A ‘mix-up’ that cost a life

Relatives of Thankam, the womanwho died after wrong blood transfusion at theGovernment Medical College Hospital, Kozhikode  

The death of a woman after wrong blood transfusion at the Government Medical College Hospital here on Thursday reminds the medical fraternity about the need for presence of mind throughout the duty hours.

The victim, Thankam, 61, from Kuttiyilthazham in the city was to be discharged from the hospital the next day.

The incident

“Wards 26 and 27, handled by one nursing station, had two patients of the name Thankam. The patient in Ward 26 had liver ailment and the one in Ward 27 needed blood transfusion. The nurse administered blood to the wrong person,” Medical Superintendent M.K. Ravindran said.

Action taken

“The nurse was suspended and an explanation sought from the duty doctor. We have gone through our blood transfusion protocol to ensure its correctness. The nurse said she had known the deceased earlier and had administered blood to her as well. When the duty doctor asked her to administer blood to Thankam, she thought it was the Thankam she knew and did not care to double-check.”

Seema, daughter-in-law of the deceased, who was in the hospital at the time of the incident, recalled that the only nurse at the nursing station was busy when she reminded her that her mother-in-law, a diabetic, required insulin.

“Another nurse, who came in the afternoon shift, administered blood to mother. After she left, mother started showing uneasiness and I informed the nursing station about it. Soon the nurse came and removed the equipment. No more than three drops of blood would have entered her body. But she started shivering soon and was shifted to the intensive care unit, where she died around midnight,” she said.

Repeated requests

Ms. Seema, speaking to The Hindu at home, said she had overheard a man complaining that his mother was not being administered blood even after repeated requests.

Knowing that the man’s mother also had the name Thankam, she came to the conclusion that the nurse had mistaken one for the other.

Stress aspect

C. Ravindran, Principal of the medical college, brushed aside arguments that stress suffered by the staff leads to such mix-ups. “It is carelessness and nothing else,” he said.

“If a nurse is stressed out, she needs to sit at home. A nurse may delay work when stressed out or she may not do it at all, but not treat the wrong patient. This involves a life. The identity of the patient needs to be double-checked before administering anything, be it blood or medicine.”

Thankam is survived by her aged husband, Mohandas C.K., three sons and a daughter. The relatives have filed a complaint at the medical college police station, and a case of medical negligence has been registered.

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Printable version | Jul 24, 2021 2:44:56 AM | https://www.thehindu.com/news/cities/kozhikode/a-mixup-that-cost-a-life/article4711033.ece

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