- A Maternity Mortality Audit concluded the cause of death as Hypovolemic Shock secondary to postpartum hemorrhage in severe preeclampsia with twin pregnancy.
- A post-mortem conducted on September 14, 2022, indicated the cause of death as cerebral edema, pulmonary edema and anemia in the background of pre-eclampsia and post-partum hemorrhage.
Image: FILE
Following the death of a 28 - year-old, Maureen Anyango at Mama Lucy Hospital, a committee was formed to investigate the occurrences that lead to her death.
On September 5, Maureen was admitted to Mama Lucy Kibaki Hospital (MLKH) with a diagnosis of severe pre-eclampsia (high blood pressure in pregnancy) and malpresentation in twin pregnancy.
Maureen delivered twins via an emergency cesarean section on September 6, 2023, at approximately 7.00 am.
Post-operatively, she developed vaginal bleeding for which she was taken to the theatre for examination under anaesthesia.
However, she failed to reverse from general anaesthesia and was maintained on mechanical ventilation.
She was referred to Kiambu Level 5 Hospital (KL5H) for critical care and was admitted to the ICU team on September 7, 2023.
Patient care and management continued from 1.20 am to 7.00 am when she succumbed.
A Maternity Mortality Audit concluded the cause of death as Hypovolemic Shock secondary to postpartum haemorrhage in severe preeclampsia with a twin pregnancy.
A post-mortem conducted on September 14, 2022, indicated the cause of death as cerebral edema, pulmonary edema and anaemia in the background of pre-eclampsia and post-partum haemorrhage.
In relation to the treatment and management that the late Maureen received, the committee observed that Maureen ought not to have progressed to term, and should have been advised accordingly during her Ante-Natal Clinic (ANC).
According to the committee, there was an unjustifiable delay of at least eight hours from the time the late Maureen was admitted to MLKH to the point that she was transferred to the theatre for the emergency CS.
The eight hours translated to at least 12 hours of active labour at MLKH from the time of admission to delivery.
The committee said Maureen's death would have been avoided if the proper procedures had been followed at MLKH from her admission to her subsequent transfer to KL5H.
The committee of inquiry now wants Mama Lucy Kibaki Hospital (MLKH) to be investigated.
According to the committee, MLKH is culpable in the wrongful death of Maureen owing to proof of medical negligence at the facility.
It recommended the professional conduct of Dr Lazarus Kumba, the hospital obstetrician/gynaecologist, be investigated for submitting false evidence before the Committee.
"Professional conduct of the nurse(s) on duty who were responsible for managing Maureen between the time she was transferred to the postnatal ward, and the time she was transferred to theatre for examination under anaesthesia (EUA) be investigated by the Nursing Council of Kenya, and held accountable for their mismanagement of the patient," the statement read.
The committee also wants the management and staff of Kiambu Level 5 Hospital to be formally recognized for the professional, timely and appropriate care that was extended to Maureen at the facility.
"In view of evident failures in the management and administration of Mama Lucy Kibaki Hospital, the Chief Executive Officer of the hospital, and management of the maternity department be held liable for failing to ensure the provision of emergency treatment and care at the facility contrary to Article 43(2) of the Constitution which guarantees every person the right to emergency medical treatment; section 7(3) of the Health Act which provides for emergency treatment; and, the Kenya Emergency Medical Care policy," the statement read.
The committee recommended that the Ministry of Health, Kenya Medical Practitioners and Dentists Council, inspect MLKH to recommend a technical classification commensurate with its actual level of healthcare service delivery.
According to the committee, the Ministry of Health, in collaboration with the Council of Governors and County Governments should develop and disseminate standard emergency operating procedures for all levels of care.
The Standing Committee on Health is established pursuant to standing order 228 (3) and the Fourth Schedule of the Senate Standing Orders.
It is mandated to consider all matters relating to medical services, public health and sanitation.