Doctors call for probe into baby's death after ambulance approval delay
10-month-old grandson, also named James Muiruri after him, died at Igegania Level Four Hospital in Gatundu North, Kiambu County.
The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) has called for criminal investigations into the death of an 11-month-old baby.
The union alleges that administrative negligence by Kiambu County's health chief contributed to the death.
In a letter to the Director of Criminal Investigations (DCI) dated August 18, 2025, the union accused Dr Elias Maina, Kiambu County CEC-Health, of obstructing life-saving medical care that could have saved the infant’s life.
Baby James Muiruri (JM) died at 5:45pm on May 27, 2025, at Igegania Level 4 Hospital after county officials allegedly delayed the approval of an ambulance to facilitate an urgent referral, despite repeated pleas from physicians.
The infant was taken to the hospital with severe pneumonia on the morning of May 27.
Dr Josephine Njoki, the attending physician, determined that the baby required immediate transfer to a higher-level facility with paediatric and critical care capacity.
However, when arrangements were made to transfer the baby to Maragua Level 4 Hospital in Murang'a County, the County Call Centre informed the nursing services manager that an ambulance could not leave Kiambu without Dr Maina's pre-authorisation.
Dr Maina was not in his office. Unfortunately, his junior colleagues could not grant the life-saving approval without his permission.
Medical evidence
In a show-cause letter to county health officials dated June 11, 2025, Dr Njoki detailed the baby's critical condition upon arrival. The infant was unconscious with an AVPU score of U, displaying severe symptoms including grunting, lower chest wall in-drawing, cold extremities, and delayed capillary refill.
The vital signs painted a grim picture: temperature of 38.0°C, heart rate of 120 bpm, respiratory rate of 72 bpm, and the child was 78 per cent reliant on oxygen support. Random blood sugar levels stood at 5.5 mmol/L.
Baby James Muiruri.
"Based on the clinical findings, I made a working diagnosis of severe pneumonia with bronchiolitis and shock," Dr Njoki wrote, noting that the facility lacked the specialist paediatric care, HDU/ICU access, and advanced monitoring equipment the critically ill baby required.
Attempts were made to secure appropriate care for the infant. Cardinal Otunga Mangu Health Centre could not accept the referral due to lack of a paediatrician, whilst Igegania, a level 5 hospital, could not confirm bed availability.
Private facilities demanded hefty deposits: St Mathias Mulumba Hospital required Sh20,000 or Social Health Authority (SHA) coverage, Vineyard Hospital demanded Sh30,000, and St Jude Hospital requested time for authorisation but never responded.
Dr Sheila Mwangi, Deputy Medical Superintendent at Igegania Level 4 Hospital, confirmed that a paediatrician at Maragua Level 4 Hospital had agreed to receive the baby, but the transfer was blocked pending Dr Maina's approval.
An area Member of County Assembly attempted to reach the CEC-Health but was unsuccessful. Dr Maina reportedly arrived at the health facility the following day, after the baby had died.
Union demands justice
Dr William Muriuki, KMPDU Branch Secretary for the Central branch, said: "We believe Dr Elias Maina is alleged to have obstructed this referral. As doctors, it pains us to say it, but accountability has no exceptions, including to our fellow colleagues," Dr Muriuki told Nation on Monday.
"An infant died because a doctor's judgment was overruled. That is not governance but politicisation of healthcare. Blocking referrals is not bureaucracy; it is a death sentence."
In the official letter referenced EXT/KPDU/01/25, the union outlined specific requests to the DCI, citing powers under the National Police Service Act, 2011, and the Constitution of Kenya, 2010.
The union has called for investigations into the circumstances leading to baby JM's death.
When contacted for comment, Dr Maina dismissed the allegations.
A distraught James Muiruri with relatives at Mangu Dispensary on May 28, 2025.
"We can't stop KMPDU from making allegations and accusations. Let them provide evidence that someone from Igegania Level 4 Hospital called me asking for permission to use an ambulance. Do they have a recording?" he said.
Dr Maina insisted he was not the only official authorised to approve ambulance use, noting that the county chief officer and county director for health could also grant such permissions.
"What if I am not available to do so?" he questioned, adding that while Kiambu County had conducted investigations into Baby JM's death, he could not share the findings.
The KMPDU letter highlighted what the union termed "systemic failures, administrative interference with medical judgement, and obstructive referral policies that denied the infant timely access to life-saving care."
Dr Njoki insisted that her team did everything within its capacity to accord the child all the necessary care that he needed.
The case has highlighted the bureaucratic obstacles that can be fatal in medical emergencies. It has raised questions about the governance structures of county health systems, and about the balance between administrative oversight and urgent medical needs.
“Justice for this baby will not come from excuses. It will come from a full investigation, and if evidence confirms wrongdoing, prosecutions must follow," Dr Muriuki declared.
