...Expert on probe panel blames it on contaminated drugs

...Expert on probe panel blames it on contaminated drugs
RESHMA PATIL

PUNE, JANUARY 10: Contaminated methyl cellulose or saline used during the cataract removal surgeries at the Sangli Civil Hospital is probably what resulted in 20 patients losing their vision, says Dr Shreekant Kelkar, appointed to probe the incident. Kelkar, however, ruled out doctors' negligence behind the tragedy.

He lays the blame on pseudomonos - a destructive bacteria that can wreak severe damage in the vitreous fluid of the eye - against which even powerful and timely doses of antibiotics are not very effective. Kelkar will visit the hospital on Wednesday to "look for sources of the post-operation infection and submit a confidential report of his findings to the State Government".

With over two lakh free eye surgeries conducted in the State every year, loss of vision after cataract removal operations is "not rare", says Kelkar, adding that such cases are brought into the open only when the numbers cross double digits. "You cannot stop holding such camps, infections will keep recurring," hesaid.

While leading ophthalmologists in the city say that the four doctors cannot be held solely responsible for a disaster of this magnitude, they question the sterility of operation theatres, instruments, cushioning material and irrigation fluids used during free medical camps in rural areas.

"It is too dangerous to conduct up to 50 operations a day in a rural medical camp," says Dr Sanjay Tekawade, and strongly advises medical camp organisers against setting surgery targets, but to schedule and plan surgeries exclusively in ophthalmology theatres, instead of general theatres. With a fixed number of instruments and solutions used repeatedly for the operations during camps, sterility becomes difficult to maintain and the risk of infection increases rapidly, he says.

And the unfortunate victims are mostly "undernourished villagers with a poor resistance to infection, who rarely comply with post-operative instructions of doctors", says eye surgeon Dr Madhuri Chandorkar. "We should be slow to blame thedoctors, the most probable fault lies in a batch of contaminated drugs," he added.

With several eye check-up and treatment camps scheduled in the weeks ahead, it is crucial for the State Government to immediately release the list of drugs and fluids that they have requested the Food and Drug Administration to withdraw from circulation. The names should be circulated to all district hospitals and ophthalmology camp organisers at the earliest, says Dr M Mehendaley, who will be participating in one such camp on January 26 and 27.

Strict supervision of asepsis or sterilisation of operation theatres, use of autoclave strips to check sterility of instruments, and trained paramedical staff to assist surgeries in medical camps to drastically reduce chances of post-operation infections, is the lesson medical camp organisers cannot afford to ignore anymore, say the city's opthalmologists.