SRI LANKA: Negligence results in death of a patient

Dear friends,

Mr. Manabalasingham Rajkumar (44) of Siriwardana Place, Munnakaraya, Negombo in Gampaha District is a fisherman. He was admitted to the Negombo Base Hospital for urgent medical treatment after having injured the 3rd finger of his right hand. After an X-ray, the doctors decided to do surgery on the finger. He was admitted to Ward-6 of the hospital. After surgery, the doctors prescribed intravenous injections of a low dose “mild” antibiotic. The patient verbally refused stating that he has a history of allergy to antibiotics. Without his consent, the doctors gave him 3 doses after which the patient suddenly collapsed and died.

The relatives complained about the negligent behavior of the doctors amounting to battery, but the medical authorities refused to take any action against them.

CASE NARRATIVE:

The Asian Human Rights Commission (AHRC), received information about Mr. Manabalasingham Rajkumar (44) of Siriwardana Place, Munnakaraya, Negombo in the Gampaha District.

Rajkumar is a self-employed professional fisherman, married and the father of 3 children. On 28th March 2015 he was getting ready to leave for work at the Negombo Lagoon Fishing Harbor. He was closing the iron gate in the front of his house when the 3rd finger of his right hand was caught in the gate. He started bleeding and the hand became numb. His family members immediately brought him to the Out-Patient Department (OPD) of the Negombo Base Hospital for emergency treatment. The doctors examined him, stopped the bleeding and sent him for an X-Ray, to which he agreed.

The X-ray showed that Rajkumar needed immediate surgery in the surgical theater. It was done and he was admitted as an-inpatient to Ward No: 6.

In the ward the doctors prescribed three doses of an intra-venous injection of a “mild” antibiotic. Rajkumar clearly explained to the doctors that he was allergic to antibiotics. When the doctors asked for further details, Rajkumar was not able to give any scientific or medical information to them. Without considering his explanation and ignoring the fact that he did not give consent, the doctors injected him three times. After each of the three injections he continuously objected to further treatment. However, the doctors proceeded with the injections saying that the antibiotic was a very mild one.

In their defense, the doctors said that they had intentionally chosen a less severe type of drug because of his allergic history. He did not complain or show any symptoms with the first two doses, but with the 3rd dose he suddenly collapsed. He was rushed to the Intensive Care Unit (ICU) where he was pronounced dead within a few minutes.

The family members of the deceased stated that the death of Rajkumar was culpable homicide due to medical negligence, involving battery and the complete ignoring of his objections. They are seeking justice against all the responsible medical officers and personnel involved in the case.

Police officers attached to the Negombo Headquarters Police Station approached Rajkumar’s family. They were told to appear before the Additional Magistrate of Negombo and assist in the Death Inquest. When they appeared, they objected to the Post Mortem Examination (PME) being carried out by the Judicial Medical Officer (JMO) of the same hospital. They requested the Magistrate to order a more competent JMO from the government sector to conduct the PME) as he would not have a conflict of interest. The Magistrate, following the request, ordered the Consultant JMO of the North Colombo Teaching Hospital to conduct the post mortem and submit his report to the court. At the PME, the Consultant JMO informed the relatives that the cause of death had yet to be determined as particular specimens of the dead body had been sent to the National Medical Research Institute for further examination.

The relatives observed that in the Magistrate’s Court the prosecution is handled by police officers attached to the Negombo Headquarters. Both the police officers and the responsible medical staff belong to the state sector of the same area, so they cannot expect justice because of a conflict of interest. They requested the Magistrate to order an independent and impartial inquiry under the aegis of a high-ranking Police Officer from the Criminal Investigation Department (CID). That request was not accepted. As a result, the family said that they did not trust the investigation as it was being conducted.

Furthermore, they are demanding that the Medical Council of Sri Lanka reappraise the medical code of ethics and regulate adjustments needed in relation to surgery, medical treatments and consent for every patient to prevent such future tragic events.

ADDITIONAL COMMENTS:

State obligations for the highest attainable standards for physical and mental health:

The State of Sri Lanka has signed the International Covenant on Economic, Social and Cultural Rights (ICESCR) on 28 Sept. 1976 and made its Accession on 27 Apr 1977. Following that the state of Sri Lanka is supposed to fulfill its obligations within Article 2 of the convention, undertake steps, individually and through international economic and technical assistance and co-operation, to the maximum of its available resources. This is with a view to achieving, progressively, the full realization of the rights recognized in the present Covenant by all appropriate means, including the adoption of legislative measures. The state of Sri Lanka has undertaken to guarantee that the rights enunciated in the ICESCR Covenant will be exercised without discrimination of any kind as to race, color, sex, language, religion, political opinion, national or social origin, property, birth or other status.

According to Article 12 of the ICESCR, the state of Sri Lanka recognizes the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. It is obligated to take steps to achieve the full realization of the rights envisaged in ICESCR. This includes the prevention, treatment and control of epidemic, endemic, occupational and other diseases and the creation of conditions which would insure the provision of medical attention and medical services in the event of sickness.

Right to information by the Patient:

We recall the rights of patients emphasized and stressed by the World Health Organization. These rights are a protection for every citizen of Sri Lanka.

SUGGESTED ACTION:

Please send a letter to the authorities listed below expressing your concern about this case, requesting:

1. Investigation into alleged medical negligence by medical doctors at Negombo Base Hospital.
2. Prosecution of those proven to be responsible under the law. 
3. Internal investigation of officers involved for breach of department orders.
4. Request the IGP to investigate the conduct of the medical doctors. 
The Asian Human Rights Commission has written a separate letter to the UN Special Rapporteur on the right of everyone to the enjoyment of the highest standards of physical and mental health.

To support this case, please click here: SEND APPEAL LETTER