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Patients probably contracted Hepatitis C at Stanley Hospital: report

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In August, 16 patients who were awaiting kidney transplants alleged that they had contracted Hepatitis C from a dialysis machine at the hospital.

The report of an inquiry committee formed to look into cases of patients who allegedly tested positive for Hepatitis C virus (HCV) at Government Stanley Hospital has determined that most of the patients are “likely to have acquired HCV infection in Stanley hospital only.”

In August, 16 patients who were awaiting kidney transplants alleged that they had contracted Hepatitis C from a dialysis machine at the hospital. They also said that the hospital had then asked them to go elsewhere for dialysis, as it did not have dedicated machines to dialyse HCV patients only. Following protests by the patients and members of the Aam Aadmi Party (AAP), the government formed a three-member inquiry committee to probe the issue. N. Gopalakrishnan, head, nephrology department, Mohammed Ali, head, medical gastroenterology, and G. Jayalakshmi, director, Microbiology, all from MMC formed the committee.

The report says that of the 16 patients who tested positive for HCV, only six had undergone dialysis at hospitals before coming to Stanley. “Though it is theoretically possible that some patients could have been harbouring HCV – but not detected by tests, it is unlikely that all the 16 patients could have had HCV infection at entry into Stanley hospital itself….it is quite possible that many, if not all patients could have acquired the infection at Stanley hospital,” it observes.

It also says that the patients could have been dialysed at Stanley itself, with 2 or 3 dedicated machines – a step that was subsequently taken. Also, “Breaking the news of HCV infection and subsequent counselling could have been done with more professionalism,” it says.

Following the protests in August, the hospital set up a special ward to treat the patients with HCV. “We have a total of 13 dialysis machines, of which three have been set aside for the HCV patients,” said hospital dean AL. Meenakshisundaram.

The wife of a patient, who is being treated at Stanley now, said that her husband was receiving regular injections for HCV treatment and was on dialysis. “But the delay has cost us. We came here in June, expecting the transplant to happen in July. Now though, it may take several more months. Many of the patients are sicker now, and several are very hard up financially,” she said.

AAP members had also demanded that all patients who had undergone dialysis at the hospital over the last six months be recalled, tested and treated if found HCV positive. The report states that 234 patients had received haemodialysis at Stanley for varying periods in the last six months. They hail from different parts of the State and PCR testing (a highly sensitive but expensive test) would cost between Rs 3-3.2 lakh.

However, hospital officials said they had already begun sending letters to the patients and some of them had already arrived for testing. “All deans and joint directors of government hospitals across the State have been informed, so that patients can go to the nearest facility and get tested. Those who test positive will be treated, and if required, kidney transplants performed,” Dr. Meenakshisundaram said.

The AAP however alleges that one patient, Rajini, passed away. “The hospital contacted her very late. Her family had not been able to afford her dialysis, and the government hospitals at Thoothukudi and Tirunelveli had turned her away as she had Hepatitis C. She died on October 21, a day after the hospital contacted her family,” a party member said. However, the committee’s report states that Rajini did not have HCV on leaving Stanley.

On hygiene and sterilisation procedures followed, the committee found that the procedure followed – dialysers washed with saline, hydrogen peroxide and then filled with formaline – was appropriate. “Dialyser reuse is scientifically accepted,” the report states, but in its recommendations, it says minimising the number of reuses or not reusing at all, would mitigate the spread of HCV. “This would cost more; but, still, it is worthy,” it says. The report also calls for strict adherence to universal precautions and strict infection control policies. Having PCR machines available at government hospitals for testing would also help, it says.

In conclusion, the report says “there is no wilful negligence on the part of the nephrology department, but, certainly, there is a lack of a robust and foolproof mechanism to vigilantly monitor for inadequacies in infection control measures.”

At a press meet on Friday, AAP members had demanded that Rajini's family be given Rs, 10 lakh, the families of the 16 patients be compensated financially and action be taken against the doctors and staff who were negligent.

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Printable version | Jan 28, 2020 6:39:15 AM | https://www.thehindu.com/news/cities/chennai/patients-probably-contracted-hepatitis-c-at-stanley-hospital-report/article6578634.ece

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