Aga Khan University Hospital has been fined KSh1 million by the Kenya Medical Practitioners and Dentists Council (KMPDC) over lapses in the care and management of a woman who died shortly after giving birth in August 2019.

The council’s Disciplinary and Ethics Committee found the hospital culpable for shortcomings in the treatment of the late Valarie Cherono Misoi, whose husband, Lawrence Oyaro, lodged a complaint alleging that inadequate medical care contributed to a hospital-acquired infection that ultimately caused her death.

In its determination in Disciplinary Case No. 70 of 2022, the committee ordered the hospital to pay the fine, review and update its medical protocols, strengthen compliance with maternal and perinatal death surveillance procedures, and enter mediation with the deceased’s family in an effort to reach an amicable settlement.

The council upheld the committee’s findings at a meeting in January 2026.

Hospital Ordered to Review Medical Procedures

The hospital was directed to demonstrate to the council that it had reviewed and updated its protocols to ensure compliance with emergency obstetric and neonatal care standards.

The revised protocols must also be communicated to hospital staff and medical contractors.

The committee further ordered the facility to implement, monitor and demonstrate compliance with Maternal and Perinatal Death Surveillance and Response (MPDSR) procedures, which are designed to identify and address factors contributing to maternal and perinatal deaths.

The hospital was also directed to enter mediation with Oyaro and report the outcome to the council within 90 days. The committee warned that failure to comply could lead to further regulatory action.

Husband Raises Concerns Over Wife’s Treatment

In his testimony before the committee, Oyaro said his wife had received antenatal care at the hospital under the supervision of Dr Mukaindo Mwaniki during her pregnancy in 2019.

He told the inquiry that the couple had been satisfied with the care she received during pregnancy, prompting them to choose the same facility for the delivery of their second child.

According to his testimony, Misoi experienced diarrhoea and abdominal pain during a hospital visit on August 18, 2019. She underwent investigations and was advised to return for a review. However, no further investigations were conducted at that stage to establish whether an infection was ongoing.

Oyaro said his wife went into labour on the evening of August 27, 2019, and delivered a baby girl through normal vaginal delivery in the early hours of August 28.

He was informed that she had sustained a tear during delivery, which was stitched and described to him as minor.

Misoi was subsequently discharged on August 29 after complaining of leg pain and undergoing investigations for a possible blood clot, according to the testimony recorded in the ruling.

The complaint centred on allegations that the hospital had failed to exercise reasonable care and skill in treating her, resulting in a hospital-acquired infection and her eventual death.

Doctor Explains Earlier Symptoms

During the inquiry, Dr Mwaniki confirmed that he examined Misoi on August 18, when she presented with diarrhoea, abdominal pain and an elevated heart rate.

He told the committee that her symptoms suggested a possible infection, but her condition was not considered an emergency requiring antibiotics before the culture results became available.

He said he collected a sample for investigation, counselled her on danger signs and advised her to return for a review within three days. According to his testimony, she did not return for the scheduled review.

The doctor also acknowledged that Misoi’s earlier symptoms, including gastrointestinal complaints and fatigue, could have warranted a closer assessment for a systemic infection, although no additional investigations were conducted during the subsequent antenatal visit.

He further confirmed that her haemoglobin level had fallen from 12.6 grams per decilitre in January 2019 to 11 grams in July and eight grams at readmission.

Dr Mwaniki told the committee that his involvement was limited to antenatal care and that he did not participate in the patient’s management during delivery, her initial discharge or her subsequent readmission.

Three Doctors Cleared, Another Admonished

While finding the hospital culpable for lapses in the patient’s care and management, the committee absolved Dr Nyawira, Dr Umar and Dr Obare, ruling that they had no case to answer.

Dr Gichuki was admonished for what the committee described as a lack of situational awareness and failure to consult senior team members promptly, contributing to delays in critical care management.

The findings followed an inquiry that considered the complaint, the patient’s medical records, autopsy and medical reports, statements from the parties, and evidence presented during the proceedings.

Family Seeks KSh100 Million Settlement

Separately, Githogori and Harrison Associates Advocates LLP, the law firm representing Oyaro, has proposed a KSh100 million settlement from the hospital over Misoi’s death.

In its settlement proposal, the firm sought KSh27.22 million in general damages for pain, loss and suffering, KSh53.46 million for lost years, KSh17.82 million for loss of dependency and KSh1.5 million in special damages.

The advocates argued that compensation should reflect the financial and emotional losses suffered by the family following Misoi’s death.

They noted that Misoi was 27 years old and earned a net monthly salary of KSh165,000 at the time of her death.

The firm also cited a separate judgment in Naila Gureshi v Aga Khan University Hospital, which it said involved an award of KSh157 million, in support of its assessment of damages.

The hospital’s advocates had earlier proposed KSh10,000 for pain and suffering, KSh10,000 for loss of expectation of life, KSh8.48 million for loss of dependency and KSh1.5 million in special damages.

The two sides’ proposals differ substantially, particularly regarding the amounts sought for loss of dependency and future earnings.

Mediation Ordered as Family Seeks Closure

Githogori and Harrison Associates Advocates LLP also expressed concern over delays in resolving the dispute, saying the family had waited six years for closure.

The firm urged the hospital to participate in mediation and compensation discussions within 60 days to avoid further litigation expenses.

However, the council’s determination directs the parties to pursue mediation and report the outcome within 90 days. The available documents do not establish whether a settlement has since been reached.

The regulatory findings concern the hospital’s professional and institutional responsibility. Any compensation payable to the family remains a separate matter to be resolved through mediation or the appropriate legal process.