Case of the week: Dr. E.L.A Chinbuah & Captain J.K Nyamekye v The Attorney General

High Court · GJ/378/2016 · July 21, 2021 · Ghana

Introduction:

This case brings into sharp focus the issue of medical negligence and accountability in Ghana’s healthcare system.

Facts:

The Plaintiffs were Dr. E.L.A. Chinbuah, the father of one Mrs. Helena Abrema Nyamekye, a PhD student who died during labor at the 37 Millitary Hospital, and was during her lifetime married to Captain J.K. Nyamekye, the 2^nd Plaintiff.

The Plaintiffs contended that they had decided with a doctor to opt for a caesarean section (C/S) as the preferred mode of delivery, but the medical team at the hospital decided instead to induce labour. They alleged that despite persistently requesting a C/S, the medical team refused and proceededwith the labour induction, causing the deceased unbearable pain. The Plaintiffs claimed this led to a traumatic delivery resulting in Mrs. Nyamekye’s death and caused trauma and a deformity to the child. They accused the doctors of not meeting the standards of their calling and breaching the trust placed in them to provide proper care, alleging negligence.

The Plaintiffs sought judicial reliefs including damages for the loss of life of Mrs. Nyamekye, for the pain and suffering she experienced, for trauma negligently caused to the infant Yaw Nyamekye and permanent deformity of his right arm, and for legal costs.

The Defendant denied the Plaintiffs’ claims, pleading that vaginal delivery was the best and appropriate option, and the deceased and her husband consented to it. The Defendant claimed the request for a C/S was made while delivery was in process. The Defendant also claimed the infant’s arm deformity had been corrected.

The issues before the Court included

1. whether the deceased and 2nd Plaintiff requested C/S and whether same was feasible at the time of the request.

b. whether the Medical Team had been negligent in their care and management of the deceased.

Holding:

The High Court entered judgment in favour of the Plaintiffs, holding that:

1. The deceased and the 2nd Plaintiff did request a caesarean section as the mode of delivery, and the hospital staff elected a different course of action. The Defendant’s pleading denying this was found to be untrue.

b. No plausible and/or reasonable explanation was given as to why the requested caesarean section could not be carried out when requested.

c. The 37 Military Hospital was vicariously liable for the negligent acts of its medical team whose actions had been brought into question.

d. The court awarded damages to the Plaintiff as a result of the proven negligence

Implications of the Decision:

This case underscores the principle of accountability for medical negligence in Ghana. It reinforces that healthcare providers owe a duty of care to their patients and can be held liable for breaches of that duty leading to harm. The judgment highlights the importance of patient consent and proper communication regarding medical procedures, questioning the credibility of claimed verbal consent in this instance. It specifically emphasizes the critical need for diligent monitoring of high-risk patients and the consequences of failing to meet accepted medical standards, such as the failure to monitor a PIH patient after induction.

Significant Quote:

“I wish to respectfully ask doctors and specialists at our hospitals to kindly take a second look at what is gradually becoming a canker in our society where many innocent would be mothers lose their lives needlessly. While the healthcare sector in recent times has emphasised a slow decline in maternal deaths, the problem still exists. I recognize that as doctors, they face challenges each day in their work and deserve our commendation rather than condemnation generally. However, the events that lead to the untimely death of the deceased in this case was just unacceptable and should not be repeated at all. If same is not corrected there would be many Captain Nyamekyes and little Yaw Nyamekye who would be robbed of brilliant wives and mothers. I hope that would not be the case.”

– His Lordship Kweku T. Ackaah-Boafo (JA)

Commentary and insight:

While commending the genuine efforts of Medical Professionals in Ghana, this judgment serves as a cautionary tale and a call to action for medical professionals in Ghana to improve the quality of care, take responsibility for their decisions, and prevent needless deaths, particularly maternal deaths.