Unable to get timely medical attention at the PGI, Anupama, a 16-year-old girl whose leg was crushed under a Chandigarh Transport Undertaking (CTU) bus last week, died at the advanced trauma centre of the PGI early on Tuesday morning.
The infection had spread to her entire body, leading to sepsis. Anupama was a student of Government Model Senior Secondary School, Sector 18, and a resident of Mauli Jagran Complex. She had been brought to the PGI on July 17 afternoon soon after the accident in Sector 18.
She required an immediate surgery in the hospital emergency. But according to the girl's family, the staff did not attend to her in time.
"The doctors told us at night that Anupama would require an immediate surgery and gave us a list of items to purchase for the operation. We arranged everything, but they kept on delaying the surgery for one reason or the other. They did not even bother to keep us informed. We repeatedly asked them about the surgery, and each time we got this rude reply that they had more serious cases to attend to," said Anupama's father Amit Sarkar.
Due to the delay in surgery, Anupama developed gas gangrene and the infection spread to the entire body. When the surgery eventually took place, her leg had to be amputated. But even that was too late. The infection had led to sepsis, in the end becoming the main cause of her death.
Defending his staff, Dr Mandeep Singh Dhillon, head, department of orthopaedics, said, "There was a heavy load of patients. All bad fractures and crush injuries are sent to the PGI. We are working in a war-like situation and the PGI is collapsing under the pressure of patients. Since 40% of our staff is posted in the emergency at any given time, delays are unavoidable," he said.
Infected eyes rejected for donation
After Anupama's family members were told that the chances of her survival were bleak, they wished to donate her eyes to the PGI. But doctors said on Tuesday that her eyes could not be donated as sepsis had even spread there.
Pending operations delayed Anupama's surgery: PGI
Facing the flak for the alleged delay in the treatment of Anupama, PGIMER on Tuesday said that she could not be operated upon on July 17, the day her leg was crushed by a CTU bus, due to pending surgeries of patients suffering from open fractures and complex trauma.
PGIMER official spokesperson Manju Wadwalkar said that the 17-year-old girl's wounds were dressed when she was wheeled in. "On the morning of July 19, during rounds by senior doctors, hemorrhagic soakage of dressing was noted and additional compression dressing was done to control oozing. She was also transfused one unit of blood," she said.
Anupama was taken for surgery on July 19 night, the spokesperson said, adding that during administration of anesthesia the patient became haemodynamically unstable though the operation theatre team on duty subsequently resuscitated her. The girl's surgery was deferred due to her unstable condition and her splint and dressings were reapplied, Manju Wadwalkar added.
Three units of blood were also transfused and ICU was called for takeover of the case. However, she added, the young patient could not get an ICU bed due to unavailability of beds and was hence kept under observation in the ward.
She was subsequently taken for surgery the next day (July 20), and underwent disarticulation of left hip in the afternoon. Intra-operatively, she again became haemodynamically unstable and was put on ionotropes and ventilator support. A call was again made to ICU for takeover, but could not be shifted there due to unavailability of beds. Anupama developed anuria, after which opinion of nephrology department was sought. A peritoneal dialysis was carried out and ICU again requested to shift the patient but without any success. Her vital parameters remained the same, the spokesperson added.
She added that the general surgery unit II examined the patient on Monday night and advised debridement again once her condition stabilised. At 4.46 am on Tuesday, she suffered a cardio-respiratory arrest and could not be saved despite the best of efforts from the doctors, Wadwalkar said.