Not negligence, post-anaesthesia convulsion is a possibility, say Doctors

Srinagar: The joy of seeing their baby in good health turned into an eternal grief for a family when their 14-month old baby, Zikra Bhat developed brain damage after allegedly receiving “faulty treatment” at the hands of doctors in the private eye Hospital of Srinagar.

Father of the baby, Farooq Ahmad Bhat of Aali Kadal locality in the old city said his daughter had developed an eye watering problem.

“Last year, we took her to the ASG hospital in Qamarwari. The doctor told us to give her a massage and prescribed some exercise. However, it did not help. He later on said it can be cured through a syringing procedure which is done under anaesthesia, and takes around 15- 20 minutes’ maximum,” Bhat said.

The parents were initially sceptical of this surgery and could not make peace with the thought of administering anaesthesia to the baby.

The doctor treating her, however, took them into confidence and convinced them for the surgery.

“He advised us it does not befit an educated person to think like that. He had himself operated upon his two children who were then of my daughter’s age,” Bhat said.

Following which, a final check- up of the baby was done by a paediatrician, who considered her fit for the surgery.

“The surgery was scheduled on April 29, 2019. It took place in one and half hours. We repeatedly asked them about the baby’s situation. They said she is fine,” Bhat recalled.

After the baby was taken out of the operation theatre, the parents noticed that she had turned pale, and ‘extraordinarily heavy’.

“We enquired from the anaesthetist and doctor if she is alright but they gave us false assurances. Later on our insistence, they decided to shift her to the neonatology unit of LD hospital but we refused to take her there. We told them it would be feasible if we take her to either SKIMS or GB Pant in our own car. However, they delayed,” Bhat said.

After three hours, as per the family, they shifted her to SKIMS, Soura in an ambulance, which was arranged from some trust. She was directly taken to the Intensive Care Unit of Paediatric section, SKIMS.

“Our baby was admitted there for 26 days and from there all the hopes of her recovery were dashed,” Bhat lamented.

The baby was taken to PGI Chandigarh, where the doctors attributed the delay for her brain damage.

“The doctors at PGI said the damage was due to the hypoxia, a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. The oxygen is delivered to the brain after every three minutes, however, in my daughter’s case it did not happen. The time had been wasted by the doctors at ASG hospital as they did not immediately refer her to tertiary care post-surgery. This resulted in irreversible brain damage,” Bhat said.

Besides, she had also developed some heart complications inside the theatre, which was noticed by the PGI doctors later in the medical reports, the family said.

This opinion was corroborated by the doctors at AIIMS, Sir Ganga ram Hospital, and Apollo, Delhi.

“Even they said the time had been wasted,” Bhat said.

Bhat pointed out that the ASG Hospital administration had assured us that they will help but now they have backed off.

“We had asked them for the compensation. They are telling me to approach the court, and then they will settle the matters,” he said.

Zikra’s life rests on tenterhooks. While the child has not slept a wink for six months, her body refuses to show any sign of throbbing life or movement.

“Sometimes, she sleeps for two hours and then cries repeatedly for 12 hours. Only God knows the pain we are going through,” her father said.

On the other side, Pediatric ophthalmologist at ASG hospital, Dr Aadil, who operated upon Zikra ruled out the possibility of any medical negligence.

“The baby suffered from watering of eyes. We call it Congenital nasolacrimal duct obstruction. It occurs in approximately 5 percent of normal newborn infants. We initially advise them to go for massaging of that duct. If it does not go well, we advise them for syringing procedures under general anaesthesia,” Dr Adil said.

He noted that the administering of anaesthesia takes half an hour.

“The syringing procedure takes another twenty minutes. The whole surgery usually takes one and half hours. It was during the post anaesthesia recovery, she developed seizures (in local parlance called as Laarne). It is a known complication in anaesthesia and can develop in one out of 100 patients. It rarely happens and the baby was an unfortunate one,” Dr Adil said.

In elders, the doctor explained that the syringing procedure is done on local anaesthesia. Since children don’t usually co-operate, their surgery is performed under general anaesthesia.

“It was only after checking all her vitals, we shifted her to SKIMS, Soura. We felt that there were inconclusive convulsions.”

On wastage of time he responded, “it was not a case of medical negligence. We were prompt enough to take her to SKIMS. We deliberately took 30 minutes and not three hours as she was in post anaesthesia recovery. We were continuously monitoring her. After she grew stiff and threw convulsions, we shifted her to the tertiary care,” Dr Adil said.

Seconding him, the anaesthetist said a proper pre-anaesthesia check-up was done before the surgery.

“The baby was alright. However, the parents did not tell me that the baby has a history of apneic spells (Breath-holding spells (BHS) are the occurrence of episodic apnea in children, possibly associated with loss of consciousness, and changes in postural tone). Anyway, they got a check-up done from a paediatrician and he had declared that the patient is okay for surgery,” he said.

The anaesthetist stressed on having used the proper drugs in proper usage.

“I had anaesthetized the patient well. For general anaesthesia, we have to intubate the patient and after the completion of the surgery, we have to extubate it. The patient was extubated, which means it was not in need of any ventilator support,” he said.

He pointed out that if the patient has a problem inter operatively, then the patient is in need of ventilator support.

“There was nothing like that in her case.The baby was fit to be shifted to the recovery area. After she got out of the theatre, her mother said that the baby is weighing more. She put the blame on the improper anaesthesia dosage, which is not acceptable,” he said.

He said the baby was monitored continuously. “She had some secretions and I removed it with suction apparatus. After sometime, she developed doubtful convulsions. We contacted a neonatologist at the intensive care unit of LD Hospital. The parents refused to shift her to LD and told us they will shift it to SKIMS,” he said.

The anaesthetist said they contacted a doctor in the paediatric intensive care unit of SKIMS. “I myself accompanied the family along with the technologist in an ambulance arranged by the hospital.”

He added that operation has a risk associated with it. “Post anaesthesia convulsions is a possibility, and we cannot predict everything beforehand. It has happened in the past in the best hospitals in the world.”

Dr Manzoor ul Mehdi, in-charge of ASG Hospital said it was not a case of medical negligence.

“We were helping the family on humanitarian grounds, not that we were at fault. Now they have demanded a compensation amount from us which was in crores. We have conveyed to them to approach us legally. If they are able to prove medical negligence in the court, then we will give them the compensation amount,” he said.

 

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