My brother died due to negligence, says doctor

A doctor has claimed that medical negligence at a hospital in the Western Province led to the death of his brother prompting the Western Province health authorities to conduct an inquiry. Dr. Dayanath Ranatunga claims that the hospital staff failed to diagnose certain symptoms while the unavailability of an ambulance and staff shift changes delayed the transfer of his brother, K. M. Upul Kumara to the Colombo National Hospital where he died having suffered severe internal bleeding.

An engineer, Kumara was admitted to the Gampaha hospital at 2.55 p.m. on December 8 after he had fallen down the stairs and knocked his head having lost balance while he was holding his daughter. He had been unconscious after the fall but had regained consciousness on the way to the hospital. Once he was admitted, he was examined by the hospital’s primary care unit and the family was informed that the X-ray seemed fine and his condition was not critical.

The patient was warded at 3.10 p.m. and at around 4.45 p.m. after further examination it was decided to transfer him to the Colombo National Hospital. However the transfer did not take place immediately as the Gampaha hospital did not have an ambulance at the time. The Divulapitiya hospital, which was the nearest located 12 kilometres away was asked to send an ambulance which arrived in Gampaha at around 5.45 p.m.

However, the transfer was further delayed when the patient was taken away to have an artificial breathing tube installed in him, while staff shift changes and the ambulance having to wait for the relevant nurse to get ready caused further delays. The Sunday Times learns that the ambulance left the hospital only at 7.10 p.m. although it arrived there well over an hour ago. The patient arrived in Colombo at around 8.00 p.m. where he had been immediately taken for surgery but died a few days after, on December 14.

Dr. Ranatunga claimed that although his brother complained of a headache, the nursing staff had not paid due attention to the matter and a paracetamol was later given by one nurse, which he had vomited. He said that the failure of the hospital staff to diagnose such a fact as vomiting and headache being symptoms of internal bleeding in the brain was an issue of concern.

“When we were informed that the hospital did not have an ambulance at the time I asked if we could get one from Colombo or any other hospital or use a private ambulance”, Dr. Ranatunga said. “However the hospital authorities did not agree and told us to wait for the one from Divulapitiya which would take around half an hour to arrive”, he said.

At 5.45 p.m., Dr. Ranatunga was informed that the ambulance was in place and the documents were being processed. However, even at 6.30 p.m. the ambulance had not left Gampaha even though the patient was ready in the ambulance.“I was told that my brother had been taken to the ambulance when it had first arrived but had been taken back to the primary care unit to install an E. T. tube (artificial breathing tube) in him. It is quite questionable as to why it could not be installed in him in the ambulance itself,” he said.

However, Gampaha District General Hospital Director Dr. Dammika Mayadunne denying the allegations said the patient was treated according to the usual procedures followed in cases of head injury and as the patient’s condition was not considered critical no immediate action had been necessary.

Dr. Mayadunne said that patients admitted with head injuries are kept under observation and not given any treatment.“That is regular checks are done by the doctor and if the patient’s condition is critical treatment would be given. In this case paracetamol was given to ease the pain,” he said.

“The Gampaha hospital had only two ambulances. One ambulance had left long before and the other was to take an elderly patient who was admitted at around the same time as Kumara with head injuries, but had to be given priority as his condition was critical,” he said.

Dr. Mayadunne said that the hospital staff was not legally able to use private ambulances as there was no mutual agreement between us and their facilities or compensation in case of accidents was not guaranteed.“In the meantime the patient developed a fit and had difficulty in breathing. Therefore we had to install the tube in him and as a general practice this could not be done while in an ambulance”, he said. According to Dr. Maydunne there was no significant delay during the changing of shifts of nurses.