Botched surgeries: Telangana government orders criminal charges against surgeon and charges against 13 others

The Telangana government has ordered the filing of a criminal complaint against a surgeon at Ibrahimpatnam Community Health Center (CHC) in Rangareddy district, where four women died after a tubectomy procedure August 25.

The government also ordered disciplinary action against 13 people including the (now suspended) Superintendent of CHC, Rangareddy District Health Services Coordinator, District Medical Officer of Health (DMHO), Deputy DMHO , the assistant civil surgeon, the head nurse, the doctors. and supervisors who have been found guilty.

Without disclosing the findings of the investigation report, the government orders dated September 23 – released on Saturday – detail a series of recommendations, including mandatory 24-hour post-operative care at the facility, follow-up visits by supervisors for a week, the latest infection control procedures and protocols, refresher training for supervisors, quarterly review of sterilization services and activities, and annual skills assessment of surgeons, to follow.

Four women, aged 22 to 26, died within two to four days after laparoscopic double puncture (DPL) surgery or tubectomy procedure carried out as part of a special camp organized by the government of State at Ibrahimpatnam CHC. Several others developed complications and were treated in private hospitals in the following days. That day, thirty-four surgeries were performed at the CHC by a single surgeon.

On August 29, the government ordered an investigation into the incident, following which the state director of public health (DPH) submitted an investigation report on September 6.

Following this, the government ordered the DPH to file a criminal complaint against the DPL surgeon, Dr Joel Sunil Kumar, and ordered the Telangana Vaidya Vidhana Parishad (TVVP) to take action against Dr Sridhar, the Superintendent of the CHC, and to provide a compliance report. .

Health Secretary SAM Rizvi’s government order, dated September 23, also ordered the TVVP to provide draft indictments along with relevant material to initiate disciplinary action against Dr Jhansi Lakshmi, coordinator of district responsible for health services in Rangareddy district. She has been relieved of her post and returned to Shadnagar CHC where she will continue as a Civil Surgeon (Specialist) in her original position.

Another official, Dr. Swaraja Lakshmi from Rangareddy District DMHO has been transferred and assigned as co-director in the office of the Commissioner for Health and Family Welfare in Hyderabad. The DPH is required to provide indictments along with relevant material to initiate disciplinary action against him under Rule 20 of the Telangana Civil Service (Classification, Review and Appeal) Rules, 1991.

In the order, the DPH was directed to initiate disciplinary action against Dr. Naga Jyothi, DMHO Deputy Ibrahimpatnam and DPL Camp Officer. He further called for disciplinary action against Chandrakala, head nurse at CHC Ibrahimpatnam; Dr. Geeta, Assistant Civil Surgeon, CHC Ibrahimpatnam; Dr. Srinivas, physician at PHC Madgul; Dr Kiran, Medical Adviser at PHC Manchal; Dr. Poonam, Medical Adviser at PHC Dandumailaram; and Alivlu, Mangamma, Jayalatha and Janakamma, who are supervisors of Madgul, Manchal and Dandumailaram PHCs respectively.

24-hour postoperative care, recommended follow-ups

In the recommendations to the government, the DPH suggested that DPL surgeries should be performed as fixed day services with other services in the hospital and that the DPL beneficiary should be kept in post-operative care for at least 24 hours. in the building.

His report suggested that the relevant supervisor visit the recipient’s home at least once within 24 hours of discharge and at least twice within a week of the operation. It is also recommended that the medical adviser, in addition to ensuring the visits of supervisors, to visit the beneficiary at least once at home in the first two post-operative days. He suggested that the Superintendent, Surgeon, and Deputy DHMO check processes in accordance with SOPs for preoperative, intraoperative, and postoperative care.

The DPH also noted a need for refresher training for all supervisory staff on the identification of possible signs of complications from the procedure. Furthermore, the report recommended that the Commissioner (Health and Family Welfare) have the skills and knowledge of DPL surgeons assessed once a year by a competent authority. According to the SOPs, only 30 family planning surgeries should be performed in a single day by a surgeon or institute. The report said the hospital’s infection control committee, chaired by the superintendent, will meet every Monday and review infection control protocols, and a refresher training course will be held for all hospital workers. infection control.

Director of Health Rizvi instructed the Commissioner of Health and Family Welfare, Director of Public Health and Family Welfare, Director of Medical Education and Commissioner TVVP to take necessary action in accordance with the recommendations.

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