Death in the incubator

Print edition : November 24, 2001

The death of 11 babies in two days in Lucknow's King George's Medical College opens the floodgates of complaints about apathy and insensitivity on the part of the hospital staff.

SIX babies, one to three days old, died inside their incubators starved of oxygen on the night of November 3. Five more deaths occurred the next day in the same ward, again owing to oxygen shortage. The parents begged the doctors to save their babies, only to be rebuked. No senior doctor looked at why so many babies suddenly died of asphyxiation. The babies were under treatment for some complication or the other in the Intensive Care Unit (ICU) of the neonatal ward of the prestigious King George's Medical College (KGMC) in Lucknow.

The King George's Medical College in Lucknow.-SUBIR ROY

All hell broke loose once the deaths were reported in the newspapers thanks to the presence of a photo journalist whose child was also being treated in the same ward. It is another matter though, that he had to shift his baby out thereafter: the doctors stopped attending to it once he was suspected of having leaked the news to the media.

Surprisingly, so many deaths in just two days, owing to similar causes, did not raise any eyebrows immediately. Neither the KGMC authorities nor the government machinery took note of them until the media went to town with them. The KGMC, situated in the heart of Lucknow (Prime Minister Atal Behari Vajpayee's constituency), together with the Gandhi Memorial Hospital, admittedly constitute the most prestigious medical institutions in Uttar Pradesh.

According to eyewitnesses and the parents of some of the babies, the deaths occurred apparently because there was no oxygen in the pipeline attached to the ventilators through which the infants were to receive the life-giving gas inside the incubators. The lapse was obviously not noticed until the babies started dying. Had the staff on duty bothered to check the availability of oxygen in the pipeline immediately after the first death took place, many lives could have been saved. Senior doctors were not available as November 3 and 4 fell on a weekend. The entire workload fell on the nurses, wardboys and junior doctors on duty, who even in normal circumstances are stressed out and edgy. No wonder then that the repeated complaints of the parents, most of them from poor or lower middle class families, elicited indifferent responses.

The fact that there was no oxygen in the pipe has been established on the basis of a complaint of leakage of oxygen at the jet point in the neonatal ward's ICU on the afternoon of November 5. An expert was summoned from Kanpur to inspect the leakage the next day. In the death certificates, the cause of the 11 deaths was cited as "cardio respiratory failure". This corroborates the stoppage of oxygen leading to the deaths. The KGMC authorities, however, are tight-lipped about this; they say that the deaths were all normal ones.

The neonatal ward at the hospital.-SUBIR ROY

The parents of the babies revealed that there was sudden panic in the ward as nurses on duty started running about and asking the parents to arrange for oxygen cylinders immediately. Mohammad Athar, who lost his baby daughter, said that he was repeatedly asked by a nurse to arrange for an oxygen cylinder, which he could not. One parent managed to procure a cylinder using his high-level contacts, and this saved his son and two other infants.

Waseemullah Hashmi, a lecturer at the Islamia Inter College in Lucknow, was not that lucky. His son, a healthy baby weighing 2.9 kg at birth, was born at the Fatima Hospital on November 3. Since the baby had "some breathing problem" the doctors there advised him to take it to KGMC. The doctors at Fatima allowed him to take the cylinder that was supplying oxygen to the baby, and instructed that it be not removed. After the child was admitted at the KGMC on November 4, the first thing the duty doctor did was allegedly to remove the oxygen cylinder and instead connect a ventilator that was attached to the central oxygen supply pipeline. Although Hashmi objected to this and insisted they allow his son to be on the oxygen cylinder, the doctors did not listen. The baby died the same day.

Pankaj and Rita Rastogi, who lost their one-day-old baby daughter weighing 2.6 kg, say their child died because there was no oxygen in the pipe attached to her ventilator. Her death certificate too shows the cause as "cardio respiratory failure". "I was asked to keep pumping oxygen to my child. I pumped continuously for 14 hours. Towards the evening of November 3, the child's condition started deteriorating. There was bleeding from her nose and mouth. There was no senior doctor available and my child died at 9.45 p.m." Pankaj Rastogi said. He faxed a complaint to the Prime Minister on November 5. A Central team of two doctors visited the city to look into the incident.

In an apparent move to cover up the lapse, the KGMC constituted a three-member investigating team, headed by the head of the hospital's paediatric department, Dr. Kusum L. Srivastava. The other members of the team were Dr. B.K. Singh, head of the anaesthesia department, and Dr. M.K. Mishra, head of the medicine department. Obviously the team lacked credibility - first because it was an inhouse team and its neutrality was in doubt and secondly because it completed its investigation in just two days, without even talking to the affected parents. "We came to know of the investigation through the newspapers. When we wanted to visit the KGMC to meet them, we were not allowed entry," said Pankaj Rastogi.

The Central team, however, was given wide publicity and advertisements were placed in local newspapers asking people to depose before it. The parents, however, are sceptical of this investigation too. "The team appears to be biased in favour of the doctors," said Waseemullah Hashmi.

The doctors at the KGMC are trying to convince everyone that the deaths were unavoidable because the children's condition was "too critical". Dr. Kusum Srivastava said: "We get only cases that are already in critical condition. In such circumstances, death cannot be ruled out, no matter how unfortunate it may sound." The team's inquiry report is awaited, yet she was confident that the deaths "did not occur owing to shortage of oxygen". Besides, she said, "two or three deaths every day are quite normal". The hospital's records show that on subsequent days, from November 5 to 10, there were only six deaths in the ICU of the neonatal ward - an indication that there was something wrong on November 3-4.

According to hospital sources, such ghastly occurrences are common in the hospital, given the pitiable state of affairs there. "It is only the tip of the iceberg, which accidentally became public. There is a lot more that is wrong here but which never comes to light." The veil of secrecy explains this. This correspondent was prevented from talking to parents or attendants in the neonatal ward and was barred from taking pictures. Doctors or nurses on duty refused to speak and appeared watchful.

Outside the wards, tales of apathy, indifference, rudeness and cruelty abound - of having to pay money even to get life-saving drugs, of senior doctors being never available except during their rounds once a day, and so on. Shockingly, parents who wanted to take the bodies of their babies were made to give it in writing that they had no complaints against any of the KGMC employees.

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