Health Ministry should inspect all private hospitals to ensure protocols followed – Medical Council

Feb 04, 2020 News

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– Medical Council recommends

A damning report in 2014 by the Medical Council of Guyana on the death of a patient has recommended that the Government continuously assess the private hospitals and other health facilities.

It is unclear what level of monitoring would have been occurring by regulators up that time.
What is clear is that the then Chair of the Medical Council of Guyana, Dr. Vivienne Mitchell, appeared not pleased with the status quo.
She called on the Ministry to act.
The regulator urged in the report: “The Standards Unit at the Ministry of Health needs to send teams of assessors to all health facilities to inspect processes and adherence to protocols.”
The recommendation was one of five that she outlined. It would raise deep concerns what would have transpired before 2014.
The report was a shocking one that has been leaked with the family of Edward Subryan, 74, calling for justice.
On February 1, 2014, Subryan, a grandfather, died at the hospital after a simple colonoscopy went horribly wrong.
A colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.
During the examination, Subryan’s colon was perforated, and it was not repaired properly.
With improper care and complications, the man died days later. The family, seeking answers, complained to the Medical Council.
According to the report on the probe done by Dr. Mitchell, a private hospital in the city, and the two doctors were responsible for the man’s death.
They were ordered to settle the matter with the family of the victim.

However, since 2014, the family of Subryan has not been able to hear whether actions have been taken as a result of the damning report.
Dr. Mitchell reviewed several documents, including from the city hospital, the Post Mortem report, the Death Certificate, and responses from three doctors– two of them are general surgeons who are reportedly no longer at the hospital.
Subryan was admitted to the private hospital on January 21, 2014 with upper gastrointestinal bleed.
“After 11 days of investigations, procedures and treatment, he died with an abdomen full of pus and chest full of blood and clots,” the report said.
According to the report, Subryan, on admission to the private admission, showed a number of things, including gastric ulcers, but no active bleeding.
The next day, during a colonoscopy, the patient’s colon was “inadvertently” perforated.
Despite a repair, there was early clinical evidence of sepsis.
Over the next few days, the man’s condition deteriorated with suggestions of “overwhelming sepsis”.
“Post mortem performed the following day found one liter of blood and clots in the left thoracic cavity. His abdominal cavity was found to be filled with pus. His stomach had fecal material.”
The cause of death was given as peritonitis, acute pancreatitis, duodenal ulcer and COPD.
In her opinion, Dr. Mitchell was harsh. She said that the doctors should have been able to diagnose or at least suspect what the man was suffering from. This would have influenced the clinical management.
Shockingly, there was no documentation by the two doctors, and the hospital by extension, of adequate history taking which must include past medical history, social history and review of systems. Further, there was no documented physical examination of all his systems.
“This is a breach of a basic standard of care taught at the undergraduate level.”
Of major concern was the fact that none of the doctors recognised that there was a critically ill patient who required aggressive intervention and management in the Intensive Care Unit.
Subryan was not given enough oxygen despite the likely need and he “was never returned to theater for a possible life-saving peritoneal lavage.”
In her damning conclusions, Dr. Mitchell found that the two senior doctors “provided substandard care with respect to their inadequate history taking, incomplete diagnoses, scant documentation, failure to recognise a critically ill patient, and failure to provide effective available life-saving interventions.”
The Chair of the Medical Council was emphatic: “These senior doctors did not meet the standard expected of a doctor.”
Disciplinary actions were recommended for the two doctors.
The administrator of the private hospital has been asked for a comment on the case over the weekend but there has been no response. The Medical Council also has been told about the matter and asked for a comment.
However, up to late yesterday afternoon, there has not been a response.
The Medical Council of Guyana is a regulatory body formed to enhance and monitor the functioning of the medical fraternity in Guyana.
In recent days, there have been a slew of allegations against a number of private hospitals, with doctors being accused of carrying out needless operations and charging hundreds of thousands of dollars for them.
One businessman is accusing the hospital of keeping his sister in and leaving them with a $1.3M bill.
The Ministry of Health has also been silent since the concerns were raised a few weeks ago.
If you know of anyone who has a story to tell and has the evidence that he or she or a family member has suffered at a private hospital, please let us know by calling 225-8491 or email us at kaieteurnews@yahoo.com.

 

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