CHENNAI: The report by the three-member internal committee, constituted by the government to inquire into the allegations that medical negligence resulted in the amputation of an arm of a toddler admitted at the Rajiv Gandhi Government General Hospital, has given a clean chit to the hospital staff on Wednesday. It states the bacterial infection (Pseudomonas) could have led to ischaemia and resulted in amputation of the limb.
However, the parents of the toddler said they were not satisfied with the report as it did not take into consideration the version of events presented by them to the committee. The toddler, who was born preterm, was diagnosed at birth with hydrocephalus, a neurological disorder caused by an abnormal buildup of cerebrospinal fluid in the ventricles (cavities) deep within the brain. Treatment involves surgically inserting a shunt into a ventricle to drain the fluid. He underwent a VP shunt procedure at the Rajiv Gandhi Government General Hospital in 2022.
After allegations of medical negligence by the toddler’s parents Azeesa and Thasthakir Meera, the government constituted an internal committee on Sunday comprising Dr N Sritharan, director, Institute of Vascular Surgery, and Dr P S Shanthi, director, Institute of General Surgery at Rajiv Gandhi Government General Hospital, and Dr D C Ravichandran, head of paediatric haematology, Government Institute of Child Health and Hospital for Children, Egmore, on Sunday.
The internal committee in its report disputed allegations by the parents that the venflon was wrongly inserted into the artery and there was a delay in attending to the toddler when the mother complained about redness in the hand.
According to the report, on June 26, the cerebrospinal fluid showed pseudomonas infection and chemical analysis revealed low SSF sugar and high protein, suggestive of brain infection. On June 29, the mother noticed the child crying incessantly and redness in the right hand after administration of IV drugs. She informed the staff nurse and the venflon was removed.
On June 30, a team of professors and assistant professor examined the child and diagnosed him with thrombophlebitis and was treated accordingly. Following increasing discolouration of the right hand and loss of movements, the vascular surgeon and radiologist were asked to give an opinion. After diagnosing the child with acute ischaemia, the child was shifted to ICH, Egmore, for amputation.
The committee said the surgery on the toddler was performed without delay. There was no extravasation at the IV site (no blebs or swelling). On noticing worsening of discolouration and loss of movement on the right upper limb, a diagnosis of acute ischaemia of the right upper limb was made.
“The arterial thrombosis and vasculitis, inflammation of blood vessels, is probably due to pseudomonas (an organism known to cause vasculitis and thrombosis of arteries) which resulted in acute ischaemia of the right upper limb leading to amputation,” the committee said.
Speaking to the press, Azeesa Abdul said, the committee didn’t hold an enquiry with other attenders in the ward. She denied that the staff nurses in the ward attended the toddler immediately. “Till the government supports the atrocities of government staff, the mistakes will happen again,” she said. Azeesa said she will ask for complete medical reports of her son from the hospital dean and decide on the next step.
FINDINGS
June 26: Cerebrospinal fluid shows pseudomonas infection. Chemical analysis reveals low SSF sugar and high protein, suggestive of brain infection. Samples sent
June 29: Mother notices child crying incessantly and redness in the right hand after administration of IV. Venflon removed by nurse. She again complains to the night duty nurse who in turn informs doctors
June 30: A team of doctors examine the child and diagnose him with thrombophlebitis - inflammation in the wall of a vein - and treated accordingly.
July 1: Following increasing discolouration of right hand and loss of movements, vascular surgeon and radiologist asked to give opinion. Colour Doppler test confirm acute ischaemia blood flow restriction to a part of the body) of right upper limb.
July 2: Ischaemia at an advanced stage and right upper limb is non salvageable. The child is shifted to ICH, Egmore, for amputation