13 MONTHS OF MISERY
WHAT should have been a small surgical procedure to correct a broken joint in the left ‘pinky’ finger of Shamiesha-Kaye Lewis has turned into 13 months of misery.
Lewis told the Jamaica Observer that last March she went on a hike where she fell and knocked the finger on a stone, which resulted in the damage unknown to her at the time.
“I went home and felt okay. It had a little tingling, but I didn’t think it was extreme. By the Sunday morning it was swollen, and on the Monday I went to my doctor and he ordered an X-ray which proved it was broken,” Lewis said.
“He recommended me to a private doctor which I could not afford, so I went back to him to get another referral and he sent me to the University Hospital of the West Indies (UHWI),” the Jamaica Observer employee went on.
Lewis said that although she took with her the initial X-rays, UHWI did its own examination to prove the finger was really broken and put it in a cast to see if it would get the bone back in order.
According to Lewis, when that did not work, she was scheduled for surgery.
“Based on the information I received from the private doctor that my doctor had recommended, he explained it was a short procedure where I would come in, do it, go home, rest up and go about my business. I am thinking [if] I go to the hospital with this said procedure it would work out just the same. After surgery I requested to be sent home, as I did not want to be admitted, and the doctor approved. I went home with instructions and medication,” she said.
But things quickly took an ugly turn as the following day, accompanied by pain, Lewis’s finger became discoloured. To make matters worse, when she returned to the hospital, she had to wait for nine hours in the clinic before she was seen.
“When I saw the doctor her initial reaction was: ‘Oh my God, what’s wrong with your finger?’ How I even saw her is because my mother had to get up and say ‘she is in too much pain’.
“She was as surprised as me when she saw it. Her first response was, ‘we’re not removing this finger’, and she consulted whom she needed to consult and it was decided that I would be admitted,” Lewis related.
“I was hospitalised for five days and on antibiotics, just being checked. That was it. Nobody was communicating with me. I was just lying in bed, being medicated, eating and getting fat. After insisting that it was just rubbish and I could medicate myself at home, I was given some information to say my finger is not in a good state and they are going to have to see me every day. Then it became every other day. They didn’t want me out in public knocking it on anything, causing any further damage. I was absent from work for 47 days,” she said.
By this time the flesh on Lewis’s finger appeared to be rotting and a plastic surgeon was called in to examine the finger to see what could be done.
This led to a meeting with a consultant plastic surgeon who advised her to amputate the finger as there was nothing else that could be done.
“The doctor who performed surgery is a resident; the plastic surgeon who came in initially was a resident and he had to call his consultant, set up an official meeting to look at it and discuss the way forward. When he looked at it he said ‘just cut off the finger’ as there was nothing he could do and can’t bring back the finger to a sense of normalcy, so just get rid of it. I decided I would not do that, and after the plastic surgeon was trying to weigh the pros and the cons, I said ‘No, I am not getting rid of the finger. I will stick it out just to see the end result. If it has to drop off, let it drop off by itself, but I am not giving you permission to remove it,’” Lewis related.
“I remember saying to the plastic surgeon that I had broken my elbow on the same left arm when I was around seven and there were no technical issues, and he said being younger your body heals faster than when you’re older. But I have colleagues older than me, twice my age, who have broken their fingers and toes and they are fine now. I am not hypertensive nor diabetic. I am in good health, I don’t drink or smoke, so what’s the issue with my finger getting to this point?
“They had even suggested that the bandage was wrapped too tight and it cut circulation, which caused the finger to get so bad. Thereafter I was still absent from work and still going for my every other day visit, until I insisted I needed to get back to work and my every other day visits became once a week visits,” she said.
“After a few weeks had passed, the resident who had performed the surgery informed me she would no longer be seeing me as every six months they rotate, so I’ll be seeing a different set of doctors. Where does that lead me? I would still have to come for visits just to be medicated. At one point she instructed me to start cleaning the wound myself and she showed me how to do it and I had to purchase my own supplies, but she started me off with a few supplies. However, when I went to the hospital to get prescriptions or get cleaning done I would have to pay for that,” Lewis explained.
“After seeing different residents in training, there was one who read through the file and saw where I was not entertaining the thought of an amputation and said to me there is nothing else that can be done because of the state the finger was in. There is an infection and in order to control it they have to cut off the finger. She never said it outright, but that’s what I got from it.
“At this point she scheduled me for a three-month visit and gave me a piece of paper to go to a lab to do a blood test to see where the infection is at. She said, ‘pick it up a week before your monthly visit in November’ to see the extent of the infection and if there were any complications before or [if] I changed my mind about the amputation, I was to come in. I decided I was not going back to any hospital or spend any more money,” Lewis said.
Now, Lewis’s pinky finger is about a quarter the size of what it was originally. Claiming medical negligence, Lewis has approached other doctors. But even though she received a second opinion from one Montego Bay-based physician, he is unwilling to testify if she pursues legal action.
“He hinted at a case of medical negligence even though he said he will not testify. He said after seeing my case, he has seen three other persons with similar injuries from the same hospital so he knows something is wrong. He also went to the point where he was examining the finger and scrutinising the X-rays and he kept asking if I was sure a surgery was done as the joint has still not been mended.
“I can safely tell you I was awake for the three-and-a-half hours and I knew what took place. The resident was in theatre with me and probably another trainee sitting beside her, and she had persons who she was throwing out instructions to say fetch this, fetch that, move this, move that. So it’s like the trainee was training somebody. There was not a consultant there to oversee what she was doing. I can tell you this because I was awake for the entire three-and-a-half hours,” Lewis insisted.
“Pretty much, this is what is there now. I wouldn’t even call it a finger,” she said, showing the finger.
Further, Lewis said the Montego Bay doctor openly questioned why the operation was done through the fleshy part of the finger, when the injury existed at the top in the joint.
“When I received the injury I did not have a cut nor bruise. It was only swollen and red the joint was broken. They made an incision and it deteriorated and resulted in this. He said them going in the flesh is the biggest mistake as the tendons, muscle strings and all the important things are there, plus they should have just operated at the top where the injury was,” Lewis said.
Plus, according to Lewis, the Montego Bay doctor said that there is no infection, as UHWI had previously reported.
“They had said to me, ‘you have an infection, and if it is not controlled it will spread to the hand and if it goes to the arm you will have to remove the entire arm’. To date I have seen improvement. He went to the point where he got a book and pointed out several articles to say look for this, look for that, [and] explained what to expect. Looking at the screen on the X-rays, there was nothing to show signs of infection,” she explained.
In addition to a second opinion, Lewis had done physiotherapy, but said she eventually stopped as each session she attended the physiotherapist had a confused look, as the tendon which controls movement was damaged; therefore, trying to restore movement was pointless.
Lewis even shared that she questioned her own self during the ordeal and the doctor who performed the surgery questioned her actions, but she said, “the pain I was in, I couldn’t do anything but lay down and cry”.
“The trauma I have been through is surreal. I cried day in, day out. Just the thought of being born with 10 fingers and at this point in my prime, at 28 years old, I am probably going to lose one because of a hospital’s fault? Leaving the hospital to come to work I’d be in tears. The medication was taking a toll on me. I was on antibiotics from March to about September. It drained me. I often say if I had paid the $301,000 the private doctor was charging I would still have a functional finger. I think I probably spent more than he was charging me,” she said.
Now Lewis said functionality has been restored in the hand but not the finger. However, she is unable to do simple tasks like washing items of clothing and has to depend on her mother for help.
“I cannot live my life depending on someone as they may not always be around. There was a point I couldn’t stick my hand in my pocket, I couldn’t stick my hand in my bag for fear it would get damaged. I had to acquire a stress ball. Even now and again it’s numb and it hurts. I can’t even make a fist. These days I have to get the stress ball and work out my hand to bring back some life to it. When I am sleeping I have to sleep with it off so I don’t hurt it,” she said.
Looking ahead, Lewis intends to take legal action and hopes more people with similar stories will come forward.
“I have approached lawyers, but though I don’t know how I will afford it, it is a fight I am willing to take up,” Lewis stated.
When the Sunday Observer contacted Dr Carl Bruce, senior director of clinical services at the hospital, he said that the CEO’s office would be the section that would handle the matter if Lewis sues.
Dr Bruce, however, explained that Lewis would have to report the matter, request a medical report, and from there the hospital would have to see if her claims are true.
Additionally, Kevin Allen, CEO of the hospital, said that he is inviting Lewis to come forward, make a formal report and request a medical report, which will be prepared and the necessary steps taken from there.
“If negligence is found, our lawyers take it from there. She has recourse. It is not an adversarial thing, but there are procedures. We are willing to facilitate a review and prepare the medical,” he said.
Health Minister Dr Christopher Tufton said Lewis can also lodge a complaint with the Ministry of Health in a letter asking for an investigation, and he would ask for it to be done.