Little Hamdi’s missing kidney still a mystery

Recent protest held in front of the Health Ministry demanding justice for little Hamdi. 
Pic by Pradeep Dilrukshana

On December 24, 2022 three-year-old Hamdi Fazleem underwent a kidney surgery at the Lady Ridgeway Hospital following a diagnosis which confirmed that his left kidney was malfunctioning. His parents placed their trust on doctors who affirmed that little Hamdi could lead a normal life with his normally functioning right kidney and that it would be advisable to remove his left kidney. After many tests, scan reports and medical investigations, the doctors performed the surgery on little Hamdi. But a few days after the surgery, the nurses observed that little Hamdi wasn’t passing urine and they later realised that the child’s right kidney was also ‘missing’. Seven months later, little Hamdi died, but his parents haven’t given up their fight to seek justice for their baby’s untimely demise. 

The fatal kidney surgery

Nine months after his birth, little Hamdi Fazleem had developed complications in his urinary system after which he was referred to a doctor at the Lady Ridgeway Hospital. After conducting several scans and tests the doctors had diagnosed that little Hamdi’s left kidney was malfunctioning and had recommended its removal. “The doctors conducted several scans to determine what had happened to my son’s kidneys,” said Fathima Risana, mother of the deceased child. “They performed several urine and blood tests and several scans before coming to this conclusion. The doctors even conducted an endoscopy to see if my son’s urine is being filtered. It was only after these scans that they determined that my son’s poorly functioning kidney (left kidney) should be removed. They said that since it isn’t functioning well it would block his urinary system leading to infections and that it would cause severe health complications in future. They further claimed that my son had been living with his right kidney and that it was functioning normally. We even asked whether removing this kidney would pose a threat to my son and he affirmed that they had done similar surgeries before and that a person can live with one kidney,” said Risana. 

Complications post-surgery 

The surgery was conducted on December 24, 2022 following which little Hamdi was admitted to the ICU. Rizana recalled how her baby’s body had swollen when she went to see him the following day. “I asked the nurse whether she could see any changes in my son and she responded in the negative. However she said that my son isn’t passing urine and that it needs to be checked. She said that the doctor had been informed and that he would come and check. While in the ICU they did another scan and they said that the right kidney cannot be seen. Then my son was taken to the main scan room and I overheard them saying that both kidneys aren’t there. Then we consulted another nephrologist who said that a CT scan needs to be done in addition to a dimercaptosuccinic acid scan (DSMA) – a diagnostic imaging tests that evaluates the function and structure of kidneys. They said that the reports of this test needs to be sent to India and that the results would be obtained in two days. He said that till then they will have to perform hemodialysis by inserting a tube to my son’s neck area. They said that it is difficult for children unlike adults but that they are doing everything possible to ensure that my son recovers fast,” she added. 

A period of neglect

Thereafter Hamdi was transferred to the ward overseen by Dr. Naveen Wijekoon who also conducted the surgery on Hamdi. “Three days later they performed a DSMA test and two days afterwards they performed a CT scan as well. After that he claimed that the doctors who performed the scan were talking about this baby and that he didn’t have both the kidneys. He also said that in that case a kidney transplant could be done in three months and that he could live a normal life. The doctors said that until then my son will have to live on dialysis.

“But after this conversation these doctors never came back and checked on my son,” said Mohamed Nizar Mohamed Fazleem, Hamdi’s father. “For seven months my son stayed in that ward. They inserted tubes to both sides of his neck, chest, stomach and leg. They accepted the fact that both kidneys were taken out and they promised to do a transplant within three months. They said that they are on the lookout for potential donors and asked us to check as well. We sought donors but the doctors never helped us. We placed our trust in the senior doctor who handled my son’s case and we never thought that my son would have to face his fate. I could never get an appointment to talk to him at Lady Ridgeway Hospital and subsequently I placed an appointment to meet him at his private practice. I told him that my son is suffering. There were multiple infections in his body. He said that they have informed various parties to look for donors. But I complained that they never even came to see my son’s condition after he was transferred to the ward,” Fazleem added.

Mounting contradictions 

While the parents were dealing with the trauma, the doctors had given an explanation to the effect that little Hamdi was born with a horseshoe kidney and that it is a rare instance. This had raised suspicions further. “Following the surgery the doctors gave an explanation to the effect that my son was born with a horseshoe kidney,” Rizana continued. “But none of the scans indicated this. How can we believe them when they say that they saw it once they performed the surgery? Why didn’t any of the scan reports indicate it prior to the surgery? In any case they could have shown it to us. They said that it is a rare instance and that the chance of a person being born with a horseshoe kidney is 1000:1. Then it’s a special case and they could certainly show it to the parents. When we questioned where my son’s kidneys were they claimed that it’s in the lab,” she added. 

Seven months after fighting for his life, little Hamdi breathed his last on July 28, 2023. The parents had to endure a lot of suffering during this period. They recalled how the nurses would take blood from his body every three days, how he was only allowed to drink 250 ml of water and how he was living in a comatose state during the latter stages prior to his death. “My son used to play in front of me and all of a sudden he was laying lifeless, in a battle between life and death. How much sorrow and pain could a mother bare” Rizana questioned. 

Testimonies before courts 

Following the death of little Hamdi a magisterial inquiry was launched to determine the cause of death as his parents suspected the incident. It was later reported that the doctor who performed the surgery, Dr. Naveen Wijekoon had fled the country. During this time, Lady Ridgeway Hospital Director G. Wijesuriya held a media briefing in which he said that the other kidney had also gone bad because both kidneys were interlinked. He further said that he had requested the deputy director of the hospital to conduct an investigation. 

The Colombo Additional Magistrate Rajindra Jayasooriya ordered the Borella Police to conduct further investigations based on the medical reports and evidence presented. The Additional Magistrate pointed out that despite medical claims that the child’s kidneys were located abnormally, medical reports have evidenced the fact that they were, in fact, located anatomically right, and thus called for a comprehensive investigation in this regard. 

The Judicial Medical Officer’s report on the other hand also indicated further contradictions and obscurities. Submissions made by Attorney-at-Law and Medical Practitioner Dr. Y.L.M. Yoosuf in court pointed out that the JMO report submitted by Dr. Nurul Haq indicated that the ‘child was born with one kidney’, raising concerns regarding its ambiguity. Dr. Yoosuf stated that after the operation, only the left kidney was made available for inspection by the parents, while the right kidney was not shown to them and had inexplicably disappeared. 

Thereafter, the Magistrate issued an order for the police to conduct an impartial inquiry based on all documents and evidence presented, without solely relying on the JMO’s report.

Giving evidence before Colombo Additional Magistrate Rajindra Jayasooriya, senior Lecturer of Colombo Medical College and Consultant Paediatric Nephrologist Dr. Malik Samarasinghe asserted that all the scan tests and other tests conducted by Consultant Radiologist Dr.  Gerard Fernando at Asiri Surgical Hospital and at the Lady Ridgeway Hospital had confirmed that both kidneys of little Hamdi were positioned in the proper places and the right kidney functioned in the normal way.

He also said that according to the tests and other investigations carried out, it had been indicated that the right kidney of Hamdi functioned in a normal way and it was in normal size. However the doctor further said that Hamdi’s left kidney was malfunctioning and was also more inflamed than the normal size. He also said according to the tests, while the right kidney functioned up to 91% the left kidney functioned only up to 9%. 

Lady Ridgeway Hospital’s Deputy Director Dr. Santhusitha Senapathi providing his testimony before the Colombo Chief Magistrate Court affirmed that the doctors who performed the surgery on little Hamdi carried out the procedures with utmost dedication and sincerity. He said that the surgical team worked with limited resources at their disposal and the right kidney may have been attached to the left kidney leading it to be unknowingly removed along with the left kidney during the procedure. He also claimed that the two doctors including Dr. Naveen Wijekoon who treated Hamdi and later migrated to a foreign country had intended to leave Sri Lanka before the surgery was conducted on the child.

In October 2024, Colombo Additional Magistrate Harshana Kekunawela ordered the arrest of the doctor who performed kidney surgery on a three-year-old child at the Lady Ridgeway Hospital, should the ongoing police investigation uncover evidence of a crime. Even though Dr. Wijekoon was expected to testify via Skype from Australia the CID had informed court that the surgeon has not responded to any summons and appeared to be avoiding his obligation to testify. 

Following the incident, the Sri Lanka Medical Council suspended Dr. Haq’s registration number for eight months with effect from December 20, 2022. 

Parents continue their fight for justice 

Hamdi’s parents recently staged a protest in front of the Health Ministry in a bid to seek justice for their deceased child. “As a family we suffered a lot. We are fighting for justice because we don’t want to see any other parent going through a similar situation. We want to know what happened to our child’s right kidney. At the beginning they said that my son has two kidneys and that he could live with one. They said that all this while he had been living with one kidney and that it’s normal. We have done numerous scans to ensure that my son has two kidneys. They said they would determine a surgery depending on scan reports. Then why didn’t they tell us that my son has a horseshoe kidney? We demand maximum punishment for the doctors who are found guilty of this wrongdoing. In fact their titles should be revoked and suspended from service,” Fazleem demanded. 

The Daily Mirror learned that Hamdi’s cause of death had not been determined, one and a half years after the child’s death. The case will be summoned on February 11, 2025.