Case of the Colluding Pathologist

Case of the Colluding Pathologist

Let me use this medium to share some views on the state of professionalism in Ghana. Our country has been blessed with many professionals, thanks to a fairly good educational system and the zeal of Ghanaians generally to acquire knowledge. In the West African sub region, one can say without fear of contradiction that Ghana is on one of the countries with the highest number of professionals per capita.

The question then is “why are we not as developed as one would expect us to be”
Your guess is as good as mine. When professionals decide to use their expertise to collude with others to perpetuate wrongdoing and support/be part of cover ups, defraud clients and or the state, distort the truth for the sake of immediate gain, then we could all see why we cannot be expected to progress beyond where our colonial masters left us. Elsewhere, people take pride in using their expertise either to advance their professions (through writing of books, contributing to discussions, volunteering to educate the public etc etc.)

We were to see the extent of this form of collusion at work when on March 9, 2010, after receiving substandard care during labour at Lister Medical and Fertility Center in Accra that led to the death of our son, Nyilale Vaah Junior, the Medical Director and Head of the facility, Dr Edem Hiadzi offered to send the body of our son to his pathologist friend, Prof. Yao Tetteh at the Korle Bu Teaching Hospital for autopsy. This was to, in his words, “enable us all learn lessions from this tragedy”. In his own words, Dr Edem Hiadzi confessed “I feel like a criminal”. “We did not do things right. If we had done things right and this had happened, at least we would know we had done things right”. We were of the view that if the reason for seeking an autopsy was to learn lessons from the mistakes that had occurred, there would be no need for anyone to want to cover up the truth, since that would beat the whole purpose of seeking to have the autopsy done.

It was in this spirit that My husband and I visited Prof. Yao Tetteh at the Pathology Department of Korle Bu Teaching Hospital to give him the background to what happened during the eighteen hours between the rupturing of my membranes and when my baby, Nyilale Vaah Junior was delivered fresh stillborn on the admission bed of Lister Medical and Fertility Center. Interestingly, this learned Prof. informed us that while his initial findings show that our baby died of “multiple internal organ haemorrhages” his report would not reflect the lack of oxygen. He told us “I have ruled out lack of oxygen because the baby was not blue”. He rather ventured into philosophy to tell us stories to confirm how everything is from God and that he had friends who wanted a boy so much the boys they had are now burdens for them. True to his words and in the most intriguing cover up of the century, his final report concluded thus

“Multiple organ haemorrhages MOST PROBABLY (emphasis mine) due to a bleeding diathesis/coagulation defect with bleeding precipitated by “trauma” of labour (child birth)”

Dear reader, this is the truth of professional “pathological” collusion that Ghanaians have to deal with everyday. Reports like this are written to conceal blatant mistreatment, negligence and medical malpractices so the poor man or woman is left with nothing but to give to God their grief and injustice and move on with life in pain. I am neither a medical doctor nor pathologist. However, what little I have read since this happened to my son shows that:

1. Human beings don’t just die. Death other than by accident, is preceded by several things – a gradual slowing down of the various organs within the body leading to their eventual seizure. Thus, especially for a foetus that is being delivered, a systematic monitoring of the fetal heartbeat, especially when oxytocin had been introduced, would have given certain indications that could have led to some actions being taken to save the life of the baby. My son’s heartbeat was last checked at 8.03am and was never checked again till I gave birth to him at 3.30pm


2. For a mother of four, oxytocin was started to induce labour at 11.20am. (I had reported with a ruptured membrane and in pain to that hospital at 11pm the previous night, and been given medication (Nospa 40mg stat, Ventolin tablet 4mg, Rocephin 2g stat) to slow down the process since according to a Dr Boye, my baby was in an oblique lie).


3. I had the urge to push at 2.30pm, but, rather than check the level of my dilation and prepare me for delivery, the nurse who was called in rather said “it means the medicine is working” and went away. I lay on my side with painful, continuous contractions till 3.30pm when I delivered Junior unresponsive on my admission bed.


4. He was left unattended at delivery for up to five minutes before his cord was cut and he was bundled away, apparently to be resuscitated.
   From my readings,
   When labour is augmented by oxytocin, lack of effective monitoring of the baby leads to fetal distress leading to death. (Turnbull and Anderson (1968) noted an increased incidence of fetal distress after the introduction of their new accelerated labour regimen in Aberdeen. They also –noted three stillbirths which they attributed to oxytocin being used to overcome pelvic contraction. Beazley and Kurjak (1972)also noticed an increased incidence of fetal distress in patients-especially multiparous ones whose labour was stimulated with oxytocin. Contractions occurring more often than every two minutes are clearly more likely to cause fetal distress, to depress a baby's Apgar score, and to make it more liable for special nursery admission.)

In his report, our learned Professor Yao Tetteh indicated that our son was not cyanosed. I have read what this means. A check on Wikipedia shows that

“Cyanosis is a blue coloration of the skin and mucous membranes due to the presence of greater than five grams per deciliter of deoxygenated hemoglobin in blood vessels near the skin surface. Although human blood is always a shade of red (except in rare cases of hemoglobin-related disease), the optical properties of skin distort the dark red color of deoxygenated blood to make it appear bluish.

The elementary principle behind cyanosis is that deoxygenated hemoglobin is more prone to the optical bluish discoloration, and also produces vasoconstriction that makes it more evident. The scattering of color that produces the blue hue of veins and cyanosis is similar to the process that makes the sky appear blue: some colors are refracted and absorbed more than others. During cyanosis, tissues are uncharacteristically low on oxygen, and therefore tissues that would normally be filled with bright oxygenated blood are instead filled with darker, deoxygenated blood. Darker blood is much more prone to the blue-shifting optical effects,[2] and thus oxygen deficiency - hypoxia - leads to blue discoloration of the lips and other mucous membranes.

Cyanosis is an abnormal blue discoloration of the skin and mucous membranes and requires an absolute concentration of deoxygenated haemoglobin of > 5 g/dL. It is actually easier to appreciate in those with high hemoglobin than those with anemia. It can be difficult to detect in patients with dark skin. When signs of cyanosis first appear, intervention must be made within 3–5 minutes.
Definition
Cyanosis is divided in to two main types: central (around the core and lips) and peripheral (only the extremities are affected).[edit] Differential diagnosis
Cyanosis can occur in the fingers, including underneath the fingernails, as well as other extremities (called peripheral cyanosis), or in the lips and tongue (central cyanosis).
Central cyanosis
Central cyanosis is often due to a circulatory or ventilatory problem that leads to poor blood oxygenation in the lungs or greater oxygen extraction due to slowing down of blood circulation in the skin's blood vessels.
Acute cyanosis can be a result of asphyxiation or choking, and is one of the surest signs that respiration is being blocked.
What happens to a fetus when contractions continue endlessly and his labour is obstructed? From my readings, oxygen supply available to him is depleted, reslting in internal organ haemorrhages.

For the benefit of readers I have added below a picture of my son.

Let anyone who reads the above and looks at the picture of my son draw his or her own conclusions on what actually led to the fresh stillbirth of Nyilale Vaah Junior. Let truth stand always, and let those who would rather use their professions to collude and cover up wrong deeds remember that their cover is being broken by the day. Thanks to technology and the internet.

GOD SAVE OUR MOTHERLAND GHANA AND HER VULNERABLE, UNSUSPECTING MASSES!!!