KUALA LUMPUR: A businessman who walked into a hospital following a motorcycle accident died seven days later after doctors failed to detect and properly manage his serious chest injuries.
The Alor Star High Court found that a series of medical failures at Hospital Sultanah Bahiyah contributed to the death of Shah Bani Shahidan, 46, on Aug 3, 2021.
Judicial commissioner Datuk Mohd Aimi Zaini Mohd Azhar said doctors had failed to recognise the severity of Shah Bani's injuries, overlooked crucial radiological findings and delayed medical interventions that could have prevented or reduced the complications leading to his death.
"This conclusion does not rest upon any single error of judgment, but upon a pattern of oversight that persisted over several critical days," he said when allowing a medical negligence suit filed by Shah Bani's widow, Azura Mat Rais, against 15 doctors, the hospital director and the government.
Azura was awarded RM355,187.50 in damages and costs, with the government held vicariously liable for the negligence of the hospital's medical personnel.
In his written grounds of judgment dated Oct 15, Mohd Aimi said Shah Bani was conscious and able to walk and speak when his wife brought him to the hospital following the motorcycle accident on July 27, 2021.
"The facts of the case unfolds when the deceased walked into the hospital on his own two feet on 27 July 2021. He was however pronounced dead a week later.
"The plaintiff's account of the events, safe to say, is quiet and unembellished. Her husband entered the hospital conscious, able to walk and to speak," he said.
Shah Bani complained of chest, back and left shoulder pain, as well as pain in his right knee.
Despite his complaints, the treating surgical team proceeded on the assumption that he had fractured only his first and second ribs.
A computed tomography (CT) scan conducted on July 28 revealed more extensive injuries, including multiple fractured ribs, a fractured sternum, blood accumulation in both chest cavities and a bruised left lung.
The court heard that the CT scan findings were available on the hospital's system, but none of the treating doctors contacted the Radiology Department for clarification in the four days before the report was formally authorised on Aug 1.
Mohd Aimi said the failure was particularly troubling because three doctors had initially reached different conclusions when interpreting the same chest X-ray.
"Yet no one did so. The contemporaneous radiological reports lay unrequested on the Hospital's own e-HIS system," he said, referring to the failure to seek a second opinion from the Radiology Department.
"Had the treating team taken the elementary step of following up the report, or indeed of reviewing the images which were available from 28 July, the severity of the injury would have been apparent far earlier than it was, and the treatment would have been correspondingly more aggressive."
Mohd Aimi also criticised the lack of coordination among the hospital's medical departments, noting that several doctors had attempted to attribute responsibility for the shortcomings to other personnel.
"It suggests not a coordinated multidisciplinary effort, but a team that was, in truth, working in the silo - each department confined itself to its own field, and no one paused to ask why the patient was not getting better," he added.
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