Baffling case of misdiagnosis that led to mother’s tragic death

Even after two visits to the hospital with excruciating headache doctors told her that all she needed was a good sleep.

By ELIZABETH MERAB

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A little-known woman breathed her last in the wee hours of Saturday October 14, 2017 at one of the country’s revered private facility.

She had spent the last days of her life battling a stroke, a secondary illness that manifested after a
short stint with postpartum preeclampsia, a pregnancy complication characterised by high blood pressure.

In pain too agonising for her to describe, the middle-aged woman, Wilder Kemunto Moturi, screamed for help from her maid, who was taking care of her newborn downstairs – at least that is how her immediate family recounted the situation.
Her elder sister eulogised Wilder, who was 44 –years old when she died, as a woman who had a unique determination and enviable resilience, a woman who was full of a doughty spirit.

We visited Wilder’s family a few months after her passing, following a series of stories published on allegations of medical negligence and malpractices against doctors.

But what makes this woman so special? Why is Wilder’s story so important? To answer those questions, we will have to go back a few weeks to her death, when she was stronger, and could walk herself into an accident and emergency department to seek treatment.

Despite having what many would describe as an almost charmed life, she was no different from many other Kenyans who have had to contend with either the long queues at public health facilities or the exorbitant cost incurred in private facilities.

Like many Kenyan patients, Wilder had suffered long waiting times for care to be provided, and a lot of dissatisfaction with services at public hospitals. To fix the problem, and given that she had access to private insurance, she opted to seek care at a private facility, where for nine months, she and the growing baby inside her womb were well taken care of during the antenatal clinics she attended faithfully.

What she did not anticipate was that exactly a month after delivering her bundle of joy, she would not be there to hold it or nurture it. She died one month after delivering a healthy, bouncing baby girl.

Terrible headache

Wilder’s tragic story began in the wee hours of Thursday, September 14 last year, exactly seven days after delivery, when she developed what her sister Joyce described as “a terrible headache,” which saw her drive to the same hospital where she delivered her baby.

Joyce recalled: “She had just been released from the hospital on September 8 after giving birth the previous day.”

On reaching the hospital and informing the doctor of her symptoms, Wilder was given some painkillers and sent home.

“The doctor told her that she was not having good sleep because of her new baby, then gave her pain killers, tablets, and she went home,” narrated Joyce.

Unfortunately, the niggling pain in her head continued, with each pound growing stronger than the previous one. So unbearable was the pain that the mother of three decided to take a trip back to the same hospital, only to be given stronger oral painkillers coupled with some injectable medicines.

It only took three days for Wilder’s health to deteriorate, from a healthy woman awaiting her baby to a dying patient, fighting for her life in the Intensive Care Unit.

“Saturday September 16, my sister woke up at 5am crying that the headache was killing her. A taxi hailed by her daughter rushed her to a different hospital. But by the time they got to Nairobi Hospital, my sister had suffered a stroke, which caused paralysis on one side of the body,” remembered Joyce, adding that they later learnt that the stroke was caused by a high blood pressure developed after delivery.

It only took three days for Wilder’s health to deteriorate, from a healthy woman awaiting her baby to a dying patient, fighting for her life in the Intensive Care Unit. After days of misdiagnosis and haphazard treatment at the first hospital, her family decided to get a second opinion from a different facility, where they were informed that her condition had worsened so much that the stroke had led to internal bleeding.

It is at Nairobi Hospital’s high dependency unit (HDU) that Wilder breathed her last, a month after she first complained about the headache.

“The doctors told us that they did their best but she had a massive brain haemorrhage which could not be managed. So she stayed in the ICU for two weeks and two in the HDU, incurring a bill of almost five million shillings,” added Joyce.
What they did not know, however, was that the stroke Wilder suffered was a secondary illness caused by an untreated postpartum preeclampsia, a rare condition that occurs when a woman has high blood pressure and excess protein in her urine soon after childbirth.

Common administrative errors in hospitals

%

3

Communication problems between health facilities

13

Absence of trained staff on duty

13

Infrastructural problems

12

Lack of equipment for obstetric surgery

11

Lack of availability of blood transfusion

9

Lack of qualified staff

4

Transport problems between health facilities

3

Communication problems between health facilities

Source: First Inquiry into Maternal Deaths in Kenya (2017) Get the data

Prompt treatment

Most cases of postpartum preeclampsia develop within 48 hours of childbirth and require prompt treatment. Left untreated, postpartum preeclampsia can cause seizures and other serious complications. It is not something new mothers typically think about, but when a woman gives birth, her risk of stroke increases considerably, especially if she develops preeclampsia.

Preeclampsia is a potentially dangerous pregnancy complication characterised by high blood pressure. According to experts, uncontrolled high blood pressure can lead to stroke by damaging and weakening the brain's blood vessels, causing them to narrow, rupture or leak.

What riled Wilder’s family, however, was that despite her quick response to have the nagging headache that nettled the back of her head checked at a hospital, her health condition kept deteriorating, information that the family got to learn about when her condition was critical.

“When we went to seek answers from the first hospital while Wilder was in Nairobi Hospital for her medical records for the two visits she went seeking medical attention, the records indicated that she had what doctors described as very high level of blood pressure,” Joyce said.

Wilder’s family was, however, baffled by the hospital’s response when they went for the medical records. According to Joyce, the attending doctor did not prescribe any medication to help with Wilder’s blood pressure despite noticing that it was abnormally high.

“The administration apologised for missing Wilder’s diagnosis. In their defense, they said it was the mistake of their staff who was under investigation as this was not the first case!”