Medics accused of negligence

Photo Supplied

The newborn son of Sok Moa, a 27-year-old first-time mother who died from blood loss following a Cesarean section on Sunday.

The Phnom Penh Post via CAAI News Media

Thursday, 17 December 2009 15:02 Mom Kunther and May Titthara

THE family of a 27-year-old pregnant woman who died from excessive bleeding after delivering by caesarean section has accused doctors of negligence in a complaint filed with officials in Kampot’s Kampong Trach district.

Sok Moa, 27, succumbed to a postpartum haemorrhage at the end of a 15-hour ordeal during which she traversed more than 40 kilometres in search of treatment on Sunday, her relatives said.

“This was going to be her first child, and ever since she became pregnant she was very good about checking up on her health at the health centre,” said Sok Moa’s 57-year-old mother, Mak Pheun.

“We have complained to the district governor, asking them to take measures to find justice for us because we did everything that they told us. We really trusted them, but they seemed careless with her.”

The case highlights one of the main dangers facing pregnant women in the Kingdom, said Chan Theary, executive director of the Reproductive and Child Health Alliance, who noted that postpartum haemorrhages account for 54 percent of maternal deaths, according to government figures.

At 461 deaths per 100,000 live births, Cambodia’s maternal mortality rate is the third-highest in the region, ahead of only Laos and East Timor.

Long road to treatment

Sok Moa went into labour at 8am on Sunday, and three hours later her family took her to the Kampong Trach district health centre, said Kon Sam Ork, her 59-year-old uncle.

“When we arrived at the hospital, the doctors told us that they needed to operate on her because she could not deliver the baby naturally,” Kong Sam Ork said. “Before the doctors operated on my niece, they asked for 300,000 riels (about US$72) and 12 fruit juice cans, and we agreed,” he said.

The baby, who has not been named, was delivered safely, but the mother immediately began bleeding profusely, he said.

“The doctors told us they could not save her and asked us to send her to the provincial hospital,” he added.

After travelling 30 kilometres by ambulance to the hospital in Kampot town, doctors told the family that Sok Moa would require a blood transfusion of about six litres.

Mak Pheun said she spent 380,000 riels ($92) on one 330-millilitre container of blood, and Sok Moa’s husband also donated blood. “The doctors gave her a transfusion for about 30 minutes, but then she died at 11pm,” she said.

Health officials said it sounded as though the doctors had followed standard procedure in Sok Moa’s case.

“The reason they operated on her was because she could not deliver the baby, and we were successful in delivering the baby,” said Pao Sary, chief of the Kampong Trach health centre. “After the operation, she was bleeding too much, so we transferred her to the provincial hospital.”

Keo Sophan, the chief of the provincial health department, said he had just returned from a trip abroad and did not know the specifics of the case, but he said he doubted that the family had been made to pay for a blood transfusion, which would have been in violation of hospital regulations.

“If they did buy blood, maybe it’s because they hired someone to give blood because no one in the family could,” he said.

Chan Theary said it was common for patients to be asked to pay for blood transfusions, though she said the price cited by Mak Pheun seemed high. The price for the caesarean section was normal, she said.

She said that doctors in Kampong Trach should not have attempted a caesarean section without sufficient blood reserves. “Normally, if we’re talking about comprehensive obstetric care, you need to have a blood bank if you’re going to do a caesarean section,” she said.

Kampong Trach district governor Oum Sinath said he had not yet received a complaint from Sok Moa’s family, though he said he would consult with Keo Sophan when it arrived.

ADDITIONAL REPORTING BY ROBBIE COREY-BOULET