Indian Medical Association (IMA) president Dr. K. K. Aggarwal said that “there has been an error of judgement in the case wherein a 22-week-premature baby was wrongly declared dead”.
“The IMA team was to visit this child but we got the news that he passed away on Wednesday afternoon... In cases where the child is born before 28 weeks the chances of survival is minimum,” he said.
“In this case the facts seem to be suggesting that the child was clinically not alive, which is typical of what happens in the case of hypothermia,” Dr. Aggarwal said.
The association recently issued directions to its doctors to “never declare a patient dead under conditions of hypothermia”.
“This death should teach us to ensure that declaration of death shouldn’t be done under condition of hypothermia. We will be coming up with guidelines to ensure that this error is minimised. In this case the patient can stay alive for nearly four hours, which we presume has happened in this case,” said Dr. Aggarwal.
The IMA, in a release, had noted that a core body temperature below 95°F is hypothermia. Core temperature 90-95°F is mild hypothermia, 82 to 90°F is moderate hypothermia and core temperature below 82°F is severe hypothermia.
“It is important to recognise hypothermia so that a patient can be timely revived using all resuscitative measures, including rewarming and CPR. In conditions of severe hypothermia in children, body metabolism is suspended, which may protect against hypoxia. Patients with core body temperature 82°F have been known to survive anoxia for 12-18 minutes and up to 60 minutes or more at core body temperature 68°F. Sometimes, hypothermic patients can be successfully revived with CPR even with total resuscitation time of 9 hours. Because of dilated pupils, asystole, hypoventilation, absence of shivering, the patient appears dead. Because of failure to recognize this state, the patient may be declared dead,” noted the association.
