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{
"id": 186739,
"url": "https://info.mzalendo.com/api/v0.1/hansard/entries/186739/?format=api",
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"type": "speech",
"speaker_name": "[The Assistant Minister for Medical Services]",
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"content": "Mr. Gitobu Imanyara demanded a Ministerial Statement on the state of baby Rose Mwaka's Management at the Coast General Hospital. I beg to state as follows. Baby Rose Mwaka, aged eight months, was admitted to Coast General Hospital on 12th July, 2008 after presenting with fever, diarrhoea and vomiting. A working diagnosis of gastroenteritis malaria with pneumonia was made and an appropriate treatment commenced. Initial care was provided by a Medical Officer Intern and nursing staff in the Paediatrics Observation Ward (POW). As part of management, an IV drip line was put on the dorsum of the child's left foot to enable administration of a drip of the anti-malarial drug, quinine, and the anti-pneumonia drugs Chrystapen and Gentamycin. Veins in the feet are the third option for administration of intravenous medication if a site cannot be found on the arms or the scalp in that order. For baby Rose, the first two options had failed. The drip was fixed twice on the left foot of the baby. The first one stopped flowing due a technical problem called \"tissuing\". This necessitated reinsertion of a second drip line which worked. As a result, the child's condition improved. The fever abated and the diarrhoea stopped. On 14th July, 2008, baby Rose's mother alerted the ward staff of the swelling and change of colour of the left limb. Immediately, the IV line was removed and the baby's mother was advised to elevate the limb. She was also dully placed under the care of a consultant paediatrician. With time, the child's general condition improved, but the left limb was noticed to have become gangrenous, starting from the little toe. Mr. Deputy Speaker, Sir, on 15th July, 2008, the surgical team in the hospital was consulted. They reviewed the child on 16th July, 2008 and advised treatment and close observation. However, the gangrene progressed upwards. On 18th July, the surgical team decided on amputation, and the father signed the consent to amputate on the same day. Unfortunately, he August 5, 2008 PARLIAMENTARY DEBATES 2335 later changed his mind and refused to have the child amputated. The situation remained the same, with the gangrene getting higher. On 25th July, 2008, the hospital obtained a court order to compel the father to consent to the amputation. However, he refused to sign and acknowledge the court order. Therefore, the amputation could not go on. On 29th July, 2008, a second opinion was obtained from Dr. L.G. Gathua, a leading consultant surgeon in private practice. Dr. Gathua recommended amputation to be followed by grafting, but the parents refused and remained reluctant to carry out the amputation. On 31st July, the father opted for a discharge of baby Rose. He was allowed by the hospital management to take away the child, but after signing a Discharge Against Medical Advice note. Mr. Deputy Speaker, Sir, we, as a Ministry, directed the Medical Practitioners and Dentists Board (MPDB), upon receiving the information on the controversy, to exercise its mandate, under Cap.253, Laws of Kenya, to carry out investigation and find out if any malpractice was occasioned in the management of baby Rose. The second thing that we did was to require a preliminary opinion from the MPDB. I wish to report to Parliament that the preliminary report, so far, indicates that a proper diagnosis of baby Rose was carried out and correct medical procedures followed. We, as a Ministry, are of the opinion that the parents should adhere to the experts' opinion in order to avoid further wastage of the foot and the gangrenous development of the foot which could ultimately lead to death. We, as a Ministry, are advising that the parents take the child to the Coast General Hospital for the procedure to be carried out. If they are not comfortable there, we are ready, as soon as they report to the Provincial Medical Officer at the Coast General Hospital, to airlift the child to Kenyatta National Hospital, so that the necessary procedures can be carried out to ensure that the life of the child is protected. Mr. Deputy Speaker, Sir, the examination and investigation of professional malpractice is a process which takes time. I have directed that before the end of August, 2008, we should receive a report from the MPDB, as to whether any malpractice was carried out, including recommendations on any disciplinary action to be effected upon receipt of the report. Mr. Deputy Speaker, Sir, may I take this opportunity to request the public to remember that a few years ago, the Ministry gave direction that there should be suggestion boxes in all public hospitals for any public complaints. We also directed that hospital advisory committees should be set up. Those are already in place. We suggest that, if the public has any complaints, they should forward them for immediate action before things deteriorate, as it was in that particular case. Thank you."
}