City referral hospital on spot over broken CT scan

Vivien Munyaburanga and his family could not believe when a close relative who had been involved in a road accident, passed on hours after he was admitted at Kigali University Teaching Hospital (CHUK) on Tuesday. A Computerised Tomography Scanner (CT scanner) for the referral hospital, acquired three years ago, went out of service after its air conditioning system broke down. This breakdown, Munyaburanga and his relatives claim, is one of the reasons their patient was not accorded the requisite treatment, resulting into his death. The bereaved family says the deceased was rushed at CHUK on Monday, around 4pm after sustaining severe injuries in a road accident that occurred in Nyamirambo, a city suburb. On arrival at CHUK, medics tried to provide the necessary emergence care but the patient’s condition only got worse and, as the family insisted that the victim be scanned. “It is like the medics were trying to treat the patient before establishing the exact problem.” Later on, Munyaburanga said, the medics accepted to use the CT scanner, only to discover that it was not functioning. The caregivers were compelled to rush the patient to King Faisal Hospital. At 11pm, a test was run indicating that he had sustained a fatal concussion and that blood had gotten into brain tissues, according to Munyaburanga. The patient passed on shortly after the scan. Munyaburanga insists the patient would not have died if the doctors had realised the emergency and scanned him immediately. “Such things are totally unacceptable at a national referral hospital,” Munyaburanga said. Munyaburanga’s frustration is shared by other people who have sought the same service at CHUK. Brigitte Nyinawingeri, whose friend passed on last month from CHUK, also attributed the death to a faulty scanner. “He was injured in an accident. It took the hospital two days to get him through the scanner. By the time he was transferred to King Faisal Hospital, it was too late,” she narrated. The patient died two days later, she says. Scanner not medical Speaking on condition of anonymity, some medical staff at CHUK admitted that the machine has had mechanical issues for the last three years. It works for some weeks, and then breaks down, they say. “The problem is complex; the machine is first of all very expensive and its spare parts are not readily available. Our technicians also lack requisite qualifications to repair it. The hospital usually hires technicians from Uganda,” said one medical staff. Another medic at the hospital said between the breakdowns, there are normally delays attributed to bureaucracy and cumbersome procurement procedures before the scanner gets fixed. Despite all these challenges, however, the two medics dismissed the validity of the allegations that the patients’ death is linked to the faulty scanner. “This test is required when a patient is already stable. When someone is in critical condition, the urgent thing is to deal with emergency medication and run other tests later,” said a medical assistant. CHUK speaks out In an interview yesterday, Dr Martin Nyundo, the CHUK medical director, told The New Times that the CT scanner has never been an issue. He also said a scanner is recommended after a patient has undergone preliminary treatment. “Even if we had a functioning scanner, the patient would not have gone through it when conditions do not permit. I also want to note that our ambulances that take patients to King Faisal are fully equipped meaning that a patient will not go for even a minute without appropriate medical attention,” he said. Concerning the breakdowns, Nyundo said the scanner, like any other machine, can break down anytime. “It also happens to the one at King Faisal and when it happens they also transfer patients to CHUK.” He, however, disagreed with his staff on the issue of inefficiency in terms of personnel to fix the machine in case of breakdown, saying that it is maintained by the country representative of Siemens, the German firm which supplied it. Nyundo said whenever the machine breaks down, it is fixed by the engineer from the supplier, and when there is need of spare parts, Siemens imports them. He refuted allegations of poor service delivery, saying their emergency service has enough personnel who prioritise cases according to their sensitivity. The patients marked red are presumed first priority, followed by those marked yellow, and then green. When contacted, Dr Stephen Musiime, a medical specialist at King Faisal Hospital, said “a CT scanner is vital in the diagnosis phase of treating a patient and should always be in a good state.” Musiime, however, said the test is not always an emergency, and it may be put on hold given the patient’s situation . “We were able to diagnose a case and treat it accordingly even before we got these scanners,” said the specialist pediatrician. In a move to ensure efficiency, hospitals are allocated budgets and autonomy so that they can streamline their operations based on the needs of their patients and their demands. When it is functioning, the CHUK CT scanner tests an estimated 40 patients daily. Such machines are only available at CHUK, King Faisal Hospital, Kigali and at the Huye-based University Teaching Hospital Butare (CHUB). CT scan tests are covered by different health insurance schemes available in the country, including the community-based Mutuelle de Santé.

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City referral hospital on spot over broken CT scan