Blow by blow account of how a patient died from medical negligence at 37 Military Hospital

Forty-eight-year-old Solomon Asare-Kumah’s oxygen tube was inserted wrongly at the 37 Military Hospital in Accra. It went under his skin so that the oxygen gas went through his body tissues, instead of the respiratory system.

The air was flowing into his body alright. But where it was going was all wrong. No air for lungs, his body bloated. No air for his heart, he bloated. And with no one at the ICU to attend to him, he “extremely bloated”. Air-starved, his heart gave up. Cardiac arrest.

Solomon was gone after midnight on October 21, 2019. A father was gone.

On June 28, 2021, some 21 months after the tragedy, Solomon Asare-Kumah’s brother, Emmanuel Asare-Kumah, has sued the consultant surgeon who was responsible for his brother’s healthcare, Col/Dr. Gordon. A.O Appiah.

He has joined the 37 Military Hospital, which employs the consultant, the Chief of Defence Staff of the Ghana Armed Forces to the suit, as well as the Attorney-General, which defends state institutions in court.

Represented by lawyer Martin Kpebu, he has sued for negligently causing his brother’s death, for breach of contract, and alleged deceitful tactic employed by the surgeon to collect more than GH¢40,000 from the desperate family.

READ ALSO : Family sues 37 Military Hospital for negligence after death of relative

All of these parties, he says, must answer questions as to why and how personal and systematic failures led to his brother’s death. And for the wrong answers, he wants a punitive compensation of two million cedis.

File photo: Solomon was described by family as an affable, humourous person who often wore a smile. Photo credit: Facebook.

Copy of the writ filed at an Accra High Court chronicles the trauma and the tears of a family whose breadwinner was first admitted at the 37 Military Hospital on Thursday, August 22, 2019.

He had been referred there from C&J Hospital in Sakumono Estates, Accra. And he came in sub-conscious. He had a mass on his brain, which required surgery. He could not speak or open his eyes and his upper limb was immobile.

Inside the Emergency and Trauma Unit of the hospital, Solomon Asare-Kumah needed surgery urgently and the consultant surgeon assigned to the case asked for GH¢40,000 to take care of the surgery, medications, keeping a nurse at the ward, and ward charges, according to the suit.

The doctor explained to Dorothy Asare-Kumah Adolf, a desperate sister of the patient, that a deposit of at least GH¢25,000 was required to start.

Within three days, the part payment was ready and the family on Sunday, June 25, 2019, went to the hospital to “seek direction on how to effect payment.”

“But none of the nurses was willing to provide information and only asked them to speak to the 4th defendant personally [Col./Dr. G.O Appiah],” the writ said. They were eventually directed to wait at the surgeon’s office.

When the consultant surgeon emerged, he asked that the monies be paid personally to him, a demand which sidestepped hospital rules completely as monies for medical services are not paid directly to caregivers. But the plaintiff says they “trusted the 4th defendant [Dr. Gordon Appiah] absolutely” explaining they had no cause to doubt a senior military officer and a medical doctor of the rank of a consultant surgeon.

According to the court documents, four dates of the surgery set by the doctor were postponed with various explanations from Monday 2, to September 16, 2019.

September 2, 2019: The doctor explained that some tools and items needed for the surgery were yet to arrive in the country and showed Dorothy a text message to confirm the delay in procuring the materials. One of these items was surgical glue. But the family, too desperate to entertain delays, ordered the surgical glue from the US. Through a catholic priest, who is a friend to the family, the surgical glue arrived on Saturday, September 7, 2019. They sent the glue to the hospital the same day. The rescheduled date for the surgery was some two days away, September 9, 2019.

September 9, 2019: Inside the theatre, Solomon had been given anesthesia to numb the pain associated with the surgery. The family was hopeful that, finally, the surgery was to proceed. But moments later, the medical team emerged to explain that a drill to be used for the operation had malfunctioned. The consultant surgeon said a new drill was to come from South Africa. The surgery was abruptly postponed again to September 13, 2019.

September 13, 2019: The consultant surgeon reported that “he had a flu.” The drill from South Africa was even yet to arrive, he explained to the family and so the surgery was once again postponed.

September 16, 2019: A family member paced anxiously in front of the theatre as Solomon was wheeled in. But at about 3pm, a doctor would come out of the operating room and explain that, while in the middle of the surgery, the drill malfunctioned again. By this time Solomon Asare-Kumah’s skull had been split open. The doctors said they had to perform an “open and close” procedure. The surgery was postponed much to the family’s disappointment.

According to the plaintiff, a source at the hospital later revealed that the drill was not from South Africa. It was from Korle-Bu Teaching hospital, an hour’s drive away on a hot afternoon.

A day after the last postponement, there was some disconcerting news. Dorothy had detected that his brother, “Solomon’s left leg was swollen and drew the attention of the nurse.” In September 2019, Col/Dr. Gordon Appiah ordered a Doppler test, which is used to diagnose conditions that affect blood flow.

The diagnosis disturbingly showed “blood clots in both legs with the left one in the deep vein.” The family noted that their relative did not have this condition before he was admitted. There was a doppler test to prove this. And so, the fresh alarm described by the specialist at the diagnostic center as “dangerous” as a result of the lack of proper medical care for Solomon Asare-Kumah.

The family was advised to “act very fast” and the very next day after the doppler test results, Thursday, September, 19, Solomon was rushed to National Cardio Centre at the Korle-Bu Teaching Hospital, for an “IVC filter procedure.” It was to cost $5,500. The consultant surgeon under whose care Solomon had developed blood clots also charged $10,000, explaining his services were of an “Indian standard.”

Col/Dr. Gordon Appiah deducted the cost of the ward fees, tissue glue, and other expenses from the GH¢25,000 initial deposit the family had made. The outstanding bill was now $4,000 and at the prevailing exchange rate of 5.61 to a dollar, the family now owed the doctor GH¢22,400.

At this point, Dorothy, sister of the patient, fell on her knees, begged, cried and wept, asking the doctor to reduce the outstanding bill. It was halved from $4,000 to $2,000.

With that agreement, the bedridden, sub-conscious Solomon Asare-Kumah was sent to Korle-Bu Cardio Center for the IVC filter procedure on 25th September 2019.

Once the procedure was completed, the patient was sent back to 37 Military Hospital for the main surgery on his brain, which was three days away, September 30, 2019.

D-day surgery

Three days before the surgery, the consultant surgeon asked for his $2,000 from Dorothy. But the sister of the patient pleaded that he should go ahead with the surgery.

The operation lasted 12 hours. It was successful, the family was told. And Solomon was sent to the ICU to recover and the family, as promised, paid GH¢11,200 ($2,000) to Col/Dr. Gordon Appiah for his services.

Twice during recovery, Solomon, on life support equipment, was sent for CT scans at Sunshine Laboratory. For a period of 11 days after the surgery, the hospital’s pharmacy expressed concern about the volumes of medicine and drugs administered to Solomon.

For example, four bottles of cough medicine were administered to Solomon in a week. The pharmacy on October 14, 2019, refused to dispense any more cough medicine, rejecting the doctor’s explanation that the “mixture was administered through a feeding tube and which, sometimes, spilled for which reason the medications ran out quickly.”

Eventually, on October 14, 2019, a number of tests to ascertain the blood clot profile showed a possible overdose “because of the high levels of Protamine in Solomon’s system.”

The hospital at the instructions of the consultant surgeon administered a prescription of IV Protamine Sulphate 50mg to reverse the overdose.

Emmanuel Asare-Kumah said he visited the ICU on October 20, 2019. But he noticed a lot of shuffling and movement among the medical team. He grew anxious and feared a fresh misfortune. But an ENT surgeon assured him his brother was fine, only that he “required an x-ray to check if his chest region was clear.”

Two doctors identified as Kutin and Mariama Iddrisu would later usher him into a meeting to explain the state of his brother’s health.

They said they had performed a tracheostomy, a medical procedure that involves creating an opening in the neck in order to place a tube into a person’s windpipe. The tube is inserted through a cut in the neck below the vocal cords. This allows air to enter the lungs.

They said later the trachea tube was removed to clear some blockage. But while reinserting the tube, it went under his skin instead of his throat.

The two doctors said he should prepare for what he was about to see because “the sight of Solomon was likely to scare him.”

It did. And Emmanuel says he was “devastated”.

“It was obvious that the level of bloating that occurred was purely attributable to the lack of due care both in the process of reinserting the tube or the neglect of Solomon for an unreasonably long time without any monitoring or whatsoever.”

The plaintiff, Emmanuel Asare-Kumah, said the doctors assured him that his brother would be fine by morning. He was not. He died after midnight, the hospital says.

37 Military Hospital frustrates family

Emmanuel Asare-Kumah said he was prevented from entering the ICU that morning and despite the company of the hospital chaplain, Rev. Fr. Lt. Col Anthony Kemetse, a psychologist Major Tentteh, and two family friends, Lawrence Ayagiba and Eric Nyamordey, he was not allowed to enter the mortuary.

The hospital said the person to authorise their entry was in a meeting. The distraught family went home expecting a call from the consultant surgeon. It never came.

On October 23, 2019, two days after the death, the family went back to the hospital to demand answers. Col/Dr. Gordon O. Appiah confirmed the death for the first time and proceeded to complete the paperwork for an autopsy.

On that same day, the hospital also gave the family a bill covering the three attempted surgeries. The family was shocked to learn they had to pay for failed surgeries when it was the fault of the doctor that resulted in the postponements.

The consultant surgeon could only produce one receipt of GH¢25,000 which showed that the money was used to buy surgical tools from Victoria Surgical Company. There was no receipt for the GH¢11,200.

Ghana Army frustrates family

The family escalated the matter to the doctor’s Commanding Officer, Brigadier General Nii Adjah Obodai, who directed the family to file an official complainant relating to the unsatisfactory explanation about the cause of Solomon’s death and extortion by the doctor.

The family in their letter accused the doctor of breach of contract, negligence, extortion by deceit and misrepresentation and demanded investigations into these claims.

The Commanding Officer refused their request. It was only after the family petitioned the Medical and Dental Council that the Military Command commissioned a Board of Inquiry into the petition.

The family appeared and gave their testimony in March 2020. But since the inquiry, the Military Command has refused to communicate its findings or make the report available to the family.

“The office simply ignored the letter,” the statement of claims said.

Impact of Solomon’s death on the family

There has been no report released to the family to date as the family struggles to come to terms with their relative’s death. Solomon Asare-Kumah, who was based in the UK, was a breadwinner who supported at least four family members with £800 per month.

He had come to Ghana to visit his sick father, Bartholomew Asare-Kumah. After Solomon died, his sick father also died shortly afterward, as he was unable to come to terms with his son’s death.

Solomon’s mother, Magdalene Asare-Kumah, also recently passed. Solomon’s siblings are having to deal with “immense mental distress and trauma”, the suit said.

The plaintiff has asked the court to award GH¢2,008,259 in damages. He has also asked for compensation for the widow for the mental distress which “eventually led to the death of Solomon’s father”.

The plaintiff also wants an order for the recovery of special damages for breach of contract and for negligence resulting in the losses of GH¢20,000, the cost for the funeral; GH¢36,200, being monies the doctor collected through “deceit and unconscionable contract”; 10,000 cedis incurred during the 60 days that Solomon remained bed-ridden at the hospital.

The plaintiff also wants to recover $5,500 for the IVC filter procedure at Korle-Bu and GH¢40,000 as solicitor fees.

Source: Fourth Estate