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January 9, 2019

First, he lost wife, then trust in the system


January 9, 2019

Islamabad : Amjad Afridi lost his wife after a cesarean operation at an elite hospital. His three children underwent psychiatric treatment for the trauma they experienced at the loss of their mother but it was just another routine casualty for the doctors accused of negligence.

For Shifa International Hospital, saving the doctors’ skin was the first and foremost priority — not the patient’s life. It changed the cause of her death four times. The reason reported in the discharge certificate was different from the cause mentioned in the death certificate. Likewise, the internal inquiry committee reported differently from the reason what the head of inquiry told Afridi in a meeting.

The role of Pakistan Medical & Dental Council (PMDC) was rather more scandalous. Its 13-member disciplinary committee first issued a censure to three doctors for their negligent behavior resulting in the patient’s death and warned the hospital management. But when the complainant, Afridi, registered an FIR against the doctors basing it on the censure as a proof that negligence had been established, the PMDC took a U-turn withdrawing the censure against the key accused.

After more than 100 visits to the hospital, the PMDC, police stations, health ministry and spending hard-earned money in millions, justice still seems “a distant and hijacked reality,” Afridi told The News. His only demand in the beginning: apology from the doctors for depriving his children of their mother. As they were reluctant to do this, Afridi has decided to knock every door for justice. In May 2012, Afridi lost his wife Waheeda Khan at the Shifa Hospital. She delivered twins through a cesarean. As the patient complained of backache followed by vomiting and complicated breathing, it was reported to gynecologist Dr. Taqdees who conducted the operation, but she didn’t turn up, as she was busy with other operations at her private clinic.

Twelve hours later, she rang a trainee doctor on duty to inject a pain killer, pethidine, which is considered equivalent to heroin.

Meanwhile, three liter fluid intake was administered to the patient but the urine output was zero resulting in multi-organ system failure. The trainee doctor and nursing staff didn’t realise the gravity of the situation. Bleeding also started. The patient lost one liter blood but that also went unnoticed.

Dr. Taqdees came 24 hours after the operation. As the patient needed to be shifted to the ICU, there was no bed available. The patient died 42 hours after undergoing pain and multiple complications. For receiving the body, Afridi was asked to deposit mandatory Rs130 IPD fee whereas other charges were to be paid by his department, Pemra, which was on Shifa panel.

What was the cause of death? Shifa changed its version four times. The discharge certificate described Postpartum Hemorrhage (PPH) bleeding as a cause but the death certificate declared “peripartum cardiomyopathy” as the reason. An internal inquiry said “probably the patient had a previously undiagnosed Atrial Septal Defect that led to a chain of events,” whereas the head of this inquiry board separately told Afridi during a meeting that she died “probably of Amniotic Fluid Embolism.”

The inquiry board gave a clean chit to the doctors involved in the patient’s treatment concluding that “no element of willful neglect can be labeled on any person involved in the management of this patient’s life.” Afridi moved the PMDC against Dr. Taqdees and two other doctors in addition to Shifa Hospital. A disciplinary committee looked into the matter. In 13-member committee, nine of them were doctors.

The committee issued a censure to the accused doctors for committing negligence and delivered a warning to Shifa Hospital ordering it to improve services. As Afridi lodged an FIR against the doctors, Dr. Taqdees filed a review petition with the PMDC. Initially, the then-PMDC president waived off the censure. When challenged as he was not authorised to do it on its own, he did that through a committee.

The incident changed the life of Afridi. He hadn’t initially informed his children about the death of their mother. He had moved them to a relatives’ residence when the body was brought to home. “I would tell them she had gone somewhere and would return soon,” he said. As they waited in vain for many days and kept asking, their conditions started deteriorating. When the reality dawned on them, they experienced depression and remained under treatment of a psychiatrist.

His department, Pemra, wasn’t cooperative either. Afridi is general manager there. His now-former boss would pressure him into withdrawing the case against the doctor who happened to be known to him. Afridi refused. The boss reacted by giving him additional assignments that kept him busy travelling when he was needed by his children the most at home.

Six years on, Afridi is still pursuing the case, undeterred. He has filed representation against the PMDC decision to secretary health which is pending for a year now; he has also moved the Islamabad High Court. While the PMDC didn’t reply when sent a list of questions by The News, Shifa Hospital somehow answered the queries.

It acknowledged that the cause of death had been changed twice but not four times. However, documents don’t substantiate the spokesman’s claim. Responding to a question that cause of death in discharge certificate was mentioned as PPH/bleeding, the answer given was that it was not mentioned in the case summary.

The summary available with The News denies Shifa’s claim, as it has also been mentioned in the case summary in addition to discharge certificate. Regarding the information about probable cause of death shared by the head of inquiry committee with Afridi, Shifa spokesman denied this. Afridi however claims he has a witness who is a doctor in whose presence the inquiry head mentioned a cause which was different from what was mentioned in the inquiry report.

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