18-year-old in coma: Medical negligence or electricity failure?

Jinnah Hospital committee yet to fix responsibility.

LAHORE:

A five-member committee, set up last week, to determine why an 18-year-old did not wake up after an appendicitis surgery is expected to report its findings in three days.

The girl, Shazia, went into a coma two months ago. According to a report published in a newspaper, on April 2, and a TV channel, a power outage caused an equipment failure, which then resulted in a coma.

Professor Javed Akram, the Allama Iqbal Medical College principal and Jinnah Hospital CEO, denied blaming the Lahore Electricity Supply Company (Lesco) for Shazia’s condition. “Patients are regularly affected by power outages,” he said but added that it was “too soon” to fix responsibility in this case.

The 18-year-old was brought to the hospital on February 8 with what Dr Akram described as “acute appendicitis”. She had to be operated upon. Dr Akram told The Express Tribune that power had broken down during surgery. A ventilator malfunctioned during the operation, said Dr Akram. The patient did not regain consciousness after the surgery.

The youngest among six siblings, Shazia, was married eight months ago. “We walked her to the operation theatre and now she just lies there, unconscious,” said her mother Sughra Bibi.

Shazia’s brother, Maqsood Ali, told The Tribune that after a doctor recommended immediate surgery, she was taken into the operation theatre around 8 pm on February 8. Ali says Shazia was shifted from the operation theatre to the ICU on February 9. The patient chart posted outside the ICU described her status as “static”.

“We were told the ‘machine’ stopped during the surgery,” said Ali. The family wasn’t told which machine. Ali wondered why the hospital did not have a back-up.

Dr Akmal said that though the hospital has back-up power arrangements, the difference in voltage between the original power supply and the back-up frequently causes problems in  the functioning of medical equipment. Sometimes, he said, the equipment stops working altogether. Equipment worth Rs5 million has been damaged. The infection and mortality rate at the hospital, Dr Akram said had gone up because the sterilisation machines require continuous power supply.

The hospital has complained to Lesco and requested that hospitals be exempted from power outages. A petition is also being drafted to be sent to the Supreme Court,.

Dr Mazhar Iqbal, Shaikh Zayed Hospital chairman, said that it was the hospital’s responsibility to make sure there was sufficient and uninterrupted power supply in case of an electricity breakdown.

The committee, headed by Prof Dr Abul Fazl, head of the surgical department, has so far interviewed 19 people, Dr Akram told The Tribune. Its initial findings confirm that the ventilator on which the patient was put during surgery malfunctioned. Shazia was administered oxygen with an ambu bag after the ventilator malfunctioned. Dr Akram, however, cautioned that this did not necessarily mean that the coma was caused by the malfunction. “We have yet to establish whether it was an electricity failure or negligence on part of a doctor that caused the incident,” he said.

Lesco issued on Monday a statement denying responsibility for the incident at Jinnah Hospital. According to the statement, the hospital and its medical college are being supplied power from two feeders while the request for a third feeder is pending payment from the hospital management. Dr Akram endorsed the Lesco statement and said it was demanding Rs9.5 million. Lesco’s statements also said that “provision of capacity generators and [uninterrupted power supply] UPS for critical areas are the sole responsibility of the hospital authority”.

Published in The Express Tribune, April 3^rd, 2012.