x Abu Dhabi, UAEWednesday 26 July 2017

Doctors ruled liable for death of girl, 7 after tonsil surgery

Judge rejects appeal after 'numerous errors' led to complications in routine operation.

ABU DHABI // The Supreme Court has upheld the conviction of three doctors for wrongfully causing the death of a young girl in their care after routine surgery.
Hoor Ahmed al Naqbi, a seven-year-old Emirati, died in June 2008 after complications arose while the doctors tried to remove her left tonsil at Al Kalba Hospital in Sharjah.
One of the doctors used tools meant for adults, which caused severe bleeding. In attempting to stop the bleeding, one of the other doctors punctured her right lung.
The girl died after being under anaesthetic for more than 20 hours. The three doctors were initially acquitted of wrongful death, but were convicted on appeal.
They appealed that verdict, but the Supreme Court sent it back to the appeals court, ordering both a conviction and a fine.
One of the doctors appealed again to the Supreme Court.
Justice Falah al Hajeri, who issued the most recent verdict, wrote that any doctor involved in an operation that goes wrong can be held accountable, even if their error was minor, indirect or unintentional. "If the errors which caused the incident were numerous, a judge should punish all those who were involved in the incident, regardless of the extent of error they are accused of making," Justice al Hajeri wrote.
"A judge must examine the error, be it technical or not, and whatever its degree, and then must hold the doctor accountable."
Justice al Hajeri ruled that doctors can be criminally liable if they neglect or violate medical standards in any of three ways: intent to violate medical norms; failing to comply with them; or failing to be fully cautious.
The girl's father told prosecutors the operation lasted for two hours, but the girl was kept unconscious for more than 20. The doctors also transfused blood type O instead of type A, the father said.
The doctors were charged with wrongful death. In 2009, the Khor Fakkan Criminal Court of First Instance acquitted them.
But the appeals court reversed the decision and fined each doctor Dh15,000. They were also ordered jointly to pay diyya, or blood money, of Dh100,000.
After the first Supreme Court decision, appeals judges also convicted the doctors of the charges in addition to the fine and the diyya.
Only one of the doctors - the man who tried to stop the bleeding - appealed again to the Supreme Court. He said the medical report presented to the lower courts showed that the doctor at the intensive care unit, from Britain, was responsible for the death.
He said the lower courts ignored his requests to investigate that doctor and the company whose product was used in the operation. The Supreme Court rejected his argument and upheld the verdict.
A magistrate at the Supreme Court said last week that the court would soon publish guidelines outlining cases in which doctors and hospitals can be held liable for a patient's death or injury. The book will be distributed to hospitals and doctors.
He said doctors were generally unaware of their liability. "Many doctors come and ask 'why do you prosecute us?' This is to tell them how and why we do," the magistrate said.
Recent cases involving medical errors include a case against an Abu Dhabi medical centre that was ordered by the Supreme Court to pay Dh1.3 million in damages to a man whose penis was amputated during a botched surgery.
In a case involving fatal food poisoning in Abu Dhabi, doctors were cleared of all charges even though one doctor had prescribed medication without proper diagnosis. The judges quoted medical experts who said the victim's life could have been saved if he had been given antibiotics earlier.
hhassan@thenational.ae