Dr Kelvin Yii said such issues must not be swept under the carpet nor should it be handled internally.
KUCHING (June 23): The Ministry of Health (MoH) must launch an immediate inquiry and investigation into the serious allegations of medical negligence by the Ipoh General Hospital’s ambulance service which had resulted in the death of a man last April, said Bandar Kuching MP Dr Kelvin Yii.
He said such issues must not be swept under the carpet nor should it be handled internally.
“It is important to restore the public’s confidence not only on this particular hospital’s emergency health response but on all government hospitals’ emergency response as well and to bring justice to the aggrieved family members,” he said in a statement.
He was responding to a CodeBlue news report where a doctor from Raja Permaisuri Bainun Hospital had accused the Ipoh General Hospital’s ambulance service of allowing his brother to die from a heart attack by failing to perform cardiopulmonary resuscitation (CPR).
“Based on a report by CodeBlue, which cited evidence based on an internal document, an eyewitness account, and police photographs from the scene, the hospital’s ambulance service was accused of not performing life-saving procedures such as CPR or using an AED device (a machine that delivers a jolt of electricity to get the heart beating again) from the ambulance which is required and standard practice in such a situation.
“Such life-saving interventions, while not guaranteed, can increase the chances of the patient being saved especially if there is early intervention,” said Dr Yii, who is the Parliament Special Select Committee (PSSC) chairman for Health, Science and Innovation.
He said based on the eye-witness report, the victim still had some movement, “like it was very hard to breathe” when the call was made for an ambulance which arrived approximately 10 to 15 minutes later.
“Technically based on such a time frame, life-saving interventions including CPR plus the usage of AED can still be performed. However, based on the eye witness’ accounts the paramedic did not perform CPR nor use the AED device to attempt to revive the victim, claiming that the victim was “already gone”.
“This was confirmed in the ‘Laporan Perkhidmatan Pra Hospital Dan Ambulans’ (No Sign of Life)’which the medical assistant (MA) or paramedic on scene signed on April 13 claiming that at 6.40pm, algor mortis – a stage of death when a human’s body temperature drops to the external temperature – had set in, indicating a “clear sign of death” and thus did not perform such life-saving interventions.
“However, if we base on the timeline and witness statements, assuming that the victim collapsed at around 6.10pm – the approximate time of the collision stated by eye-witness that the victim was reportedly still breathing – this means the paramedic pronounced the victim’s death in just 30 minutes at 6.40pm and even claimed the body had turned cold within that short period of time,” he said.
He pointed out that generally, algor mortis only begins two hours at the earliest after the heartbeat stops, and is established at around 18 hours after death.
“This disputes the claims of that MA, thus giving him no excuses why he did not perform any life-saving manoeuvres.
“That is why, based on such evidence, there is definitely clear medical negligence and possible criminality in such a case. On top of that, based on the news report, it is not an isolated case as similar cases happened before as well in May of this year,” said Dr Yii.
In view of this, he reiterated that the Ministry of Health must not sweep this issue under the carpet as it involves lives and public confidence in the country’s hospital emergency response.
“We do not want the public to worry every time they call our ambulance and not trust our health services,” he stressed.
He suggested that the ministry must carry out a clear investigation on the entire chain of events from the time the emergency call was received to the time the ambulance response team left the scene of the incident.
“They should also carry out a nationwide review to ensure such cases are isolated and are not happening in other areas around the country,” he added.
He said all MAs involved in such emergency situations must be given the needed support and even continuous training for proper management of patients who collapsed at roadsides to ensure that they are competent and have the right attitude when approaching such emergency situations.
“Secondly, they must also carry out an audit on all equipment and medications on all ambulances to ensure they are adequate and properly maintained to ensure when needed, it can be used effectively and swiftly.
“The government must also increase public awareness and training on such life-saving interventions including CPR and the usage of AEDs,” he said.
With the announcement by Health Minister Khairy Jamaluddin last March that the installation of AEDs would be made mandatory in public areas by 2025, Dr Yii also proposed that the public be trained to use them during emergencies while waiting for the arrival of first responders.
He also said that the government should not take any disciplinary action against any public health workers or whistleblower of such negligence practices.
“Instead they should review and improve on any short-comings to ensure quality of care to our people continues to improve,” he said.
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