Health care in Mpumalanga suffers another blow

MBOMBELA – A new disaster has hit Rob Ferreira Hospital with all major orthopaedic operations coming to an abrupt halt.

None have been performed over the past two months due to problems with the procurement of orthopaedic material. Some patients could face permanent disability and the loss of life is also a possibility.

Also read: More than 2 000 patients waiting on orthopaedic surgery

The awarding of tenders to suppliers has been stalled for months now and the department has requested a deviation from normal procurement procedures to get things back to normal.

No fractured thigh bones could be repaired with femur nails in Rob Ferreira for the last three months because the necessary material is not in stock. In this hospital alone, 15 patients are currently awaiting these surgeries.

Lowvelder was informed about the situation by a whistle-blower who said for many years, orthopaedic surgeons in government hospitals in Mpumalanga had been able to use implants from a variety of companies. “The advantage of this is that the surgeon can choose the best implant from each company for each specific kind of operation.”

Also read: Man fears he may have to wait months for operation

The regular stockists included Synthes, Smith & Nephew, Zimmer and Stryker. “These companies are well known worldwide for orthopaedic implants and are used extensively throughout South Africa in government hospitals because they are well regarded for the quality. Most of them are established companies and stock a variety of implants and an adequate number of trained theatre technicians who are available to advise surgeons during operations. But it all changed two months ago when the orthopaedic department at Rob Ferreira Hospital was informed that all orthopaedic implants in the future had to be ordered from Clinipro.

“Doctors working in orthopaedic surgery know who the main suppliers of implants are and were concerned because they had never heard of Clinipro,” the source said.

Problems encountered with the awarding of tenders
On September 3 an internal departmental letter sent by chief financial officer, Mr CB Mnisi to acting HOD, Dr Savera Mohangi stated that the department had advertised an open bid for the supply and delivery of the material, but that it couldn’t be finalised due to technical problems and had to be re-advertised.

Shockingly, the letter further read that, “The process of re-advertisement and award will take at least four to six months and therefore, patients who require these orthopaedic implants and material will have to wait for a very long period before they are assisted.

“This poses a very big risk because some injuries are so severe that they can lead to loss of life.”

Spokesman for the department, Mr Dumisani Malamule was asked what they meant with “technical difficulties” and he replied: “The department wasn’t happy with the level of compliance with the treasury regulation that governs supply chain in government.”

Mnisi recommended that the bid be awarded to Specmed Medical Services, Professional Orthopaedics, Safarmex and Clinipro. He further recommended that the bid be on a month-to-month basis until the tender for implants is awarded.

Also read: Rob Ferreira Hospital: interns say they work without supervision

Lowvelder wanted to know why Stryker, Zimmer, Smith & Nephew and Synthes weren’t used for the service any longer. “The tender was advertised on December 12 last year and closed a month later. Only Stryker tendered with Specmed, Professional Orthopaedics, Safermex and Clinipro,” Malamule said.

Yet Lowvelder‘s source was adamant that he had consulted with representatives of the old suppliers, who claimed that they had been told stories about deadlines having passed. This publication’s own attempts to reach representatives of the said companies were unsuccessful.

Further complications
Whether Clinipro could render the service was also questioned by the source and an internal letter from the department also voiced a concern: “It should be noted that none of the above recommended bidders have all the required orthopaedic implants and material and therefore it is clear that each service provider will only be required to supply the orthopaedic implants and material that they have given prices for.”

A grave concern raised was that some of the companies were unknown and didn’t even have websites. According to the source, sales representatives from these companies have come to the hospitals to demonstrate the items and not all doctors agreed on the quality of the products. Many of them came from manufacturers in third-world countries like India, China, and Brazil.

Malamule refuted the allegations at first and said the so-called inferior quality hadn’t been brought to the attention of the department but later said orthopaedic specialists was consulted on the quality of the products.

With regard to femur nails being fitted, the source added that at least five of these procedures had to be performed per week under normal circumstances. Malamule said the 15 patients in Rob Ferreira have been waiting for “less than four weeks”. The operations will apparently be done in October.

• Lowvelder reported earlier this year that in 2014/15, 202 cases of medical negligence were registered against the department. Of these, 114 were because of alleged injuries sustained during patients’ stays in state hospitals. The rest of the claims involved obstetrics and orthopaedic surgery. Twenty-nine of these patients were treated at Tintswalo Hospital, 18 at Themba and 16 at Rob Ferreira. Claims ranged from R85 000 to R21 million.

Also read: Claims of medical negligence paints bleak picture of alleged incompetence