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Case review into death of 10 year old child reveals major negligence.

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Drawing by: Fathmath Mishka Mohamed.

The Ministry of health has publicized the case review following the allegations of negligence surrounding the death of 10 year old Fathmath Mishka Mohamed on 2nd June 2021. The report published by the ministry revealed major negligence and violations of protocols and procedures from the Health Emergency operations Center (HEOC).

According to the Health ministry, stated that they had investigated how the call center, Medical Response Team (DMRT), Clinical management and Advisory Team (CMAT) and the Emergency Medical Service (EMS) had acted on the night of the incident.

Below are points noted by the health ministry on the events preceding the 31st May 2021.

  •  COVID-19 test samples were taken on 28th May 2021 and tested on 29th May 2021. Contact tracing teams had contacted the parents of Fathmath Mishka Mohamed on 30th May 2021 and informed that that she had been tested positive for COVID-19.
  • According to procedure, the contact tracing team inquired whether they need a doctor’s consultation for which her parents stated that they would need a doctors consultation. This was noted on the information sheets, but a doctor’s consultation was not provided as requested by her family.
  • According to procedure, all information collected should be entered into the Outbreak (OB) system.  However, none of the information collected on Fathmath Mishka Mohamed’s case was entered into the system.
  • According to set procedure, the Care Cluster has to call and check up on all patients under the age of 15. However, reports show that they did not call the parents of Fathmath Mishka Mohamed from the time she was tested positive to the time of her death.

Below is a timeline of the events that preceded the death of Fathmath Mishka Mohamed according to the Ministry of Health.

  • 14:20 –  Parents of Fathmath Mishka Mohamed informed the call center that she was experiencing high fever, coughing, tiredness and is unable to eat any food.
  • 14:24 – The information was entered into the OB system and a ticket was raised.
  • 14:27 – Information entered into the call center information system.
  • 15:53 – Based on the information provided by the parents, a general doctor from the DMRT provided consultation. They were advised to continue using the medications at home and to call back if her conditions worsened.
  • 21:06 – The parents called the call center and informed that her conditions were worsening and that she was having difficulty breathing. The parents requested urgent consultation with a doctor.
  • 21:10 – The information was entered into the OB system and a ticket was raised.
  • 21:15 – The information was entered into the call center information system.
  • 21:53 – DMRT doctor tried to call the parents of Fathmath Mishka Mohamed but was unable to contact them at the time. The case was labelled as “Attended” on the DMRT information sheet.
  • 22:06 – The parents of Fathmath Mishka Mohamed called and stated that they missed the call by the DMRT doctor and stated that she was having difficulty breathing. This information was again entered into the OB system an another ticket was raised.
  • 22:12 – The information was entered into the call center information sheet.
  • 22:33 – DMRT Doctor called the parents of Fathmath Mishka Mohamed. Based on the information provided by the parents, the doctors noted that she had been having breathing difficulty (for 1 day), dry coughing (2 for days) and fever ( for 6 days) and that she was unable to properly tell her discomforts as she was a special needs child  for which they had been receiving therapy. They also informed that she does not take any long term medications.
  • 22:39 – DMRT Doctors informed CMAT. It was noted that even though the information was received by the DMRT and CMAT which is responsible for activating ambulance service, no orders were made to send the ambulance.
  • 23:16- 23:33 The parents made calls to the call center 5 more times. In one of these calls they informed that the child’s condition was further worsening and had lost consciousness and was bleeding from her nose. In these calls the parents repeatedly asked for an ambulance for which the call center informed that an ambulance had been sent. But the ambulance was not activated at that point.
  • 23:27 – A representative of the parents of Fathmath Mishka Mohamed came  to the Health Emergency Operations Center (HEOC) at “Dharubaaruge” to inquire on why the ambulance was delayed.
  • 23:32 – HEOC facility management informed the EMS that an ambulance was needed.
  • 23:33 – EMS called the parents and informed that the ambulance was on the way.
  • 23:38 – Ambulance arrived at the house. CPR was initiated as the child was unresponsive.
  • 23:42 – Ambulance arrived at IGMH ER.

In the case review, the Health ministry also noted that the HEOC had failed to identify the case as an emergency case and failed to activated the ambulance service on time. It was noted that from the time of the first request for an ambulance, there was a delay of 2 hours 26 minutes.

However, a family member of Fathmath Mishka Mohamed has pointed out irregularities in the timeline provided by the Health Ministry. According to a screenshot of the call logs, the parents were on call with the call center  from 23:42 for 6 minutes 39 seconds while the Ministry of Health claims that the child was already at IGMH ER at the time. He also noted that she had no pulse by the time the ambulance arrived but no CPR was done.

                    Call logs of the parents of Fathmath Mishka Mohamed.

The Ministry of Health assured that steps would be taken to ensure that no such incidents would occur in the future. However, fact remains that a child died from the negligence of those appointed to guard the public health and safety.

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