Health Ministry's case review on the death of 10-year old COVID-19 patient, Fathimath Mishka Ali has brought to light several acts of negligence in handling the case.
Fathimath Mishka Mohamed was in quarantine with her family after testing positive for COVID-19 and was doing well. According to the family, Mishka's condition started deteriorating on Tuesday night, and the family called for an ambulance around 9:00 pm. However, the ambulance arrived almost 3 hours later around 11:40 pm and Mishka was not conscious by the time she was finally taken to the hospital. She passed away in IGMH's ER at 12:10 am, making her the Maldives' youngest COVID-19 victim to date.
The report on the Health Emergency Operation Centre (HEOC)'s handling of the case said Mishka tested positive for COVID-19 on May 30. As per protocol, Mishka's family was asked if a doctor's consultation was needed and the family had said they require consultation. However, the consultation was not arranged.
According to COVID-19 protocols, if any child under the age of 15 tests positive for COVID-19, HEOC's Care Cluster must make regular phone calls to check on their condition. However, no calls were received for two days.
The Health Ministry's report said the patient's family informed the Health Protection Agency's call center that Mishka's fever was getting worse and that she was unable to eat anything on the afternoon of May 31. The call was made at 2:20 pm. The complaint was added to the call centers' 'OB' system and a ticket was raised.
Based on the information provided by the patient's family, a DMRT doctor called the family at 3:53 pm to provide a general consultation. The doctor recommended to continue using the same medication the family had been using and to contact HPA again if her condition did not improve.
When Mishka's condition worsened later the same night, her parents called the call center once again and informed they felt her condition was deteriorating. They relayed that Mishka was having trouble breathing and was flapping her arms about. They said they wished to see a doctor immediately. The information was updated on the OB system once again and a ticket was raised.
A DMRT doctor attempted to call the family following the information, but the doctor was unable to reach the family, the report said. However, Mishka's parents called the call center at 10:06 pm when they missed the call, and again updated that the girl was having trouble breathing. Although an update on Mishka's condition was given when the doctor called back, no request for ambulance deployment had been made by the call center even by 10:39 pm, the report said.
Mishka's parents called the call center five times between 11:16 pm and 11:33 pm. During one of these calls, the parents informed that the child had lost consciousness and that she was bleeding from her ears. Although the call center assured that an ambulance would be sent to fetch Mishka, no ambulance reached their residence, and there were significant delays, said Mishka's parents. The report said ambulance deployment had not been activated despite the call center informing that a vehicle was on the way.
A family member went to the HEOC operation center at Dharubaaruge to personally inform that no ambulance had arrived to fetch Mishka at around 11:27 pm. It was after this that the HEOC's facility management cluster informed EMS to deploy an ambulance. The time was 11:32 pm when the order was activated. The ambulance reached Mishka's residence by 11:38 pm. By that time, Mishka was unresponsive, and CPR was administered. The ambulance reached state-run IGMH's ER at 11:42 pm.
The Health Ministry said the protocols followed on the night of Mishka's death were not in line with the guidelines for emergency response. Ambulance deployment was not triggered according to protocol, and 2 hours and 26 minutes passed before the trigger was activated, the report said.
Health Ministry said steps are being taken to avoid such a situation in the future.