The HEALTH : July 2018 | Page 14

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The HEALTH | JULY , 2018
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Malpractice surgery claim in Malaysia

by NURUL AIN HUDA ABDULLAH
ainhuda @ revonmedia . com
Never events that could be avoided
N April 21 last year , the nation

O was taken by storm of news reports of 56-year-old Pertemahwadi , who filed a civil claim at the High Court registry against the government as well as a hospital for RM20mil in general and aggravated damages and RM223 , 487 in special damages for negligence which she claimed resulted in the loss of her breast .

In her claim , the housewife said she was advised to undergo a heart bypass surgery when she sought treatment at the hospital on January 22 , 2016 . Subsequently , the bypass surgery was performed the following month on February 16 by the
hospital ’ s specialist .
She was discharged nine days later , despite complaining to the specialist that the wound on her chest was beginning to open up . She also said that the specialist failed to advise her on the potential consequences of the bypass , especially in view of her diabetic condition and the weight of her breast .
In her statement of claim , she said that she was not given antibiotics although she was prescribed medication in addition to being advised to seek post-operative treatment at a health clinic .
On February 27 , 2016 , the attending doctor advised her to return to the hospital upon finding an open 5cm wound with infection on her left breast . Subsequently , she was admitted and had to undergo another surgery to remove the infected part of her left breast .
This , however , was futile as the infection had spread to the entire breast which
CREDIT : WISEGEEK
again had to be removed in a second surgical procedure .
113 cases in five years
Although there are no statistics to show the number of surgical error claims called “ the never events ” on a yearly basis in Malaysia , the statistics obtained from ‘ What You Do & What You Don ’ t on Medical Negligence , Trends & Challenges to the Medical Profession ,’ International Islamic University Ahmad Ibrahim Kulliyah of Laws , Civil Law Department , Professor Dr Puteri Nemie Jahn Kassim showed that the number of potential medico-legal cases and medical legal cases settled from 2005 to 2009 was in total 113 cases .
RM6 , 664 , 248 was paid in compensation upon court orders and ex gratia within that five year period .
In a report ‘ Alert public of alarming medical error statistics ’ published by an

Statistics

The number of potential medico-legal cases and Medical legal cases settled 2005 – 2009 O & G

42

Surgery

17 Orthopaedic

8 Paediatric

17 Anaesthesia

1 Medical

24 Psychiatry

1 Ophthalmology 1 Oncology

2 Source : Complaints , Enforcement & Medicla-Legal Section , Malaysia ’ s MOH , ‘ What You Do & What You Don ’ t on Medical Negligence , Trends & Challenges to the Medical Profession ,’ International Islamic University Ahmad Ibrahim Kulliyah of Laws , Civil Law Department , Professor Dr Puteri Nemie Jahn Kassim .

online web portal Malaysiakini , the article highlighted findings on a study ‘ Patient Safety in Primary Care ’ conducted by the Ministry of Health in 12 primary care clinics in four states in Malaysia .
It was noted that 50 per cent of the medical records had a medical error and over 93 per cent were related to medication .

Standard operating procedures in government and private hospitals

BASICALLY , standard operating procedures ( SOP ) are very important in a hospital setting .

University of Malaya Medical Centre , Deputy Director ( Clinical ) Associate Professor Dr Nazirah Hasnan explained that hospitals have clinical practice guidelines , and also clinical pathways that need to be followed in additional to Standard Operating Procedures ( SOP ).
“ Basically , we practice guidelines , we either develop them by ourselves or we use clinical practice guidelines that are nationally or internationally developed .”
“ This clinical practice guidelines will help us make decisions . These are actually evident based on literature , published journals and books with experts ’ guidelines .”
“ In addition to clinical practice guidelines , we also have SOP ’ s with certain set of rules that guides you on what to do , when , how , who and where to do .”
She further explained that an SOP outlines the management plan based on clinical practice guidelines that is being followed .
“ For example , when a patient comes to the emergency department , and the patient is unconscious , there ’ s a SOP that is being followed , where a professional
Dr Nazirah Hasnan .
will be called and accessed based on the patients response . “
This SOP is available in the hospital where there are hard copies as well as made available on line .
In the meantime , Pantai Hospital Kuala Lumpur Medical director Dr M . Narayanan emphasised that medicine is not an absolute science .
“ There are a lot of individual variations . Unlike arithmetic where 2 plus 2
Dr M . Narayanan
is four , medicine is not like that . What works for you might not work for everyone .”
“ Today , there is clinical governance which explains how to run it successfully , how to prevent the corporation from risk and the practice of medicine .”
“ This clinical governance has been formulated over the years , has caused a shift in the practice of medicine . So ,
now we are open , accountable and responsible for safe delivery of health .”
“ It is now mandated in the private hospitals , that you should have a certain level of clinical governance . So , there are rules and laws as to what you do . There are also accreditation bodies in healthcare like MSQH and Joint Commission International from The United States who come to survey whether we have all this controls in place ,” he said .