The fight against Saudi's medical malpractice

The ministry of health is currently permitted to handle all complaints of malpractice, giving it the power to cover up mistakes made by doctors.

JEDDAH // When a Saudi woman went to a large Riyadh hospital to deliver her baby three years ago, she did not think it would be the last time she would ever be able to have a child.

The woman whose uterus was damaged by the doctor who performed her Caesarean section, was compensated with only 140,000 riyals (Dh137,000) after a three-year legal battle with the ministry of health. "One-hundred-and-forty-thousand riyals is too modest to compensate a woman who can't give birth anymore in her life," said the Saudi lawyer and human rights activist Walid Abu al Khair, who is handling the woman's case. She requested anonymity for legal reasons.

Mr Abu al Khair said his client has had to endure 13 additional surgeries in unsuccessful attempts to fix the damages made by the doctor to her womb. The woman's case is one example of the increasingly public issue of medical malpractice, a problem legal activists and sections of the media have taken up, demanding an overhaul of the state's oversight system. The current system allows the ministry of health to handle all the medical malpractice claims against its doctors with little independent oversight or transparency.

"The problem in the Saudi legal system is that it allows every ministry, including the health, to handle claims against it in case of violations related to it and this gives the ministry of health the power to cover up for many mistakes done by medical practitioners," he added. "The ministry of health handles its cases through a legal committee it forms and this committee can't impose punishments on doctors other than financial fines," added Mr Abu al Khair. A final ruling on the case is expected later this month.

Reports on medical errors have become a daily front-page feature in Saudi newspapers. But the health minister, Abdullah al Rabeah, accused the media for sensationalising the problem and for focusing too much on malpractice cases that are eventually proved by the ministry to be false. On Sunday, Mr al Rabeah discussed the issue with the justice minister, Muhammad al Isa, and minister of culture and information, Abdulaziz Khoja, in a major government symposium on medical malpractice in Riyadh in response to the growing publicity surrounding the problem.

At the symposium, the health minister asked the media to be more responsible in reporting cases that involve medical errors as most of them turned out to be false after investigations. Mr al Rabeah told Al Watan daily on Sunday that the number of medical errors is relatively small. He said that his ministry received 1,356 medical errors claims in 2008 and only 650 of those were proved valid. Mr Abu al Khair explained that the number of cases was low because all the claims have to be handled in Riyadh by the health ministry itself. "Many people can't go to Riyadh to continue on with their claims and even if they did most of the time they will not have a fair hearing as the ministry's legal committee doesn't welcome the presence of lawyers with their defendants."

At the symposium, according to local media reports, Mr al Isa said rulings by the health ministry's legal committee are not final and they can be appealed in courts. A deputy minister of justice presented a report at the symposium that suggests rulings made by the medical errors legal committee of the health ministry were accurate because the committee is headed by top judges from his own ministry.

However, Mr al Isa said that courts have looked at many cases because rulings made by the health ministry's legal committee were thought to have given insufficient compensation. He has also joined the health minister in blaming the media for the poor accuracy in reporting local cases of medical errors. Abdulrahman al Hazzaa, the deputy minister for internal media at the ministry of culture and information, also was critical of the local media for their coverage of medical errors.

"There's a difference between a clear error like extracting a healthy kidney instead of one with a problem and surgery during which unexpected and unstoppable bleeding occurs." He told journalists who attended the event that the ministry does not intend to curtail journalistic freedoms, but at the same time it cannot allow false claims against doctors, the Jeddah-based paper reported. Mr al Hazzaa said that journalists must exercise responsibility in covering stories although he supported stories on medical personnel who make repeated mistakes.