Hornbill Unleashed

October 21, 2011

Hospital ‘acted correctly’ in billing bereaved parents

Keruah Usit

Medical staff at Miri Hospital and Limbang in Sarawak provided “appropriate care and management” to the Penan couple whose child died a day after birth at the hospital in Miri, the Sarawak Health Department says.

Department director Dr Zulkifli Jantan also came out in defence of the behaviour of billing counter staff at Miri Hospital, following news reports yesterday about the impoverished young rural couple being forced to pay RM180 as their medical costs.

Seri Yung, 25, and Roy Dumai, 26, from Long Napir in Sarawak, had travelled four hours by ambulance from Limbang to Miri for the delivery of their second child, but the baby died of asphyxiation.

“We are of the same opinion as you, that it is tragic that a precious life was lost. However, our investigation shows that the staff in Hospital Miri and Limbang had provided appropriate care and management,” Zulkifli said.

“If at all they can be faulted, then I think they could have managed the charging of the bills with more tact and finesse,” he wrote to Batu Lintang assemblyperson See Chee How.

See, a human rights lawyer, had highlighted the injustice of the poor being forced to pay hospital bills.

Hospital ‘misled by the patients’

Zulkifli said the billing counter staff had conducted themselves appropriately, despite Roy’s claims that three staff had abused him verbally and had threatened him, when he asked for exemption on the bill.

“On the matter of the hospital charges, there seems to be some communication problem leading to a misreading of the situation by our staff,” Zulkifli explained.

“The patient presented herself as a ‘Rela’ staff, not as a Penan. The Miri staff acted correctly in imposing the hospital charges based on the Fees Act. If she had presented herself as a Penan who could not afford the charges, the usual fee exemption process would be activated.”

Roy’s response to this statement was that he had gone to the billing counter alone.

NONE“The people (at the counter) are lying. They knew we were Penan,” he insisted. Her IC (MyKad) has our home address on it, Long Napir, Limbang. Are they illiterate?”

Roy said he had also taken with him guidelines issued by the Health Department that Sarawakian families with an income of below RM765 a month qualify for exemption from hospital charges.

The document does not stipulate that poor families must be of Penan, Iban, Malay, Chinese or of any particular race.

See said the department should clearly and officially enforce the ‘usual fee exemption process’, rather than leave this to be decided by individual officers.

“The Miri billing counter staff have clearly failed to act professionally in this instance.”

See urged the state Health Department to immediately enforce the fee exemption for the poor in all hospitals and clinics, so that all billing departments would comply, without exception.

‘Management was correct and appropriate’

Zulkifli told the press that Seri went to the Limbang health centre on Oct 15, at a very early stage of labour, and was referred on to Miri for “high risk” pregnancy, and not because of failed labour.

She had undergone an emergency Caesarean section in 2006. According to obstetricians, a previous incision weakens a woman’s womb, and increases the risk of womb rupture during each subsequent pregnancy.

Repeat surgery would also be more difficult because of adhesions, or scarring, from the prior operation.

The ambulance was deemed adequate for her journey to Miri through Brunei, because Seri was not in established labour yet, and was, in Zulkifli’s words, in very good medical condition.

“Her condition and the infant’s condition were monitored carefully throughout. However progress was slow and the infant began to show signs of distress,” he said.

A Caesarian section was then carried out and Zulkifli said the baby girl was born with poor oxygenation, and despite intensive care, she died on Oct 17 from brain damage caused by lack of oxygen.

NONE“This condition most probably occurred because of the extra long time needed to perform the Caesarian operation due to the massive adhesions present. The situation could not have been dealt with in a different way,” he noted.

According to Roy and Seri, she had been in labour in Miri for more than 14 hours before she had surgery. Zulkifli did not comment on Roy’s allegations that a junior doctor had sneered at Seri and scolded her when she had asked him for an urgent operation.

All reasonable care and management, Zulkifli said, had been duly provided to both Seri and her infant while in Limbang and Miri.

“Please know that we feel for this patient. We share her pain and sorrow, and wish the outcome was different,” he concluded in his letter emailed to See.

See has called for an independent inquiry into the baby’s death.

He also pledged to continue to press for universal application of the waiving of hospital bills for low-income people who qualified for exemption under the Health Ministry’s guidelines.

1 Comment »

  1. The director said “We wish the outcome was different”. If wishes were horses, beggars would ride. The department needs to take disciplinary action against the offending staff and improve its work process to prevent future outcomes from being the same.

    Comment by Analist — October 22, 2011 @ 9:53 AM | Reply

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