KNH to pay family Sh2.4m for negligence in kin's death

The court held the hospital and the doctor 100 per cent liable in negligence for Mwakisachi's demise

In Summary
  • Mwakisachi was put on dialysis and was being treated by Dr Joshua Kayima until August 26, when he collapsed and died a few hours after the procedure.
  • Prior to the renal issue and subsequent death, Mwakisachi lectured at a school in Bura, where he received a gross monthly pay of Sh19,362.
Milimani Law Courts
Milimani Law Courts
Image: FILE

It was a tragedy that could have been averted for a while longer if the doctor had been keen to check up on him after the procedure.

In 2003, lecturer William Mwakisachi, 38, developed kidney disease and started sessions of dialysis.

On August 19, the same year, he was admitted at the Kenyatta National Hospital where a series of tests were conducted and reports revealed he had a kidney trouble.

Dialysis was recommended under the care of Dr Joshua Kayima.

But out of the blue on August 26, after a dialysis session, he collapsed and died only hours after the procedure.

Prior to the kidney problem and subsequent death, Mwakisachi lectured at a school in Bura, Tana River county, where he earned a gross salary of Sh19,362 a month.

He had two children—a son and a daughter—with his wife, Faith Ringo, all who were his dependants.

He had been diagnosed with high blood pressure, but which was under control.

Following his death, a post mortem examination was conducted that  established death was caused by a massive right-sided haemorrhage (haemathorax) due to intercostal artery severance (injury) in patients with renal failure.

It also revealed that there was a collapse of the right lung and that there was massive right side haemothorax  (collection of blood between the chest wall and the lung) of about 2.5 litres of fresh and clotted blood, which had caused a collapse of the right lung.

This bleeding would have taken between three to five hours.

Mwakisachi's grieving widow would move to court, suing both the hospital and its doctor for negligence.

She asked the court to grant her compensations including special damages of Sh45,100 derived from her husband's funeral expenses of Sh30,000, fees paid for probate being Sh15,000 and a death certificate of Sh1,000.

Probate is the legal process for reviewing the assets of a deceased person.

When the trial begun at Milimani High Court, a Professor Kiama Wangai appeared alongside the witnesses for Mwakisachi's widow.

He told the court that the cause of death was negligent injury to the intercostal during dialysis.

He produced his report, which was based on the findings of Dr Andrew Gachii,who did the postmortem.

Gachii told the court that the patient should have been monitored after the procedure.

This, according to him, should have been done every 20 minutes to confirm whether a complication had occurred.

In his defence, Kayima produced two other kidney specialists, one who told the court that the dialysis was not without risk even for the most highly skilled doctors.

He said the risks at all times are explained to all patiences and their families or guardians prior to the commencement of the treatment, as a matter of hospital policy.

He indicated that KNH's  medical staff gave Mwakisachi adequate professional medical care prior to his demise, however his condition deteriorated very fast leading to cardiac arrest in spite of the first aid intervention by the Renal Unit.

He went on to say Kayima was one of his finest students at school, however added that did he advice on the kind of treatment the deceased underwent.

He said the high blood pressure may cause kidney failure.

Another one of kidney specialists and physician Ahmed Twahir told the court that a catheter was inserted on the right side but it did not work and it was inserted on the left side and it worked.

He added that the catheter procedure used on the deceased was blind. He said these days they use image intensifier and ultrasound which were not available when Mwakisachi was admitted at KNH.

Twahir said there should have been readings every half hour provided on blood pressure.

This is such that between 1 1pm and 3pm on August 26, 2003,  there was supposed to have been six readings provided.

He admitted before the court that the records had a gap.

Twahir also admitted that there was no interventions indicated from 10.35pm to 5am in the morning and that the dialysis notes were missing.

Appearing at before Justice Asenath Ongeri of Milimani High Court, Kayima said his last contact with the patient was when he inserted the catheter.

He left the matter to the nurses to do the rest of the treatment.

He would later learn that Mwakisachi went to the bathroom before he collapsed upon returning to the bed.

Stating that it could not be held liable for negligence, Kenyatta National Hospital said it had taken all reasonable steps to ensure that a patient received proper care.

This is by employing the services of duly qualified personnel to attend to patients and they exercised due care, skill, diligence and competence as was reasonably expected from an ordinary and competent health provider of its nature.

The deceased's family proposed for Sh250,000 as damages for loss of expectation of life, for his pain and suffering before death it proposed Sh200,000.

The family further prayed for a ratio of 2/3 on his monthly pay which totalled to Sh3,405,952.

Mwakisachi's widow also submitted exemplary damages of Sh3 million.

The hospital denied the compensations, saying the man died shortly after the procedure and asked for minimal award for pain and suffering being Sh100,000.

It also asked for a similar amount as damages for loss of expectation of life.

Upon determining the case, Judge Ongeri found that negligence was confirmed, noting that if Mwakisachi had been monitored, the bleeding on account of the severance of the intercostal, would have been noted.

"I find that proper monitoring of the deceased after catheterisation and the subsequent dialysis was not undertaken otherwise the bleeding on account of the severance of the intercostal would have been noted and documented and efforts made to address the attendant emergency," she said.

The court held the hospital and the doctor 100 per cent liable in negligence for Mwakisachi's death.

She also found that the family was entitled to remedies.

Considering that the man was suffering from a chronic illness, she awarded a multiplier of 14 years and a multiplicand of Sh19,352 (14x12x19,352x2/3)=Sh2,167,424.

In a relief with 20 years in waiting, the family also got remedies for loss of expectation of life and damages for pain and suffering being Sh100,000 for each.

In total, they were awarded some Sh2,412,524, with the added special damages.

"Judgment be and is hereby entered in favour of the plaintiffs against the defendants jointly and severally in the sum of Sh2,412,524 together with costs of the suit and interest at court rates from the date of this judgment until payment in full," Justice Ongeri's judgement reads.

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