Update: Both mother and baby in the latest reported case improve and come off life support.

Saturday, February 9, 2008

Both baby and mother who were in critical conditions in intensive care at IGMH have improved and come off life support.

The baby's condition is reported as "stable with no evidence of asphyxia or brain injury" and although still being managed in the newborn ICU is reported to be making a full recovery. This comes as a relief for both parents and doctors. We can confirm that the baby was on artificial respirator for about 24 hours when 2 days ago baby was "weaned" off the machine. The initial communication that parents received from the doctor who was in charge of the case at that stage, Dr Vikas Bopache, was that baby has severe asphyxia (a condition in which the brain suffers damage from lack of oxygen) and that there was a strong likelihood of baby developing fits. This fear has now been removed by the new team of doctors looking after the baby; who say that there are no signs to suggest such a possibility.

The father was visibly relieved when our source saw him in the Obstetric ward. He was telling the people around him that he was happy at the progress and very publicly praised the doctors for their efforts.

In more good news for the father, the child's mother has also improved in leaps and bounds since her admission to ICU after delivery. Apparently, doctors from the internal medicine department got involved in the case on the request of a family doctor, Dr Zumra. It is believed that, with their experience in handling cases corrupted by other departments, they were able to get the patient to safe territory. The last update we got was that the mother had come off mechanical respirator, was shifted out of ICU, did not require to have the uterus removed (bleeding did get controlled finally) and was in a special private room at the expense of the hospital.

The case was reportedly reviewed by the hospital administration and some statement is expected in the coming few day. We believe that IGMH will not make a public statement but expect the family to be briefed about their findings.

Blood transfusion stand-off:

Rumors have been circulated around the hospital that the father had refused transfusion of any blood other that his own to his wife when she was in a critical condition. This rumor is false. We can confirm that the issue of blood transfusion arose well before the patient was taken for C section. Apparently the hospital has a new donor policy (that is reportedly in accordance with international red cross's own donor policy) that blood will be collected from donors and then cross-match done. The father was asked to get a donor while the patient was in the ward for "monitoring". He had himself volunteered. At the blood bank he was asked to donate the blood first and told that cross-matching would be done after the full blood pint was collected. This father did not want to have a pint of blood removed from him IF it was not going to be used for his wife. This was where the misunderstanding started.

Because of his religious beliefs, he is a devout muslim, "who takes pride in looking like a true muslim", he didn't want blood of someone whose character and health was unknown to himself to become the donor. He was counselled on this issue by doctors and his views on the issue changed. MMW supports non-renumerated blood donation and wold take this opportunity to call on the blood bank to inform the public on the benefits of this system of donation.

The father had not refused transfusion as a life saving treatment for his wife.

We wish the family a speedy recovery. We hope that the father and family is given support in overcoming this intensely traumatic experience.


Note: MMW does write on issues and events that are happening outside of IGMH. Check our archives for them. We will however not wander away from an event like this where interest of the patient were given secondary importance. If any reader feels that we have presented a false case, feel free to have your say! We are witness to many sad stories that have happened in our health system and would like to make it very clear that we will report these kinds of events; not to destroy IGMH or the health system but to let them know that these events will not go unheard. We too want to see a reliable and trustworthy health system and hospitals, but we have remained calm and waited for the administrative bodies to do the right thing for far too long. We shall not stay quiet as we did before. We shall pressure the authorities to bring good change. For all our sake!

38 comments:

Anonymous said...

Kudos to the medical team.

We appreciate the flexibility of MMW in taking the concerns of this blogs viewers into consideration.

Pressure is good; oversight is necessary;but Falsehood does not foster understanding.

As was evident from this case, more than anything else it was misunderstanding that fed into this prevalent perception of "rampant negligence".

we shall not falter, and we shall persevere in fostering greater understanding between the public and doctors, and it starts in this blog.

thank you MMW

filigas said...

Good work MMW. But stay unbiased. Sometimes the language used suggests otherwise. Eg: "experience of internal medicines doctors in managing cases corrupted by other departments" this demeans some very good doctors in other departments who are doing extremely good job.It appears that doctors in internal medicine are very good.Most of them are very good but there are few who are medically good but very responsible.
It is high time medical administration(headed by Fatima didi and supported by yaseer) at IGMH developed standard guidelines in managing cases so that if there were deviations, deviating practitioners can be made answerable.

Anonymous said...

aadheyheve. Aharumenves mikamugaa dhemi thibeynameve.

we did not give up the best years of our life, only to be lynched by the very people we are trying to help.

shukuriyya

kareem said...

There is another important issue that MMW can pressure IGMH to do.This is something that should be done.That is timely documentation patient records. from what I understand it is the nurses who document records properly, but the medical guys fail miserably in this.Offcourse I should not discrdit the few who does it very well. If this is properly and timely done IGMH will not have the chance to cover up things, because all the events will be in chronological order and no additions or alterations can be made.Some doctors at IGMH should take this to the heart at drive the initiative. I understand that this was initiated by hospital in 2006 but it was resisted heavily by some very vocal but few male' doctors. But this is something vey important in medical practice.

Anonymous said...

This was not resisted by doctors...the task was assigned to medical records dept, from there to the clinical assistants...the doctor is not a record keeper; it is the duty of nurses and assistants to meticulously maintain records!

What the doctor records in the prescription/case is what is required to exercise his function as a clinician.

yes, i agree records are an integral part of hospitals, not just for accountability but also because many patients loose their case records or give incredible history.

Anonymous said...

kareem ebunee varah ves thedu vaahaka ennu dho. Meekee ekakah ves olhigenva kameh heneh hiyeh nuvey. hama nukuranee.

Anonymous said...

ahh "hama nukuranee"...doctarunge sikundiyaai hithakee galun hadhavaafa huri etcheh viyyah!

Anonymous said...

dhivehin comment vattah meeha; kaley doctarukan kiyavan dhaanveenu, igmh doctarunna vureh rangalha kantha kuran ingenyya!!

kaleymen kahala meehunna aharunna dhimaa veyeh hospitaluga...ekkaireega thibeyne bas vattah vattah...amilla athunai fayin ekkamves vaniyyeh noon

Anonymous said...

anonymous bunantha naruhun nakee varai caring baiye meehun naruhunaa dheytherey dhekey goi badhalu kuranvejey

Anonymous said...

welcom to the club Nurse(last anonymous)

Anonymous said...

this is very unfortunate that such false information has been dissipated to the public, especially by professional people working in IGMH.it is obvious that whoever is the source of MMW information is a mentally sick person. None of the events in the 2 cases you have written about occurred in the manner described by you. for example, how much of an incision is to be given during a cesarean can be determined by only an obstetrician. even another
doctor say a paediatrician cannot say what size of a incision to be given because he or she doesnt have the practical experience to say so.if they think they do, why dont any tom or dick just take a knife and cut the mothers abdomen from one end to the other and take out the baby. the baby might survive but what will happen to the mother? it is a routine practice to give an incision and extend it if the surgeon feels that the incision is a bit small.delivering a baby by cesarean is a surgical technique in which certain steps are followed.and just like any other surgery it is learnt by obstetricians by years of training.
and when you talked about the baby being sick where was the senior paediatrician when the baby was born? my source say that despite the obstetrician informing the paediatric junior doctor that the case is a high risk one and needs to be attended by the on call peadiatrician, he was not there when baby was born. the initial resuscitation of the baby was done by one of the junior most doctors. this could very well be the reason why the baby got sick as was the case many times. if the intention of your blog is good , then bring out the truth. a distorted version of things that puts the blame only on certain people is not the way to do it.

Anonymous said...

um actually, he DID refuse to donate blood and created quite a scene in the bloodbank. i was there myself that day :)

Anonymous said...

true. and there are documents in which he has signed in the afternoon saying that he was explained about the necessity of blood donation to his wife but doesnt want to give it at that time.. and his wife was taken to emergency operation at night.

Anonymous said...

if he was such a devout muslim and concerned about his wife then when he was explaind initially that his wife will most likely require blood , he should have followed the IGMH policy and donated the blood in the afternoon itself.if his wife did not require blood the blood donated by him would be used to save the life of some other person.such a devout muslim should have agreed to that. right?

Aviicena said...

Clearly we need to look both ways before we rant....no?

Unfortunately we maldivians hav a mob mentality, we are the same ones who slaughtered our first prez over a triviality, rwe not?...I hav seen the ruckus som patients create inside the hospital because they've head to wait in line to consult the doctor...i've seen people attacking the security guards over visiting rights against hospital policy...I've seen people making disturbances because the doctor does not give definitive assurance that a patient will be ok, instead of the prognosis being explained to them....I've seen many a times..

Ultimately, as someone has said here, the problem is of managment...of managing an unruly population of patients(not withstanding the good Samaritan patients), in a hospital that is struggling to cope with an influx of patients from all corners of the country....despite the best efforts on the part of doctors, little thanks do they get..even in this PP case, it is the hard work of the medical team that has saved the mother n child DESPITE it being a serious case of Placenta previa which presented late, and despite the hurdles the father placed on the clinicians!

For the people to be happy,IGMH needs to develop a persona like that of KIMs or Appollo, with all the elaborate investigative techniques and sohpisticated equipment, AND all these needs to be available free of charge, and doctors working for a measly pay(compared to other countries)need to do slave labour 24-7 without so much as a brake...then we wnt hv this problem....,...the docotors need to stop dressing smart, they need to stop talking smart, they need to stop having AC in their consultation room etc....decades of living lik zombies under one regime has made us even more soulless & this repulsion we have to authority or heirachy has becom inbuilt into our mentality...a mob mentality

Doctors represent the cream of society, the resented precipitate of this society...and they need to have much courage and will to bring about good changes, both in the management of a hospital under the worst possible circumstances and also in taming a unruly patient population(not withstanding the good, respected-respect giving humane patients who give a crap about the service we provide and who listen and follow our advice and our health guidelines for wot they are worth, even though we don't do MRI scans n wotnot for every disease that presents to us, who value the "jab/pokes/rounds " we do)...

Good luck to all the docs...thanku all patients who believe in us, we will do our very best to provide the best service we can...

MMW can be a force for good, if it does it in the proper way.i think

some truth said...

the person who is repeatedly commenting about the size of the incision clearly has no idea of how C sections happen in IGMH.

First of all, in both said cases Pediatricians were at the site for the deliveries. Dr Shafga was in the labour room for the "fundal pressure delivery for over an hour of the application of excessive force" and received the baby herself for resucitation. The baby was in such a state that even a senior peds doctor could achieve little. In the second case Dr Ankur was at the C section before the baby was extracted. He did successfully resuscitate the baby.

True, no tom, dick, harry or golhabo would take a scalpel and start doing surgeries. The obs surgeons at IGMH usually give small incisions for cosmetic reasons. That is OK if the baby is extracted. But ask any nurse or anesthetist at IGMH and they will tell you that struggling to extract the baby at C section because of too small an incision is almost a daily occurence at IGMH. Precious minutes are wated in this way. Often it has taken more than 10 minutes of struggling to get the baby out.

I think mmw has been writing biased stories. But what would you expect.

Your version is also very distorted. When these sad events are this frequently happening the admin needs to take notice and do something about it.

mmw has got the people talking. and I suspect the people who are doing these misdeeds have also taken notice that these things will be written about.

They may deny and counter accuse, but what is truth will remain truth.

I assure you that, many staff at IGMH will agree to these stories. It is sad that it had to come to this for the public to take notice of these and for IGMH admin to look into the practices of their doctors. Repeated complaints have been dissmissed by the admin rather off handedly......this is what has come of it.

Anonymous said...

finally some good came out huh!!

Anonymous said...

woh

loks lik an inter departmental squabble has spilled over here...

i think, if the incision was extended then also a backlash will be here, sayin out Obs dept is full of hutchers who cut so wide open that our young girls are left with horrible big unsightly cosmetically devastating scars!!!!

so its a lose-lose as always :)

n u guyz battling it out here dsnt help...shud kno better than that...pls com to a consensus

virion said...

I think we are loosing sight of the bigger picture here. Mishaps are not always avaidable in meidcal profession as anyone remotely to health system will agree.
we need to make a differentiation between medical negligence nad criminal negligence which have different connotations and legal implications. Unfortumately for MMW everything amounts to criminal negligence.

I wish they were a little unbiased. The idea is to bring about the truth and not to print juicy stories catered to the public demand to keep the print in circulation. Unfortunately during this changing turbulant political times everyone is on a wicth hunt with their new found freedom and these stories appeal to them.

MMW should be wishing that there are no stories to write instead of hoping on hitting some juicy ditbit which they can explore

Anonymous said...

do you know what struggling to deliver a baby means? yes its a fact that some persons give a smaller incision than others.but that is given 4 a reason. these days cosmetic side of any surgery is takan into account.thats why even in western practices small incisions are being given . and through that incision if the baby is delivered with a little struggle and with the help of fundal pressure that does not cause the baby any harm,as the baby comes out through soft structures (unlike in a normal delivery where baby comes through the bony pelvis and if that pelvis is small it MAY cause some harm).and application of fundal pressure during cesarean is practised everywhere. It is described in standard western and american obstetric text books also. as i said before please dont write about things that you dont know about. and yes Dr. Shafga was there to recieve the baby in the first mentioned case. but in the case of PP, the paediatrician came while the junior doctor was struggling to resuscitate the baby and then did something.this has happened many times .. we have seen the junior most doctors in the department of paediatrics who doesnt know anything about neonatal resuscitation attending deliveries and doing all sorts of blunders. even babies who comes out crying, when they goes into secondary apnoea, the attending doctor panics and doesnt know what to do. as a result baby gets sick.and some distorted story will be spread that the obstetrician has done something and baby got sick.IGMH administration, please note that most of the doctors in the paediatrics department are not competent to handle neonates and we need a neonatologist in IGMH as soon as possible. dont blame the obstetricians alone when babies get sick because a neonatologists role is equally important.

Anonymous said...

hehehe... real fight. hmmm i dont believe that you are that good a department to go and rubbish that department.if i was to say i will say that its obs gynae that needs to improve most. paeds has some real good doctors and there have been good junior docs too.. gynae and obs also has good docs and not so good docs...so no point in blaming each other..as often happens. work together as a team.ultimately the good of the patient is the aim..

Patient said...

Hey..nothing s gonna change by arguing here..one is saying how incompetent gynecologists are n another s saying about paediatricians...tat means something is going wrong. y to blame each other..guys DO the right thing..if anything goes wrong then learn from the mistakes.

Ratzinger said...

guys plz...this isnt helping....

yes igmh needs a neonatalogist..so is that OBs fault?...take it out on the admin or the MOH!

wot is this...the FBI vs CIA schism??

The patient is the focus here...if u guyz cant com to a consensus, n continue to stab each other n keps on playing the blame game, this WILL hurt the patient!

dnt let this get to u....now shake hands : ]

Anonymous said...

stop bickering....

golhabo said...

This apparent argument between the IGMH obs and peds dept is fictitious. This story is being played out by some very sick people.

These 2 departments work fine amongst themselves.

Anyway......this issue that mmw has brought about is neither against peds nor obs department. it is against the admin.

it is about lack of accountability, any sort of it.

After reading all this I wonder why IGMH is investigating just who it is who leaked the story to mmw!!! Looks like everyone at igmh is on the internet and having their say on this comment book.

I guess it is the hospital admin trying to make this argument look like a fight between peds and obs.....what nice way to get people off their backs. I bet more than half the comments are coming from fathun Didi.

nurse said...

guys do not keep on fighting with each other.most of this is crap. Stay professional and take care of your patients and work on developing your deaprtment and standard of care with the contraints and limitations you have.Objective assesment of complicated cases is required to improve our care. It is not something to loose heart. Most of u doctors are very competent and doing a wonderful job. Dr.Shafga and Dr. Malaka are competent doctors and if someting has gone wrong in thir hands , definitely means there was something beyong their control. Just leave the case to medical guys, beacuse they only will undersatnd the intricacies that are threir in such cases

Aisha Juman said...

"these days cosmetic side of any surgery is takan into account."

I know that. But i was scarred for the rest of my life by very incompetent doctors and i am suffering from it. Even this day. It has caused so much pain and grief in me. I know if i raise this issue i will not be compensated.I know justice is not going to get delivered in a place where there is no justice.

kahoot said...

well aisha juman, u being a nurse wanna be...u shud know ! we all know from whr this propaganda against igmh is comin from dnt we?

perhaps somone can recall the scandal that erupted in igmh few yrs bak regarding a certain nurse?..involvin indecency???,anyone?

Anonymous said...

i think this aisha juman is talking about female genital mutilation.

i dont think its done in igmh though

kufr said...

me ekkala maldiveshealth eyy kiyaafa siteh hingaa kaafiru manje dho....mi aishath juman

islam dheenaah idhikolhu comment tha aruvafa ahen comments tha gavaidhun mimanje delet kuraane!

athujehen dhen madu kollanthaa jehenyy

Anonymous said...

lol...yeah she's being making lotta noise on fbook also...was driven out...MH huh..i didnt know that! explains a lot though...why does she call it 'maldives Health'??

Anonymous said...

lol

Jinn said...

WELL Those who are poor and cant afford to go abroad will suffer in IGMH because there is no team work,the rich go abroad so they dont bother whats happening at grass root level,so all i can say is if u think a doctor has done wrong to ur pt bash him up,instead of fighting ,As we all know DR JUMRA and DR fazna were hit thats the right way then the courts can take care of u,and in such cases igmh has to prove that the doctor was hit,otherwise u have to prove that there was malpractice and its hard with the Gang in IGMH Dr solih/fathima/yasseer.

Anonymous said...

my my, miss jinni here is taking pride in inciting violence against docs..bravo

yeah if any nurses or doctors treat you unfarly,, bash them up...RAPE them

Anonymous said...

Bala e manje mashah heevanee thi mees meehunnah vureh maa smart hen . Enmen e manjege vaahaka viyya mihaaru dhakkanee dho .. Gadha manje gadeh nu.

Anonymous said...

People who know Aisha will be laughing their heads off. Kudos

Anonymous said...

Hey last anony.. That wasnt me. that was someone else. You are so paranoid these days. Seek help .. i advise u.

Anonymous said...

Yes he did REFUSE about crossmatching and tranfusing the blood and created a BIG scence there. I was there when every thing happened. Hama meehaku echekey bunaa irah thiliyanee ey, hageegai balaanulaa...