The Telangana Government has initiated stern action in the death of four women due to a botched family planning operation at a mass sterilisation camp at the Community Health Centre in Ibrahimpatnam on Hyderabad outskirts on August 25.
The government has transferred the Rangareddy District Medical and Health Officer Swaraj Laxmi and in-charge District Coordinator of Hospital Services Jhansi Laxmi. It also issued an order to file a criminal case against the duty doctor who conducted the procedure and initiated disciplinary action against twelve other medical officers and para-medical staff.
To prevent recurrence of such incidents in future, the government has also issued certain guidelines including making tubectomy and Double Puncture Laparoscopy (DPL) operations as an integral part of hospital service delivery system and not as camps. Henceforth, the DPL surgeries shall be conducted as fixed day services along with other services extended by a hospital and the women who undergo DPL procedure shall be kept in at least 24-hour mandatory post-operative care at the same facility.
Action against those responsible has been initiated after a committee headed by Director of Public Health Dr. G. Srinivasa Rao inquired into the incident and filed its report recommending the action. Accordingly, orders have been issued to file a criminal case against Dr. Joel Sunil Kumar, who conducted the DPL procedures on 34 women, as per rules in vogue.
Charges would also be framed against Dr. Jhansi Lakshmi, in-charge DCHS of Rangareddy and Dr. Sridhar, Superintendent of CHC Ibrahimpatnam, who has already been placed under suspension.
Based on the recommendations of the DCH committee, disciplinary action has been initiated against Dr. Naga Jyothi, Deputy DM&HO at Ibrahimpatnam and DPL camp officer, Chandrakala, Head Nurse at Community Health Centre at Ibrahimpatnam and Dr. Geetha, Deputy Civil Surgeon at CHC Ibrahimpatnam.
Others against whom action has been initiated include Medical Officer Dr. Srinivas (PHC Madgula), Dr. Kiran (PHC Manchal) and Dr. Poonam (PHC Dandumailaram), Supervisors Alivelu and Mangamma (both PHC Madgula), Jayalatha (PHC Manchal) and Janakamma (PHC Dandumailaram).
Further, Dr. Jhansi Lakshi, in-charge DCHS, was directed to report to her original post of Civil Surgeon Specialist at CHC Shadnagar. Dr. Varadha Chary, Superintendent of Area Hospital Kondapur, has been placed in-charge of the DCHS Rangareddy post. Dr. Swaraja Lakshmi, DM&HO Rangareddy, was transferred as Joint Director in the office of Commissioner Health and Family Welfare.
Secretary (Health) S.A.M. Rizvi has also issued guidelines which include guiding the beneficiaries of tubectomy/DPL procedures to access services at the hospitals of their choise as per a pre-scheduled calendar.
Supervisor concerned shall make one visit to the house of beneficiary within 24 hours from discharge
Ensure two more visits within one week on subsequent post-operative days and prompt follow-up and appropriate referral, as per need
PHC Medical Officer shall visit all post-operative cases at least once within first two days
The Medical Officer shall ensure Supervisor duly visits the post operative acceptor as per schedule
Superintendent, surgeon and DM&HO (camp officer) of the area shall verify the processes as per the SOPs for pre-operative, intra-operative and post-operative care
Refresher training shall be conducted for all supervisory staff on the identification of any possible signs of complication of procedure
Commissioner of Health and Family Welfare shall put in place a mechanism to access the DPL surgeon’s skills, knowledge once a year by a competent authority
The State team headed by JD (H&FW) shall review the processes and all activities pertaining to sterilisation services with all FP program officers, teams at least once a quarter
As per SOPs, only 30 family planning surgeries are to be performed on a single day by a surgeon/institute
Hospital infection control committee chaired by its Superintendent shall meet every Monday to review the measures on infection control protocols without fail
A refresher training course for all the infection control officers and nurses under DME and VVP shall be organised through NIMS covering latest infection control protocols and practices
DME and Commissioner of VVP shall ensure implementation of infection control practices with particular focus on OTs and ICUs