Four weeks ago, the imprisonment of Dr. Guy Iriba, a doctor at the Germain Martin polyclinic in Ngozi, caused a lot of noise. While a certain public opinion was quick to crucify doctors denouncing their irresponsibility, we lent the pen to a doctor to go beyond the news item.
The case was a hot topic. On June 24, 2024, Dr. Guy Iriba was imprisoned in Ngozi, following the death of a patient on whom he had performed a caesarean section about a month earlier. However, the doctor was not unknown to the deceased since he had already followed her for three pregnancies without incident.
According to the order of doctors in Ngozithe cesarean section took place on May 26, 2024. Three days after the operation, the patient had a post-operative complication that was treated. Better still, the patient was discharged from the hospital in good health on June 3, 2024. However, her doctor recommended that she return later for a check-up. So far, nothing abnormal. But the patient’s health deteriorated rapidly. On June 6, 2024, she consulted a hospital in Bujumbura, was admitted to the emergency operating room, before dying on the operating table. A medical report was hastily written, incriminating the first operator, which led to his arrest. Since her incarceration, the charges have continued to change. From homicide to failure to assist a person in danger to refusal to transfer in time.
Apart from the cases of Dr Christophe Sahabo et Dr Patrick Bitangumutwenzi who are behind bars for reasons unrelated to the prescribed care, what happened to Dr. Guy is reminiscent of the cases of Dr Pascal Ndanibenga in Bubanza as well as Dr. Wayman Habimana and Dr. Dieudonné Niyonkuru in Rumonge. The latter two were not as lucky as their colleague from Ngozi who was quickly released on bail. They were acquitted by the court after several weeks of detention.
“Medical error” or “medical complication”?
All those interviewed are unanimous. Dr. Guy Iriba is not an apprentice doctor. With his 13 years of experience, he has seen some green and unripe things under his white coat. But his experience does not constitute immunity from possible legal proceedings.
But how is a police officer going to distinguish between “medical error” and “medical complication” without taking into account the opinion of the medical association?
There, I see you saying that there was already a medical report to enlighten the justice system. But who wrote this report? By taking a look at it, and without playing devil’s advocate, we realize that it was signed on April 7, 2024 for a patient who died on June 6, 2024. Such a dating error should have alerted the justice system.
In addition, in the event of a death related to childbirth, a manager of the national reproductive health program within the Ministry of Health and the Fight against HIV/AIDS states that there is a whole process called “maternal death audit”. The latter is carried out after the investigations into the death. Any service provider who has dealt with the file is questioned. The hospital admission forms, the surgical and post-operative protocols are revisited. We are therefore very far from a medical report drawn up by individuals who themselves were directly linked to the file. This constitutes a case of conflict of interest.
Furthermore, performing a caesarean section, however simple it may be, is not part of a general practitioner’s job description. It is a specialized act that is performed by a specialist in gynecology and obstetrics. And general practitioners do it to save lives in a country where there are not enough specialist doctors, particularly in the interior of the country. The accusation of “failure to assist a person in danger” is therefore not valid, because the doctor is going beyond what is normally required of him to assist this patient.
Beyond the news item
Every act performed by a doctor, even the most banal, can have an adverse effect. Not to mention the therapeutic hazards and the working conditions of health professionals in Burundi. Furthermore, the doctor has an obligation of means but not an obligation of results. The establishment of laws specific to medical practice would prevent doctors from being prosecuted for common law offenses or crimes. This idea is not new. It has already been suggested to the National Assembly of Burundi.
Doctors are advised to explain the risks to the patient and to obtain their consent, where possible, before performing a medical procedure.
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2024-07-26 10:56:03