INDONESIA: Police fails to finish investigation into a boy’s death due to wrong medicine prescription

ASIAN HUMAN RIGHTS COMMISSION - URGENT APPEALS PROGRAMME

Urgent Appeal Case: UA-282-2007
ISSUES: Child rights, Right to health,

Dear friends,

The Asian Human Rights Commission (AHRC) writes to inform you regarding the failure by police in West Pasaman Resort Police to carry out an investigation into the death of a two-year-old boy who died from incorrectly prescribed medicine. Despite existing legal requirements that they could demand the post mortem report to carry on their investigation, they instead halted it mainly because of the hospital’s refusal to cooperate to provide the report.

CASE DETAILS: (According to the information received from Padang Legal Aid Institute (LBH Padang)

On 1 February 2007, two-year-old boy Reihan Rifki Prananda became feverish. The following day his mother, Maimurni (42), took him to a doctor, Dr. Ishlahuddin, whose clinic was located near their house. Dr. Ishlahuddin had a billboard advertising that he was a doctor outside his clinic but he did not provide his license number on it.

Nevertheless, the boy’s mother allowed him to examine her son. During the medical examination, the doctor diagnosed him as suffering from ordinary fever. Shortly after the medical check up, Dr. Ishlahuddin prescribed medicines good for a week. They were: 1boxes each of liquid medicine Yusimox and Novagesic and some home made medicine.

One week later, numerous blisters had emerged all over the boy’s skin and his body. On February 16, his mother too him back to Dr. Ishlahuddin to inquire as to why he had blisters. He, however, told the boy’s mother: “It commonly happens. The medicine was reacting and [there was] no problem at all”. Once again, he prescribed another medicine for the boy. This time he gave 1 bottle of liquid medicine Omemox, 1 powder medicine Caladine and home made medicines.

After the boy consumed all the medicines prescribed to him by his doctor, the blisters and red spots persisted. On February 18, his parents decided to take him to a government regional hospital, the Jambak Regional Hospital in West Pasaman. There he was confined for only two hours before he was transferred to another government hospital, M. Jamil Hospital. His parents were never given a proper explanation as to why their son was being transferred to another hospital.

After arriving at the said hospital, they put him on dextrose confined him for the next five days. On the fifth day, February 22, the boy asked for drinking water from his father, Jamaluluddin (47), who was attending him in the hospital. Jamaluluddin consulted a doctor who was on a night shift duty at the time first whether he could serve water to his son. He was told he could  give his son water. However, when he gave the child some water his stomach became bloated shortly after drinking it. The doctor immediately instructed Jamaluddin to produce a medical tool quickly to be used in siphoning the water from his son’s stomach. Jamaluluddin had to hurriedly go out of the hospital to purchase the tool the doctor was asking for. However, when he returned with the tool his son was already dead.

Prior to the boy’s death, medical laboratory findings performed by the M. Jamil Hospital on the boy indicated that his blood samples were sterile and that they have not seen any infections. The blood samples were taken by Doctor Cholina of the same hospital. The report, which was released on February 25, was signed by Dr. A. Aziz Djamal.

Due to their son’s suspicious death, Jamaluddin and his wife Maimurni filed a complaint requesting an investigation with the West Pasaman Resort Police on March 7. The case, however, have not shown any substantial progress since then. On June 23, although Police Commissioner Wisnu, chief of the Criminal Investigation Division in West Sumatera Regional Police, was properly informed of this case and had promised he would instruct the West Pasaman Resort Police to take action, yet no progress has so far taken place yet.

On July 24, another Police Commissioner, Bambang Suharyono, chief of the Criminal Investigation Division in West Pasaman Resort Police, issued a report regarding the progress of their investigation but it contained no substantial progress at all. On August 14, they once again issued another report but it contained the information as the previous report. They mentioned having investigated a doctor who wrongly prescribed medicines and interviewed many witnesses, but no actions were taken against him. The police then halted the investigation of the case because M. Jamil Hospital refused to cooperate and to issue the post mortem report.

ADDITIONAL COMMENTS:

The West Pasaman Resort Police should take further action into investigating this case instead of halting it due to the hospital’s refusal to cooperate. The hospital’s refusal to release the post mortem report, which could have helped in determining the victim’s cause of death, is unacceptable. A government hospital refusing to cooperation in investigation arbitrarily denies and obstruct the course of investigation that could have determined who would be held responsible for the boy’s death.

Under Article 222 of the Indonesian Penal Code, it clearly stipulates that any person who deliberately prevents, obstructs or frustrates a judicial post-mortem examination could be held liable and [should] be punished for nine months maximum imprisonment. Article 359 also provides that any person whose negligence resulted to the death of another person shall be held accountable and punished with five years maximum imprisonment. The Code of Ethics of Indonesian Doctor Association also stipulates that post mortem report should contain factual information and it should be made readily available, particular for investigation.

For refusing to provide the post mortem report to the police, the M. Jamil Hospital has likewise seriously violated the Code of Ethics which requires doctors to cooperate for purposes of investigation with the police and that they are required issue medical reports once the police, or prosecutor requires them to do so. It is also the utmost responsibility by them as a government hospital to ensure this is done.

However, the police have instead continuously failed to carry and on their investigation despite this legal requirement. They also were unable to take immediate action, as mentioned in their two separate progress reports, against Dr. Ishlahuddin for wrongly prescribing medicines to the boy which resulted to his death.

Deaths of patients resulting from medical negligence and malpractice commonly take place in Indonesia. However, once a patient is given wrong medical treatment by doctors or given improper treatment by the hospital, they do file a report with the police for investigation, but they had little expectation it would progress in court at all. What the victim’s families are doing is instead to file a civil case demanding for compensation from the hospital. This, however, in effect exonerates them from being held accountable for criminally acts; for instance for death of patients and negligence in carrying out their duties. The hospital in most cases refuses to cooperate with the police investigations particularly when it requires them to produce medical reports and documents, in connection to complaints filed on them.

SUGGESTED ACTION:
Please write letters to the authorities listed below expressing your grave concern in this case. The police must be held accountable should they continuously fail to complete their investigation into the death of the boy. Those responsible for the victim’s death must be held accountable and charged without further delay. The government hospital refusing to release medical report must also be investigated and sanctioned accordingly.

To support this case, please click here: SEND APPEAL LETTER

SAMPLE LETTER

Dear __________,

INDONESIA: Police fails to finish its investigation into a boy’s death due to wrong medicine prescription

Name of the victim: Reihan Rifki Prananda, 2 years old, a resident of Padang City
Name of the doctor and hospital attending him: Doctor Ishlahuddin and M. Jamil Hospital, Padang respectively
Name of police unit who fails to complete its investigation: West Pasaman Resort Police
Date of incident: From 2 to 22 February 2007

I am writing to voice my deep concern regarding the police?continued failure to complete its investigation into the death of a two-year-old boy, Reihan, due to wrong prescription of medicines by his doctor in Padang City, West Sumatera. He was first diagnosed to have acquired normal fever, but the medicines prescribed to him by his doctor, Ishlahuddin, caused blisters all over his skin and body which resulted to his death.

I am disappointed by the police’ action to halt its investigation for reasons that the hospital, M. Jamil Hospital where the boy died, refused to cooperate in the investigation and to produced to the post mortem report. The hospital’s refusal and failure by the police to take action despite having legal requirement of doing so is completely unacceptable. The act itself constitutes violation of Article 222 of the Penal Code of Indonesia which imposes punishment to persons preventing or obstructing judicial post mortem examination. The Code of Ethics of the Indonesian Association of Doctors also requires doctors to cooperate in any investigation and to produce documents necessary for the case being investigated.

It is disappointing that the police, despite having legal requirement to demand from the hospital in producing the medical documents necessary for their investigation, they instead have chosen not doing it so. I completely reject the police’ actions and the manner they are investigating this case. As you are fully aware, post mortem report is necessary for investigation and failure to secure this would have tremendous consequence into the case—as it is already happening. The failure by the police to file appropriate charges against the doctor responsible wrongly prescribing medicines to the boy and for excusing themselves from completing its investigation due to the hospital’s refusal to cooperate is completely unacceptable. The police themselves must also be investigated as to why they have continuously failed to comply with the legal requirement and to promptly complete their investigation.

I also reject the practice by the government’s central hospital, the M. Jamil Hospital, for not having been fully prepared on handling patients admitted to them. At the time the boy needs to be treated with urgency; his father has to purchase medical tools as they did not have sufficient medical tools ready on emergency cases. This must be adequately addressed by the government without delay. Treatment of patients requires competence and preparedness as this involves human lives. The government hospital, however, fell short of what is expected from them by their patients as in this case.

Under the Indonesian Penal Code Article 359, any person whose negligence resulted to the death of another person could be held liable and shall be punished with five years maximum imprisonment. However, I have learned that Dr. Ishlahuddin has not been charged or held to account yet for this offense, nor the hospital where the boy died for not being fully prepared by having necessary medical equipment in cases of emergency.

The refusal by the hospital to produce the post mortem report also violates the Code of Ethics of Indonesian Doctors Association, which requires them to issue medical reports to the police investigators or prosecutors necessary for their inquiry should it be requested from them. This was not complied with and observed in this case. I am gravely concerned of the hospital action obstructing the investigation by the police. The report is necessary for the police to carry on their investigation and in order to hold those responsible for the boy’s death. By preventing and obstructing the process of investigation the hospital is blatantly violating Article 222 of the Penal Code.

I urge you to initiate legal action against the doctor and others that are found responsible for the boy’s death. They must be charged promptly and held to account. The government must also ensure that the victim’s family is given adequate compensation as well.

I am aware that this is yet another case of death of patient resulting from negligent practice by doctors and hospitals. I therefore urge the government to take appropriate action concerning this matter. It must strictly implement laws and policies concerning public health and ensure that doctors and hospital particularly those manage by the government are held to account should there be negligence on their part. Police investigation must be completed promptly and that it must ensure legal remedies are obtained by the victims.

I look forward to your prompt and effective response in this matter.

Yours sincerely,

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PLEASE SEND YOUR LETTERS TO:

1. Mr. Susilo Bambang Yudoyono
President
Republic of Indonesia
Presidential Palace
Jl. Medan Merdeka Utara
Jakarta Pusat 10010
INDONESIA
Tel: + 62 21 3845627 ext 1003
Fax: + 62 21 231 41 38 / 345 2685 / 345 7782

2. Mr. Hendarman Supandji
Attorney General
Kejaksaan Agung RI
Jl. Sultan Hasanuddin No. 1
Jakarta Selatan
INDONESIA
Tel: + 62 21 722 1337 / 739 7602
Fax: + 62 21 725 0213

3. Gen. Sutanto
Chief of National Police
Jl. Trunojoyo No. 3
Jakarta Selatan
INDONESIA
Tel: +62 21 721 8012
Fax: +62 21 720 7277

4. Ms. Siti Fadilah Supari
Ministry of Health
Jl. H.R. Rasuna Said
Blok X 5 Kav. 4-9 Blok A
Jakarta 12950
INDONESIA
Tel: +62 21 5201590
Fax: +62 21 520 1591

5. Mr. Ifdhal Kasim
Chairperson
KOMNAS HAM (National Human Rights Commission)
Jl. Latuharhary No. 4B Menteng 
Jakarta Pusat 10310
INDONESIA
Tel: +62 21 3925230
Fax: +62 21 3151042 / 392 5227

6. Brigadier General Police Utjin Sudiana Djamhari
Chief of West Sumatera Regional Police
Jalan Jenderal Sudirman No 55, Padang
INDONESIA
Tel. No.: + 62 751 38565 
Fax: +62 751 34410

7. Mahavira Zen
Chief of West Pasaman Resort Police
Jalan Bhineka Tunggal Ika No 60, Simpang Empat
INDONESIA
Tel. No.: +62 753 65110 
Fax: +62 753 65110

8. Mr. Paul Hunt
Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health 
OHCHR-UNOG
1211 Geneva 10, 
SWITZERLAND 
Fax: +41 22 917 90 06
E-mail: urgent-action@ohchr.org (ATTN: SPECIAL RAPPORTEUR ON THE RIGHT OF EVERYONE TO THE ENJOYMENT OF THE HIGHEST ATTAINABLE STANDARD OF PHYSICAL AND MENTAL HEALTH)

Thank you.
Urgent Appeals Programme 
Asian Human Rights Commission (ua@ahrchk.org)

Document Type : Urgent Appeal Case
Document ID : UA-282-2007
Countries : Indonesia,
Issues : Child rights, Right to health,