By Nirmala Kannangara
Who is accountable to the critical health condition of H. A. D. Hemamala who is receiving treatment at the Intensive Care Unit of the Colombo South Teaching Hospital, Kalubowila after an unsuccessful Laparotomy (surgical incision into the abdominal cavity)
Consultant VOG Prof. Harsha Seneviratne performed a Laparotomy on Hemamala to remove a cystic mass in the pelvis on April 5 at Durdans Hospital in Colombo. Later she had to undergo yet another operation – Exploratorary Laparotomy within five days, as she had shown several complications after the first operation.
Her condition started to deteriorate after the second operation and in the absence of Prof. Seneviratne who had left the country after the Exploratorary Laparotomy procedure, the doctors who attended on her transferred the patient to the Colombo South Teaching Hospital in Kalubowila 8 days later. According to her family, she was transferred without any request either from the patient or from the guardian. Upon her admission to Kalubowila, Hemamala once again underwent a Colostomy procedure (surgical creation of an opening between the colon and the surface of the body). Since then she has been at the Intensive Care Unit at the Kalubowila Hospital for the last four months and 22 days, in a critical condition.
However, neither Durdans Hospital nor the Consultant VOG Prof. Harsha Seneviratne is ready to take the responsibility for Hemamala’s health condition. Refuting allegations levelled against him, Prof. Seneviratne said that no doctor would harm patients intentionally and claimed that he took all the necessary safety measures at the operation. However he said that if the family is having any issues over the operation they should come to a proper forum to discuss the matter.
“I have met the patient’s husband on two occasions and thought I had a cordial relationship with him on the matter. When the husband was abroad I even spoke to him over the phone. As far as I know I attended on this patient very carefully – the way I attend on all my patients,” said Prof. Seneviratne.
The Manager, Medical Services at Durdans Hospital Dr Ruwan Senathilleke said that there was neither deficiency in their medical care nor has any medical negligence on the part of Durdans Hospital.
“As requested by you we write to confirm that patient Mrs. H. A. D. Hemamala was admitted to Durdans Hospital on April 05 on the instructions of Prof. Harsha Seneviratne, Consultant VOG who had been previously consulted by the said patient at a different hospital. The consultant had performed a Laparotomy for a cystic mass in the pelvis and thereafter an Exploratorary Laparotomy had been performed by Professor Seneviratne along with another senior consultant surgeon on April 10th. Thereafter she had been seen by the above surgeon and another consultant obstetrician and on the instructions of above consultants the patient had been transferred to Colombo South Teaching Hospital on April 18 for further investigations and treatment,” said Dr Senathilleke
He further said, “We must stress that this was a surgical procedure performed by the consultants and during the stay of the said patient at Durdans Hospital. The best possible medical care was given to her and there was absolutely no deficiency in our medical care nor had any medical negligence on the part of our hospital. We have complied with whatever instructions given by the consultants and reiterate that the best medical care was afforded to the said patient during her stay, like in all other cases”.
Further Dr Senathilleke said that Durdans Hospital is not obliged to give answers to the questions this reporter had forwarded for clarification.
Althogh Senathilleke claimed that the patient was continuously seen by her consultant and she was transferred to Kalubowila on his instructions, Prof. Seneviratne confirmed that he left the country after the second operation and he knew nothing about the transfer.
“Yes I left the country for an official matter and did not know anything about sending her to Kalubowila as I did not give any such instructions,” said Prof. Seneviratne. Hemamala had complained of a severe stomach ache three days after the first operation. “My sister who was with my wife had seen a green colour discharge from the incision and had informed Prof. Seneviratne. Although he had first said that it was due to an infection, the hospital and the doctors panicked when my wife got intermittent fever, persistent diarrhea and vomiting. Hence she was taken for an emergency Exploratory Laparotomy. This has done to correct the damages caused to the small intestines during the first operation. However the second operation too was not successful as they could not correct the damaged intestines,” alleged Upali Gunathilake, the patient’s husband.
Gunathilake returned to Sri Lanka on June 9 giving up his floral designing job in UK to be with his ailing wife.
“I was in UK when my wife called and said that there was a cystic mass in the pelvis and had to undergo an operation to remove it. Although she first went to De Soyza Maternity Home, later she decided
to go to Durdans and consulted Prof. Seneviratne. Refusing to go through her previous records, Prof. Seneviratne had asked my wife to get all the reports once again. Claiming that it is a simple operation and the patient would only have to be in hospital for three days, the VOG had said that the entire cost would be around Rs.2 lakhs including professional charges. She was also told that Consultant Obstetrician Prof. Sherifdeen too would be called to assisted at the operation,” said Gunathilake.Prof. Seneviratne however refutes Gunathilake’s claim that he promised to get Prof. Sherifdeen’s assistance at the first operation. “Whatever operation I do, I take the necessary precautions. In this instance I never told the party that Prof. Sherifdeen’s assistance would be taken. Their claim that I had damaged the patient’s small intestines is an accusation as far as I know. Since this incident happened a few months ago, I am furnishing you the details recalling the incident. The actual details are given in the patients diagnosis card which is very confidential. I had to leave the country for an official matter leaving the patient in good hands. I told the patient and her family that I will be going out of the country. She was in good health when I left but I did not know that she had been transferred to Kalubowila as it was not a decision taken by me,” said Prof. Seneviratne. However according to Gunathilake, the simple procedure finally turned serious and had to pay Rs.8.47 lakhs (according to final bill No: PF1120000344 of April 18) for ‘medical negligence’ “If Prof. Seneviratne wanted to get Prof. Sherifdeen’s assistance why couldn’t he obtain it as we didn’t have any objection for that decision? The reason given was that there was no necessity to call Prof. Sherifdeen. However his assistance was sought at the second operation. What we understood was, had Prof. Sherifdeen been present at the Laparotomy procedure, my wife wouldn’t have had to face such an unfortunate situation. He would have been so careful to prevent damages to my wife’s small intestines. If the VOG was really concerned of his patients, he would not have travelled abroad soon after the second operation when my wife was in a critical condition leaving her with Dr R. Colonne and Prof. Sherifdeen,” said Gunathilake. Gunathilake further blamed Prof. Seneviratne for ‘washing his hands off’ by getting one of his students – Dr Aloka Pathirana to take care of the patient by transferring her to the Kalubowila Hospital.
“This is an eye opener to anyone that wishes to admit patients to Durdans for any treatment. The moment they find out that the patient’s condition is getting worse they will transfer he/ she to a government hospital without the consent of the family. How can they claim that they transferred my wife because of the consultants’ decision? Why couldn’t they ask us whether to transfer the patient or not as it was we who are paying the hospital bill not the consultants? For any other issue they will inform the guardian but knowing that the hospital’s ‘reputation’ would be in trouble had the patient died under their roof, she was transferred without our permission,” claimed Gunathilake.
However Gunathilaka is happy as his wife is now in the safe hands of a dedicated team of doctors and nurses led by Dr Aloka Pathirana.
“Even I should thank Prof. Sherifdeen too for his kind gesture. He has visited Kalubowila to see my wife more than six times. Although he was not responsible for my wife’s condition he still had the courtesy to visit my wife to inquire about her condition. We really need doctors of such calibre. Although the team of Kalubowila doctors were able to save my wife’s life, she is still in a critical condition,” said Gunathilake.
He further accused Durdans of keeping his 13-year-old daughter as hostage till the final payment was settled.
“After discharging my wife on April 18 morning, Durdans Hospital delayed sending her to Kalubowila until the final payment was made. Reacting to the inhumane conduct of Durdans staff, my brother-in-law had shouted at them to send the patient to Kalubowila immediately or send her back to the ICU without keeping her in the lobby. Then only they had taken my daughter hostage for more than two hours till the final bill was settled,” said Gunathilake.
Little Sanduni Rashmika described how she was taken to a room to be with ‘an aunty’.
“When I came to the hospital that particular morning with my aunt, I saw my mother in a stretcher and my uncle shouting at the hospital staff. It was then only the hospital wanted my uncle to keep me with them until the payment was made and took me to a room where an aunty was working,” said Rashmika.
However Dr Senathilleke vehemently denies the claim and said that it was the patient’s family that wanted to keep two family members until the payment was settled. “The normal procedure for payment is that all bills are settled prior to the discharge of the patient. However in this instance the patient’s party on their own accord kept two members of their family in the hospital until the payment was settled. We vehemently deny that we had requested a 13-year-old daughter of the patient to be kept as surety until the final bill was settled,” said Dr Senathilleke.
Meanwhile a reliable source from the ICU Kalubowila Hospital on the condition of anonymity confirmed that Hemamala’s present condition was solely due to medical negligence during the Laparotomy procedure. “When Hemamala was brought here, she was in a critical condition. Due to the small intestine leakage, whatever nutrition given to her through the Naso-gastric tube were coming out. As a result we had to open the cut once again and clean the intestine leakages. This will be kept open till the intestine heals. A colostomy bag (a receptacle worn over the opening to receive the faecal discharge from a Colostomy) is now fixed and it is changed every day. The patient’s husband is very helpful and brings whatever medicine we ask him to bring. The hospital too is now running short of these colostomy bags and changing the bag every day would be an issue in future,” said the source. According to the sources, although the patient’s condition has now improved slightly, it is till unpredictable as her blood could clot easily since she has been in one posture for over five month. “There is chance that her blood could clot and she could get either a sudden heart attack or a stroke. Considering this situation we gave her anti coagulants. Since then she is bleeding from the damaged intestines and we have decided to change the drug to save her life,” added the source.