save us!

Anonymous said...

People . never ever deliver in this hospital. If u can go abroad. Do u want your first baby to be killed by ignorant doctors?

Anonymous said...

LOL

Yes everybody abandon maldives; dont go to maldivian hospitals, dont buy maldivian products, dont trust maldivian govrenments, dont trust doctors,nurses,imaams,gov officials here; the outside world is paradise; abandon this hell while u still can!!!

Hurry!!! women n children first.

Anonymous said...

"There is no denying that there is negligence"..??? Why? Becos U say so?

U know wot they say, get too close to the tree n u lose sight of the forest.

A perception of negligence is not equal to negiligence. This country is suffering the effects of a long slumber, from which it has jus woken- now every1 is on a witch hunt, looting n defaming everything n anything they run into.

MedEx said...

Well since we're not stating names I won't state my sources either but according to my reliable sources, the patient's husband refused blood to be transfused to the patient unless it was his blood. So the doctors had to stand by and watch the patient deteriorate while the stubborn jerk let his wife die. God knows whether he even had the same blood type as his wife.

But of course MMW won't look up such details cos it works against your agenda of defaming IGMH by hook or by crook.

Anonymous said...

lol

Rao said...

It is vey sad to hear about the cases like this.Medical care is not without complications and at times even precious lives are lost. Not all such incidences are negligence or incompetence,It can happen in the best of the hands.A through reveiw of the case should be done, and incorrect information should not be written in mass media. This is injustice to the dedicated doctors who give priority to patient care over their own affairs. I suggest Dr.Fathimath Ali Didi and Dr.Yasir(from medical administraion , who are supposed to to manage medical care in IGMH)to review the case as soon as possible to establish facts and make them public.

Anonymous said...

well done nurse!!!
u certainly have showed that u understood medical ethics if they taught u any...did it ever occur to you that you as part of the medical professional should be more responsible when it comes to patients information confidentiality...
an yeah!! how much should the incision be.when is it too small and when is it too big???and did you not know that it is very likely a patient with PP will have high chances of bleeding from uterus? forget the laymen who mentioned that "the doctors tried to conceal the bleeding" i thoutht u pple new better...guess u pple should start lecturing doctors now!

Anonymous said...

hey then which hospital should we go to...give us some of the names MMW...LOL!!adu ehin kaleymen hingaa hospitalegga meehun marey nuveye...LOL LOL

golhabo said...

meehaku maruvumeh nooney massalayakee. maruvaan dhimaavaa goi massalayakee. maru veema dhen ulhey goi massalayakee. gos koh kameh dhimaa vedhaane, hurihaa thaakuves vey. gos kon kanthah veema ekan ehen vikan gaboolu kuraanee, kiyaa dheynee, foruvaanee kee noon. makaru hadhaanee kee noon.
kanthah islaahu kurumuge beynumuga kan vee goi saafu kuraanee, dhen ehen viya nudhee veytho gadha alhaa masakkai kuraanee.
mihen situ thakuga faadu faadu vaahaka liyan jehigen mi ulhenee mikahala kanthah veema verin amalu kuraa gothun. dhen vaahaka eh thanaku jahaa irah thelhi gannanee damage control. dhen investigatu kuranee vaahaka noosverinnah dhinee noonee situga jehee hospitaluge kon muvazzafeh tho balan, emeehaku ge dhuvas dhuvvaalan. kan vee goi belumeh, kanthah islaahu kurumeh nei.
mi vaahaka dhakki meehaa gos vaanee, mihen kanthah hingi meehun hama rangalhu. mee massalayakee.
dhen ekun, mikahala web situ thakuga jahaahaa vaahaka eh gaboolu kuraakah nuvaane. ekamaku mi vaahaka rasmee noos majallaa thakuga hama mi meyrumun jeheema mi meehunge vaahakaiga thedeh vaakan gaboolu kuran jehey.

Anonymous said...

haadha beykaare vaahaka ey thee..!!

Anonymous said...

nah...i think this person thinks he/she can go to American Idol and sing "i am gonna save everyone from dying...relax and just watch me doing it doctors!"..haha

Anonymous said...

Hooon!

A 'PERCEPTION' of negligence is NOT equal to negligence !!!!


compendre' ??

Anonymous said...

Liyaa etcheh bolah vandhaakah beynun nuvaane kan ingeyey...boah harukamaaih goidhoonukurun!

Mee dhivehinna jehifa oiy bayyeh, thrz no treatment for this!

kiyaa dheyn miulhey etcheh eba visneytha??....

Has we not tried to explain here why 'pokes/jabs/rounds are imp? hav we not tried to explain why exceesive bleeding is unavoidable in Placenta Previa? have we not tried to explain why Antenatal diagnosis is imp to detect PP early? have we not tried to explain why Admision and bed rest in hospital(forced rest is part of the managemnt of PP)was done? hav we not tried to explain that a PP delivery is a coplicated one that is fraught with risks????..

despite the best of doc n best services a Low Lying placenta carries significant morbidity and mortality!!

"comprende' ?? "

thi ethereyga roakoggen ulhey alifan gandu nivvafa kiyaadheyn ulhey mivaahakatha adu ahaabalah!!!...kameh vaaira thibeny hama ready ga valhin jahan thayyaaarah!! kamuge emme goas gothakah kimmaigen ready veggen!!

This does not in anyway, from wot little info is available, appear to be a case of negligence!! For rational minded people only, mind you...kannu vefa thibi meehunnakah noon

DeJoker said...

hehe dear public/patients

obviosuly nothing we say is worth anything to you, so here
http://pregnancy.about.com/cs/placentaprevia/a/previa.htm

Lets take a sentence from this article in the link given above;

"..there is a 10% false positive diagnosis rate, usually because of the bladder being over full. There is also a 7% false negative rate, typically caused from missing the previa that is located behind the baby's head"

what this is talking about is doing ultrasound during the last trimester of pregnancy(28-40weeks), the point im trying to make here is where it is mentioning "10%false positive diagnosis, 7%false negative rate"...this means evenduring a scan it is possible to miss a case of PP....so, does this also amount to negligence??? the reasons why it maybe missed are explained in the site as well..

I agree, the "perception" of negilgence does not amount to negligence; this can be solved by better communication between the hospital n the public

ofcos with some,there is just no reasoning with, people will believe what they want to believe..
A baby has died, so someone needs to be burnt at the stake, or charaded across male' in a napkin!

DeJoker said...

please note also the following quote from that site-

"True placenta previa at term is very serious. Complications for the baby include:

* Problems for the baby, secondary to acute blood loss
* Intrauterine growth restriction (IUGR) due to poor placental perfusion
* Increased incidence of congenital anomalies

Risks for the mother include:

* Life-threatening hemorrhage
* Cesarean delivery
* Increased risk of postpartum hemorrhage
* Increased risk placenta accreta (Placenta accreta is where the placenta attaches directly to the uterine muscle.)"

what Im trying to explain is, IF these complications arise, this does not automatically means it was due to 'Negligence' !! PP by default carries these risk, whether or not it will occur is a statistical probility; even with exceptional care PP is dangerous!

As a clinician what we can do is try our best to enusre that WHEN a patient does present with PP, all possible precuations and management guidelines can be followed.

Anonymous said...

i found out about this site frm minivannews

patients die in hospitals everyday, and it dsnt necessarily mean its due to negligence

this website is gonna hv to make a lot of stuff up, in order to com up wit a malpractice case everyday!!

But IGMH needs to definitely improve; in terms of better handling the patient load, better PR, and diversifying the services available by introducing more sub-specialities....the prob is they keep in mind big Private hospitals abroad who charge ridiculuosly high prices and most often do unnecessary tests, but this appears as 'sophistication' to maldivians..

so this frustration boils down to allegations of 'negligence/malpractise etc wenever n wotever

good luck to igmh docs lol

pachas said...

Why everything in mmw is revolving around igmh? Don't we have other hospitals where "negligence" happens?

Stories in mmw give a false impression that not a single patient receives a proper treatment at igmh or any other maldivian healthcare facility. I am sure there will be stories of patient receiving good treatment.

Any group with a mandate to “watch”, (eg Human Rights Watch), should bring the good and the bad things. Perhaps MMW sees only bad! MMW has to mature, bring unbiased reports and think on a broader picture.

Anonymous said...

As far as i am aware of MMW was created to bring all the bad things that happen. If some one wants the good stuff to be reported.. i think IGMh should announce all the good thngs that happn there..if any...

Also the good things people can come up with their own website to report on good stuff .. if any to report..

Anonymous said...

It is important that MMW be bold and report .. they should not get caught up in this good stuff reporting...

Anonymous said...

i disgree with last anonymous

Anonymous said...

"good things if any?????? " thats amazing..i think thts great.. all the babies born in IGMH are brain dead.. alll are retards roaming street. maybe the druggies around must be due to something bad that IGMH did... oh and everyone who had a heart attack are dead. anyone who gets to ICU never became better and got out..everyone who had appendix operated died.no one's bones healed.. all who went to IGMH are dead...must be ghosts on the streets of male' of all who were killed by " Insaanun Gasthuga Maraa Hospital".... as if they got nothing better to do than kill people

Anonymous said...

lol

moto said...

I think it would be better if you could investigate properly and write about stories. As for this case half of the story was just noncense.... In future i hope you will investigate.. get more information and then write the true story.. thaa kuhama vaahaka eh adhuivey irra jahanee dhoo... theeves gotheh!!!

Anonymous said...

I think it would be better if you could investigate properly and write about stories. As for this case half of the story was just noncense.... In future i hope you will investigate.. get more information and then write the true story.. thaa kuhama vaahaka eh adhuivey irra jahanee dhoo... theeves gotheh!!!

Anonymous said...

This story is impossible to interpret.
As a Canadian obstetrician, I can tell you that even here women end up with hysterectomies, in ICU, with blood transfusions, and occasional dying due to a placenta previa. Most cases are diagnosed antenatally with ultrasound, but as has been clearly pointed out, this is not universally the case due to a variety of non-modifiable factor (fetal position, maternal bladder, etc.).
Cesarean sections in the setting of placenta previa can also be notoriously difficult. I have difficulty believing that a "too small" skin incision would cause problems - this can be remedied in under 30 seconds with a scalpel. Once in the abdomen, however, the lower segment of the uterus in the setting of a previa is often undeveloped or poorly developed (even moreso with a preterm baby), making an adequate incision difficult to impossible (a classical cesarean section is often required). If the placenta is on the front wall of the uterus, it must be cut through or sheared off in order to reach the baby (and this must be done very expeditiously). Once baby is out, there is a 10%-ish risk of placenta accreta, where the placenta has grown into the wall of the uterus and cannot be easily (or safely) removed. Finally, once the placenta has been removed, the bed where the placenta was located often does not contract down well, resulting in excessive bleeding. Up to 10% of women who have a placenta previa will have severe enough bleeding to require a hysterectomy. (I say up to 10% because this is what the textbooks say, even though that has dropped significantly with modern obstetrics).
Based on this somewhat details-sparse account, this woman received relatively similar care to what would have been provided at tertiary hospitals anywhere in North America (except that we don't allow family donors to give emergency blood donations - all blood goes through our non-remunerated donor blood bank to allow pre-testing for HIV, hepatitis, etc).
I landed at this site randomly as there are some requests for foreign obstetrical and midwife support in the Maldives... with sites like this I think I'd best keep my well-trained, well-meaning obstetrical hands away from the vigilante masses.