Wednesday, January 11, 2023.
Retained foreign body in the abdomen after surgery. Hush-hush!
Nkitinkiti Government Hospital.
Kwaku Nkrabea moves to Dr. T’s consulting room for a discussion.
Kwaku Nkrabea: Dr. T., you remember the Maame Tawa, the woman you operated on 3 weeks ago with the huge tumour?
Dr. T: Yes. Has she come back for review?
Kwaku Nkrabea: I just saw her. She came with pus from the umbilicus. I did an ultrasound scan for her. Not very clear but she has an irregular mass in the abdomen. It could be pus. It could be a foreign body.
Dr. T: Did you tell her it could be a foreign body?
Kwaku Nkrabea: I told her I am not too sure what it it but she needs another surgery. She is being prepared for theatre.
A couple of hours later.
Theatre. After surgery. Maame Tawa stable in Recovery Ward.
Dr. T. comes to find out:
Dr. T: What was it?
Kwaku Nkrabea: An abdominal towel.
Dr. T: Ei! Is she awake? Have you told her?
Kwaku Nkrabea: She is stable in the Recovery Ward.
Dr. A: We have a difficult situation here.
Dr. Ahuofe: Does this happen often? What can be done to prevent this?
Dr. B: We don’t have to tell her o. We are dead if we tell her.
Dr. C: Nobody should tell her.
Theatre Matron Odopa: Many of you doctors don’t do the swab and instrument count after surgery. You are in a hurry to finish and go and do locum at Opompojay Specialist Hospital. Why won’t these things happen.
Kwaku Nkrabea: Dr. Ahuofe, it doesn’t happen often in this hospital. I know a doctor in another hospital who has done this three times but never tells the patients. In fact, he never even records it in the operation notes.
Dr. Ahuofe: That is unethical!
B: Keep quiet. You are young. Wait till it happens to you.
C: Don’t mind Ahuofe. He hasn’t seen anything in life.
Kwaku Nkrabea: It happened to me once. I left a towel in the abdomen.
Dr. Ahuofe: Ei, you too?
A: You think Kwaku Nkrabea is a Saint? Or a Spirit?
Kwaku Nkrabea: Many of the hospital staff said I shouldn’t tell the patient after the surgery. I said no way! I told her before she was discharged. She was grateful for what I did and my sincerity. Then a few months later she sued the hospital and me.
Dr. Ahuofe: Ei what happened? You went to court?
Kwaku Nkrabea: It is a long story. It was finally settled out of court. The hospital had to compensate her.
Dr. Ahuofe: You learned a lot from it?
Kwaku Nkrabea: Sure. Before that, this hospital didn’t do swab and instrument counts before and after surgery. That brought the change. We started the swab and instruments count after this unfortunate incident. Even before the current World Health Organisation checklist came out. If bad outcomes are properly audited, the system gets better. That is why we shouldn’t hide bad outcomes. We must face them to improve the system.
A: I still think we shouldn’t tell Maame Tawa about this.
B: I also think we shouldn’t tell Maame Tawa about it.
C: The interesting thing is that other health workers who think they are equal to medical doctors and should take the same salary as medical doctors. When these law suits come, they run away and say the medical doctor is in charge. Did the medical doctor perform the surgery alone? Could someone in theatre intentionally leave a foreign body in the abdomen to sabotage a medical doctor he or she doesn’t like?
Dr. Ahuofe: Dr. C likes conspiracy theories!
B: Medical Doctors and other health workers should think about Insurance to cover these law suits in Ghana. Times are changing. Now many people are suing medical doctors and other health workers.
Kwaku Nkrabea: Now all of you who think we shouldn’t tell patients about these bad outcomes. What will you say if it is your relative or you? The public, in fact nobody, including us, will trust hospitals if we are not sincere. That is why some staff of the hospital try to be in theatre when their relatives and friends are brought to theatre. Because they cannot trust us.
A: Kwaku Nkrabea, I hear Administrator Fabonekye wants to speak to you in his office.
In the Administrator’s office.
Kwaku Nkrabea: Good afternoon, Mr. Fabonekye.
Mr. Fabonekye: Good afternoon, Dr. Kwaku Nkrabea. I have been told about the findings of Maame Tawa’s surgery. Acting Medical Director Dr. Dr. Anibie has travelled. He asked me to talk to you. The hospital does not have money. If we are sued, we cannot pay. I know you are an honest man, but please don’t tell the patient that there was a foreign body in the abdomen.
Kwaku Nkrabea: Sir, you are suggesting that I should lie to the patient? What should I tell her if she asks what I found?
Mr. Fabonekye: Leave that to us.
A few days later.
On the ward. Ward Rounds.
Dr. T: Maame Tawa, all is fine. You have been discharged.
Maame Tawa: Thank you, Dr. What was found in my abdomen during the surgery?
Dr. T: A lot of pus. So we drained it and washed the abdomen.
Maame Tawa: Please where is Dr. Kwaku Nkrabea?
Dr. T: Our Medical Director had to send him at short notice to some of the remote villages in the district to organise some workshops. He will be away for a week.
To be continued.
The characters in this piece are fictitious; any resemblance to real people or facts within your Corporate Institution is pure coincidence only.