Crucial details missing in anaesthesia form

Crucial details missing in anaesthesia form

 Even as three-year-old Mariyam Kousar is battling for her life, following brain damage due to alleged overdose of anaesthesia at Sanjay Gandhi Institute of Trauma and Orthopaedics, analysis of her medical reports by other professionals reveals that some crucial details are missing in the “anaesthesia form”.

The anaesthesia form given as a part of the medical documentation with the patient’s details by Sanjay Gandhi Institute of Trauma and Orthopaedics, a copy of which is with Deccan Herald mentions an occurrence of hypoxia (lack of oxygen supply) and bradycardia (resting of the heart) during the surgery on December 16.

However, the report of this patient with hospital ID number 45616 does not mention the duration of the said condition.

“It is important to understand the time that has lapsed as we have a different sustainability period for each organ. After that, the damage begins. The brain can withstand hypoxia for a maximum duration of three to five minutes,” an anesthetist whom this reporter spoke to explained.

The document mentions that post securing the IV line, Midazolam (used to treat acute seizures) and short acting general anesthetic (GA) Propofol were administered.

Yet, the dosage (measure) of the same which was given to Mariyam has not been mentioned in the form. Ideally, the dose should be mentioned, the anaesthetist explained. The patient’s family has alleged that anaesthesia overdose had led to the brain damage.

The anaesthesia form also has various columns that remain unfilled including the duration of anaesthesia and also the duration of surgery.

The pre-operative details marked by the anesthetist concludes that patient is healthy as under category 1 as per norms of the American Society of Anaesthesologists.

 However, post surgery records given on December 17 states that the patient “is not well-oriented and general condition not fair.”  

The case summary reads: "Under GA and C-Arm assistance, closed reduction of the fracture was performed. In the mean time, episodes of Hypoxia and Bradycardia was observed. Immediate endotracheal intubation and ventilation with 100 per cent oxygen was provided."

When Deccan Herald tried to get the hospital’s reaction on the medical reports, B G Tilak, Medical Superintendent, Sanjay Gandhi Institute of Trauma and Orthopaedics of Trauma and Orthopaedics refused to comment.  

Mariyam  was admitted to Sanjay Gandhi Institute of Trauma and Orthopaedics of Trauma and Orthopaedics on December 13 at 10.30 am after she came with a fractured left hand. The toddler’s condition grew worse after she underwent the close reduction procedure for the bone.   
Mariyam is now being treated at Malathi Manipal Hospital in Jaynagar. "Her condition continues to remain stable, yet is critical. She is on ventilator and is in coma," explained Dr Sudharsan Ballal, Director, Manipal Hospital besides stating that all parts of the brain were damaged.

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