The Namibian (Windhoek)

Namibia: Doctors Charged With Negligence

TEN years after a baby was stillborn in the Katutura State Hospital, two doctors are the subject of a hearing into alleged unprofessional conduct which started on Monday.

The Health Professions Council has charged Dr Martha Iiyambo and Dr Anna Kalilo with unprofessional conduct.

According to the charge sheet, they failed to treat a patient, Ziita Akawa, properly on September 11 2002, which resulted in the death of her unborn baby.

Both doctors are denying that they were at fault in contributing to the death of Akawa’s baby.

At the time of the incident, Akawa was 37 years old, had a history of two previous assisted deliveries and suffered prolonged labour, it is stated in the charge sheet.

Dr Iiyambo, when she heard about the patient at 09h20 on that day, had chosen a natural birth for the patient instead of opting for an emergency caesarean section, “thereby exposing the patient and her unborn child to unnecessary health risks”, the charge sheet states.

During her testimony yesterday, she said that she did not remember seeing the patient although she admitted that she had recommended a natural birth.

Dr Kalilo is equally accused of having failed to perform an emergency caesarean section when she was informed of the patient’s deteriorating condition at 23h35.

The first witness who was called by the Health Professions Council on Monday was Dr Wolfgang Mannschatz.

He was the intern at the time of the incident, while the two doctors – Iiyambo and Kalilo – were a level above him as medical officers.

Dr Mannschatz initially said that he and Dr Iiyambo jointly saw the patient at 09h20. Later, during cross-examination by Iiyambo’s lawyer Mbushandje Ntinda, he was not sure whether he had seen Dr Iiyambo or whether he had spoken to her over the phone.

But, he maintained, the instruction to allow the patient to have a natural birth came from Dr Iiyambo.

The patient was 37 weeks pregnant and had arrived at the hospital with labour pains.

At about 23h35 that evening, he phoned Dr Kalilo because he was “concerned about the weak progress” of the labour, Mannschatz testified.

He said that after it was eventually decided to give the patient a caesarean section, he pushed Akawa to the theatre because there was no porter available.

In the theatre, it was discovered that Akawa’s uterus had torn and that the baby had died.

Because of the trauma to her uterus, it had to be removed.

Asked what had gone wrong, Dr Mannschatz testified: “A lot of factors led to that disastrous night.”

In the first place, he said, a sonar scan should have been done during Akawa’s pregnancy. Also, by 13h00 that afternoon, a caesarean section should have been performed given the poor progress of the labour, he said.

Under cross-examination, Dr Mannschatz conceded that because ten years had lapsed, all he could remember was based on his notes.

When Kalilo’s lawyer Richard Metcalfe said that Mannschatz deserved a lot of the blame for what had gone wrong, he said: “Yes.”

Next, the Charles Visser for the council called Dr Dorothea Krönker. She was the specialist – who worked above medical officers – at the time of the incident.

She was adamant that Akawa should never have gone through labour because of her history of unnatural births.

The council also called midwife Rosa Hinda to testify on their behalf.

Yesterday, Iiyambo testified that she had completed her medical training in Cuba in 1997.

In December 1997, she started with her internship at the Katutura State Hospital.

At the time of the incident in September 2002, she had nine weeks’ experience of obstetrics and gynaecology.

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