Medical Errors…A non-stop bleeding!

High fatalities in the absence of oversight and accountability
Adel Thamer
August 2, 2022

Medical Errors…A non-stop bleeding!

High fatalities in the absence of oversight and accountability
Adel Thamer
August 2, 2022

Critical moments experienced by the patient, Ahmed Abdullah Hamid Al-Nabous (54 years), a victim of medical errors, in a government hospital in Sana'a.

Al-Naboos, who works as a director of the Capacity Building Department in the Training and Rehabilitation Division in the Sana’a Education Office, arrived at an eye clinic in a government hospital on foot, complaining of slight poor eyesight. Based on the results of tests he had previously done in a private hospital, it was shown that the visual acuity in the right eye is (400/20), and (CF1-50mt) in the left eye due to cataracts in the eyes.

However, Al-Naboos completely lost his sight due to a medical error. Al-Naboos’ injury is just one of dozens of accidents and mistakes that may lead to the death of patients or cause permanent disabilities and impairments, in the absence of supervision and a lack of a sense of accountability.

It is worth noting that medical errors have become a concern for all Yemenis who have lost confidence in medical services in general, and perhaps the failure to monitor these errors, whether in government or private hospitals, is an obstacle to determining the extent of the disaster, but what is certain for everyone is that the series of medical errors continues and no one knows when it will end.

Serious crime and human violation

Abdul-Rahman Al-Zubaib, a legal and media advisor, told "Khuyut" that: "The patient resorts to the hospital, whether governmental or private, in order to seek medication and relieve pain, but this resort may turn into a cause of permanent disability or greater and more severe pain due to the possibility of committing a medical error. Medical errors are not limited to large or small surgeries only, but may occur at any stage of the medical treatment process; consultation, diagnosis, treatment, surgical interventions, or even in the post-operative care stage, as a result of a lack of material and equipment capabilities of hospitals or unqualified human staff.

On the second day, they removed the gauze from my eyes and asked: “Do you see?” I replied: “No, no.” They turned on the lights of the mobile phone and the flashlights for the eyes to no avail, while the treating doctor hurried from his room to ours after hearing the nurse’s statement that I've lost sight! The doctor whispered the nurse in faint words: "The fault is in the (anesthesia)!"

Unforgivable Mistake

Ahmed Al-Naboos wiped his tears while speaking to “Khuyut”: “I was suffering from weakness in the eyesight. I resorted to a medical camp to remove cataracts. They told me that the water was not complete in the eye. I waited a short while and went to a private hospital for comprehensive examinations of the eyes, retina and intraocular pressure. The results of the analyzes showed the presence of (cataract) that needs surgery to remove it at an amount of 600,000 Yemeni riyals for both eyes. My circumstances did not allow me to pay this amount because I am a government employee and we have been without salaries for six years. They advised me to go to one of the government hospitals that announced discounts on the occasion of the Prophet’s birthday."

Al-Naboos went to perform cataract surgery at the government hospital. They repeated all the tests, which showed the existence of cataracts. After that, he was admitted to the operating room, walking on his feet and seeing everyone around him, after which the anesthesiologist gave him anesthesia. As soon as she finished the anesthesia, Al-Nabs lost his ability to see immediately, as if she had turned off his eyes. At that time Al-Nabs cried out at the top of his voice: “My sight is gone, my sight is gone.” They told him: “Don’t worry, this is only because of the anesthesia, and your eyesight will return to normal after finishing the operation."

Al-Naboos told Khuyut that: "The operation was performed by ophthalmologist consultant who is also the head of the eye department. After the operation was completed, the doctors and nurses took me out, my eyes were covered with gauze. I tried to look from under the gauze to no avail. I could only see complete darkness, no signs of sunlight, and not a glimmer of light, at that time I was sure that I had lost sight.” He adds: “On the second day, they removed the gauze from my eyes and asked: “Do you see?” I replied: “No, no.” They turned on the lights of the mobile phone and the flashlights for the eyes to no avail, while the treating doctor hurried from his room to ours after hearing the nurse’s statement that I've lost sight! The doctor whispered the nurse in faint words: "The fault is in the (anesthesia)!"and he gave me special bleeding medicine to use at home on the basis that these medications will restore my sight. ".

Negligence is also a crime

Al-Zabib added: "The crime may be committed intentionally or negligently, and in both cases the doctor and the hospital bear the legal and moral responsibility."

The Yemeni law considers medical error as a serious crime if it results in the death of the patient. Article 241 of the Penal Code stipulates that: "A person who assaults the integrity of the body of another by any means shall be punished with a heavy blood money or imprisonment for a period not exceeding five years, without intending to kill, but the assault led to death."

In the event that the patient does not die, the crime is not serious, and therefore the penalty is two years imprisonment or a fine with indemnity based on the text of Article 245 of the Penal Code: “The blood money or compensation, according to the circumstances, shall be imposed on whoever, by his own fault, compromising the integrity of the body of another, shall be punished by imprisonment for a period not exceeding one year or a fine, and if the crime results in a permanent disability, or if it occurs as a result of the offender’s breach of what is obligated by the origins of his job, profession, occupation, or violation.” According to the laws and regulations, or if he was under the influence of drunkenness or anesthesia when the accident occurred, his penalty shall be imprisonment for a period not exceeding two years or a fine.

Useless Medication

Al-Naboos suffering continued after the surgery, as he was absolutely certain that it would be impossible for his eyesight to return, and that all those medications he was taking in the hope of recovery were of no use and would not bring any positive result. He says: "At that time, I had a severe breakdown and shock, especially after my case was examined by their most senior eye surgeon, and the result was disappointing; (the eye lost vision)."

Ahmed Al-Naboos was so angry and disappointed that he returned to the government hospital that performed the operation. However, the doctor who carried out the operation reassured him, and told him about the possibility of performing a second operation at the best ophthalmologist in Yemen, by gas injection, where gas is injected to those who suffer from partial separation in the retina, but Al-Naboos was suffering from a (total detachment).

 After the gas injections operation was completed, Al-Naboos stayed at home for two weeks, during which time he was forbidden to raise his head and move, in addition to the obligation to use the new medicines. After the nursing period was over, he then returned to the doctor, to tell him that he had not benefited from the gas injection!

"Later, I underwent a major operation that lasted three hours, during which I was exposed to new complications, including increased liver function, severe sensitivity in the eyes, in addition to other problems due to anesthesia and the long operation time. After all this, the operation failed, and I knew that they were aware that it was a failure from the beginning." Al-Naboos said about his suffering.

Consenting to the surgery is not consenting to misconduct

The law on the practice of medical and pharmaceutical professions requires that the patient be given the necessary information about the surgery that will be performed on him before it is executed in addition to (his written consent). However, if the patient is unconscious or incompetent or has a disability that prevents him from expressing his will, the consent of his guardian shall be valid), and there is no any indication that the written consent includes a waiver or disclaimer of the right in the event of any medical error happened during the surgery.

According to the prevailing medical laws, a practitioner of the profession is subject to disciplinary accountability if he/she breaches one of his/her professional duties or violates the profession’s rules and ethics. In this case, the Supreme Medical Council has the right to apply one of the disciplinary penalties that may amount to striking off the name of the doctor from the Council’s records, and canceling the license to practice the profession. 

Raising the case to the Medical Board

Al-Naboos continues: "I decided to go to the medical council to file a complaint, but I was surprised by the decision of the medical council, which was biased towards the doctor who did my operation who lied in his testimony when he said that I was able to see on the second day of the operation."

Legal and Executive Shortcomings

Counselor Al-Zabib assures us that the Yemeni law has authorized the Supreme Medical Council exclusively to be the competent authority to review and decide on crimes of medical errors, in accordance with the text of Article (21) of Law No. (28) for the year 2000 regarding the establishment of the Supreme Medical Council, which states: “The Supreme Medical Council is the authorized body to decide on the submitted complaint within ten days from the date of receiving the complaint,” which was not actually achieved; in fact, complaints with the Supreme Medical Council are delayed for many months without being processed.

Moreover, the law grants the party rejecting the decision of the Medical Council the right to appeal, while guaranteeing the right to resort to the judiciary according to Article (22) of the law establishing the Supreme Medical Council.

The law referred the organization of investigation procedures into medical errors to the executive bylaws, which have not yet been issued.

I'd rather die in my bed

In the end of his story to "Khuyut", Al-Naboos says: "Because I am poor and helpless, this crime has gone unnoticed, and I now wish for nothing but death on my bed at home, better than going to hospitals in Yemen, whether governmental or private"

Infinite Errors

The lives of dozens of citizens in Yemen are exposed to endless fatal medical errors that may make doctors as ghosts in the eyes of patients. And between the doctors’ lack of experience and the material exploitation of people who have nothing in the medical profession but its name, the patient turns into a mere commodity to be traded, and (Ahmed Al-Naboos) is not the only victim, as there are dozens or hundreds of victims as a result of medical errors in Yemen.

Adel Thamer

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