Victim showing signs of severe organ failure: Singapore docs

Dr Kelvin Loh, Chief Executive Officer, Mount Elizabeth Hospital, said her family members have been informed that her condition has deteriorated and they are currently by her side to encourage and comfort her.

"The patient's condition has taken a turn for the worse. Her vital signs are deteriorating with signs of severe organ failure. This is despite doctors fighting for her life including putting her on maximum artificial ventilation support, optimal antibiotic doses as well as stimulants which maximise her body's capability to fight infections," Dr Loh said.

Earlier, doctors said the woman had suffered a significant loss of brain function and there was fresh threat of infection spreading to her lungs.

The brain damage could possibly be attributed to a cardiac arrest she suffered early on Wednesday morning, which snapped oxygen supply to her brain for at least 3-4 minutes, sources said on Friday, a day after she was admitted to the hospital in the city-state.

The victim is "struggling against odds and fighting for her life" said Dr Loh. "Our medical team's investigations upon her arrival at the hospital yesterday showed that in addition to her prior cardiac arrest, she also had infection of her lungs and abdomen, as well as significant brain injury."

"A multi-disciplinary team of specialists has been working tirelessly to treat her since her arrival, and is doing everything possible to stabilise her condition over the next few days," he said.

Sources told The Indian Express that a CT scan of the brain had revealed some edema or swelling, and subsequent neurological examination had shown deteriorating cognitive functions.

"We believe the edema which resulted from the cardiac arrest caused the loss of brain function. Tests such as the pupil dilation test where a light source is flashed near the pupils to see if there is any dilation, and the plantar reflex test to assess the reflex action on the sole of the foot by rubbing it with a blunt object, have shown that her neurological functions have been significantly compromised," a source said.

The patient has been unconscious and on maximum ventilator support since her cardiac arrest around 1 am on Wednesday. "She continues to be unconscious and on complete ventilator support. There is no spontaneous respiratory function at all now after the cardiac arrest," the source said.

Both the Indian doctors who accompanied the patient were scheduled to return late on Friday night. The patient has been admitted under colon and rectal surgery specialist Dr. Denis Nyam. A chest X-ray has shown accumulation of fluid in her lungs, indicating the infection which began from her intestine and spread to the abdomen has now reached her lungs.

Doctors said this could be attributed to the continued ventilator support over a period of time, and her immobile condition. Her kidney and liver functions have been compromised.

Sources said the fluid in her lung, the first signs of which were seen on her last day at Safdarjung hospital, cannot be removed surgically at the moment because of the patient's "critically low" platelet count. Her blood pressure, which had also become very low during the flight, has now been maintained at around 100 after extensive medication. "She is also constantly being administered antibiotics to control the fast-spreading infection," the source added.

Her cardiac function, believed to be the trigger for her neurological problems, continues to be a concern. "Her ejection fraction — the volume of blood pumped by the heart in one cardiac cycle — is way below the optimum," the source added.

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