Henny Maretta Silalahi (right), 37, and Rudianto Simanjorang, 47, visit the grave of their 4-month-old daughter, Tiara Deborah Simanjorang, at the Tegal Alur cemetery in Kalideres, West Jakarta, on Saturday (9/9). They are still unwilling to let go of their daughter, who possibly passed away because of delayed medical treatment at Mitra Keluarga Hospital in Kalideres, West Jakarta.
JAKARTA, KOMPAS – The Jakarta Health Agency has said that it had discovered two pieces of evidence indicating Mitra Keluarga Kalideres Hospital’s negligence in the death of baby Tiara Deborah Simanjorang on Sunday (3/9/2017). The conclusion was made after a 2.5-hour meeting involving the agency, the hospital, the West Jakarta Healthcare and Social Security Office (BPJS Kesehatan) and the Hospital Monitoring Agency (BPRS) on Monday (11/9).
First, communication between the hospitals’ information desk and the patient’s family was not maintained properly, as the hospital received the patient underan emergency condition. “First of all, the hospital did not know that the patient was a BPJS member. They only learned about it at 6 a.m.,” Jakarta Health Agency head Koesmedi Priharto told a press conference on Monday. This was despite the patient having been received by the hospital’s emergency room at 3:40 a.m.
Attending the press conference were Mitra Keluarga Kalideres Hospital director Fransisca Dewi, BPJS Kesehatan West Jakarta head Eddy Sulistijanto and BPRS Jakarta head Supriyantoro.
The meeting revealed that the Deborah’s family immediately processed the administrative requirements to pay for the pediatric intensive care unit (PICU). The family had become agitated, as they only had Rp 5 million (US$379.1) while the down payment for the PICU service was Rp 11 million, out of a total fee of Rp 19.8 million.
“This was a mistake. The hospital should have asked at the very start who would pay for the services. Apparently, the patient was a BPJS member. This information was not obtained from the beginning. If the patient is a BPJS member, all payments for emergency medical care, including PICU services, can be billed to the BPJS,” said Koesmedi.
The second incident of negligence, Koesmedi said, occurred when the hospital requested the patient’s family to find a referral hospital that partnered with BPJS. This should have been the hospital’s responsibility.
“The hospital tried to find a referral hospital using the telephone, but they also told the patient’s family to try finding one. This should have all been taken care of by the hospital,” Koesmedi said. Baby Deborah died before she could be taken to Koja General Hospital in North Jakarta.
Investigation team
Despite the findings, the Jakarta Health Agency said that it could not sanction the hospital, as the agency was still waiting for the investigation team to speak with Deborah’s family.
“The hospital management has promised to serve all patients properly. If another problem occurs, the hospital management has said that it will accept the revocation of its permit,” Koesmedi said.
He hoped that a similar incident would not reoccur in the future. In line with Health Minister’s Regulation No. 69/2014, all emergency room patients must be provided with emergency medical care.
“I hope such incidents will not happen again in Jakarta. We need to improve the system to ensure [it will not]. Even if a hospital is not a BPJS partner, it can send patient bills to the BPJS in emergency situations. This has not been properly socialized to private hospitals,” Koesmedi said.
Regarding the hospital’s follow-up measures, Mitra Keluarga Hospital director Fransisca Dewi said the hospital would conduct an internal audit.
“We will conduct a medical audit to prevent such incidents from happening again,” she said.
Separately, BPJS Kesehatan spokesperson Nopi Hidayat said that all hospitals should provide medical services to all patients arriving to the emergency room and stabilize their condition.
If the patients were BPJS Kesehatan members and the hospital was not a BPJS partner, then the hospital must refer the patient to another hospital that is a BPJS partner once the patient’s condition is stable. The hospital can then charge the emergency care bill to the BPJS.
