High court in Kampala has ordered Mulago Hospital to pay damages amounting to Shs 500 Million to Ms Sarah Watsemwa and her 10 year old son, David Goseltine, who suffered permanent brain damage, due to negligence by the hospital workers during his birth in October 2004.
The UK based Ugandan Mrs Watsemwa says her baby was in a healthy condition for the nine months of pregnancy until she gave birth to him at Mulago Hospital by Caesarean section.
The birth was overseen by one Dr Christine Biryabarema who had examined Sarah a few days before delivery, both at Mulago Hospital and her private Christa Clinic in Nakasero.
Mrs Wastemwa says on the fateful 28th day of October 2004, she was admitted at Mulago Maternity Ward and put on labor inducing drip.
While her cervix was only dilated at 6cm, a midwife came in ordered her to open her legs and she ruptured her membrane, which caused a cord prolapse; a dangerous condition that could cause the baby to die due to lack of oxygen.
She says that even after realizing her prolapsed cord, the midwife, didn’t bother to call in Dr Christine and that it took a whole 50 minutes until the doctor came in on her routine check up to find that normal birth was no longer possible.
Watsemwa was then taken to theatre where there was another 40 minutes delay because it was not ready. By the time she was operated, the baby’s brain was irreversibly damaged and it was diagnosed with severe asphyxia.
At 10 years, David cannot sit, stand or walk. He cannot feed or assist himself in any way and his mother told court that he needs full attention.
“I had to get a part-time job where I work only four hours a day, and spend the rest with him. We also had to acquire him wheel chairs and many other gadgets that help hoisting him out of bed, and moving him around. He needs special education,” she told court.
Although reports from the Milton Keynes Hospital in England confirm that the foetus was in a healthy condition, upon birth he had a low apgar score [general health assessment of the newborn] of 3/10.
He was resuscitated in the theatre without much improvement and was later admitted into the special care unit. He was also found to have grunting respiration, had respiratory distress and was diagnosed with hypoxic ischaemic incephalopacy grade 2 and aspiration pneumonia.
Dr Christine in defence, admitted to court that she had ordered Sarah’s admission and labour induction, but was absent by the time the cord relapsed, and had not been alerted about it by the midwife.
She only came on her routine check up to find that Sarah’s membrane had been ruptured while the cervix dilated half way at 6cm instead of the normal 9cm.
When she angrily interrogated the midwife why she had ruptured the membrane at 6cm, her response was that she thought it was at 9cm.
In her judgement last Friday, High Court’s Justice Elizabeth Musoke observed that this reflected negligence and incompetence of the highest order on behalf of the National Referral Hospital.
In her words, Mrs Sarah Wastemwa testified:
“The midwife came to me with a trolley. She told her colleagues that she was going to rapture my membrane. She ordered me to open my legs and she placed an instrument inside me, and I felt warm water gushing out. She then commanded me to push hard. I kept pushing but nothing was forthcoming, but she kept blaming me for not pushing hard enough.
After 30 minutes she examined me again and I saw her face change like she was scared; yet she continued shouting at me to push hard.
When Dr Christine came in, she rebuked the midwife for rupturing the membrane. She was in a state of panic and she told me that it was an emergency situation and I had to be operated immediately. She advised me to be on my knees and elbows to keep the cord in the birth canal until operation.”
I was taken to the theatre but it was not ready and I had to wait for another 40 minutes before I was operated.”
Literature shows that in the rare case of a prolapsed cord, the baby has little chances of survival especially when it is not delivered very fast.
It makes the baby’s heart to stop beating and could die fast due to lack of oxygen. But if delivered quickly, the baby can come out normally without defects.
Perhaps unaware that when there’s a cord prolapse, time is of great essence, the midwife did not rush to call Dr Sarah, and the 40 minutes of delay, would have lifetime effect on 10 year old David. He has since never responded to any treatment or shown any signs of improvement.
Mrs Sarah who in the suit was seeking damages totaling to Sh 12.5 billion, was awarded by the court only 500 million because she could not prove a number of expenses she claimed.
“There is no medium exchange for happiness,” ruled Justice Musoke. “No Money can provide true restitution. It can only be provided through proper care.”
She granted damages for the plaintiffs of Shs 450million for the pain, suffering and costs to Ms Sarah, and 50million for the pain suffered by David.