A joint investigation team of the Center and UP government, probing an unusually high number of deaths within three days of a surgery ward of a hospital attached to the Benaras Hindu University has found out that industrial-grade gas, not permitted in medicine, was being used for administering anesthesia to patients undergoing surgery, said a report by The Times of India.

Background of the incident

Three patients had died within a day of undergoing surgeries in the SSL Hospital, and six other patients were in critical conditions on 6 and 7 June 2017. The hospital was compelled to close down the operation theatres for three days.

An emergency meeting was convened by the medical superintendent of the hospital. A seven-member probe committee was formed at the meeting as per instructions from BHU Vice-Chancellor (VC) GC Tripathi to ascertain the cause of the deaths.

Details of the probe

At least 14 surgery patients lost their lives between June 6 and 8 at the BHU’s Sunder Lal Hospital. This prompted the Allahabad High Court to order a probe into this matter. UP Food Safety and Drug Administration’s probe report, dated July 18 said, “It has been found that nitrous oxide of the non-pharmacopoeial grade was being used at this hospital” reported The Times of India.

The officials said, whether usage of industrial-grade nitrous oxide (N2O) is directly responsible for the deaths in the hospital is still under investigation. The reports added that Parerhat Industrial Enterprises, an Allahabad-based private firm that was supplying the nitrous oxide, did not have a license to produce or sell any medical gas.

The reports also mention that both the Central Drugs Standard Control Organisation (CDSO), Ghaziabad and a fact-finding committee of BHU had endorsed the findings on June 9.

Links are being made between the BHU VC and his preference for BJP that might have led Parerhat Industries to get the contract instead of an international company, Linde that was equipped for supplying nitrous oxide used for medical purposes.

The Allahabad High Court post the hearing on the case on 22 August, directed the Director General of the Health Department of UP to carry out a detailed investigation into the matter. It has also questioned the hospital’s decision to send out tenders to a company that did not have the required license for the supply of the gases.

The next hearing of the case is scheduled to be held on 27 October.

No license to produce medical N2O or oxygen

The director of the firm, Ashok Kumar Bajpai, is the father of BJP’s Allahabad North MLA Harshavardhan Bajpai, who owns Rs 1.21 crore in shares in Parerhat Industrial Enterprises. The firm is a part of the Parerhat Group of Industries that also have its interests in domains like steel, chemical, foundries, paper mills and solar power.

The firm’s N2O producing unit is located at the industrial colony, Chak Dawood Nagar, Naini, Allahabad. The firm had not been issued any license by the UP government to manufacture or produce any medical gas. “The firm neither has any license to produce medical nitrogen nor oxygen,” said KG Gupta, assistant drug inspector, as a reply to the RTI, which is a part of the report issued by the UP Food Safety and Drug Administration.

Harshavardhan Bajpai, on the other hand, has dismissed the charge that gas had led to the deaths. He admitted that his firm did not have license to produce medical N2O. He further said that the same gas is being supplied to hospitals in King George Medical University in Lucknow and Motilal Nehru Medical College in Allahabad.

Lodging a FIR

A FIR alleging medical negligence was separately registered at Lanka police station on 14 June 2017 after a complaint was registered by kinsmen of an Allahabad resident, Mehraj Ahmad, who one of those victims who had lost their lives upon being administered with industrial grade gas during anaesthesia. He was administered anaesthesia prior to a surgery to remove kidney stones.

Four doctors, including Dr P Ranjan, head of the anaesthesia wing were named in the complaint registered.

Why industrial grade gas should not be administered

The medical nitrous oxide is used when inhalation anaesthetic is required, the administration is usually accompanied by simultaneous administration of a volatile agent such as halothane, etc. Inappropriate usage of N2O comes with its own set of medical complications and results in serious side effects. “Diffusion Hypoxia” can occur, where N2O will diffuse into air-containing cavities within the body faster than nitrogen diffuses out.

Inappropriate dosage or usage of gas which does not comply according to the medical standards will ultimately result in unconsciousness, passing through stages of increasing light-headedness and intoxication, it could also result in death from anoxia. Many anesthesiologists believe that the harmful effects of N2O so great that it should no longer be used at all for routine clinical anaesthesia.

Usage of nitrous oxide, specifically of the industrial grade is not suitable for human bodies and this has triggered to the loss of human lives.

The Logical Indian take

The Logical Indian community strictly condemns the usage of industrial grade gas for medical purposes. The hospital authorities should have cross-checked the supplier and verifies his license before sending out orders to the aforementioned company. The Logical Indian community urges the concerned authorities to look into the matter and ensure that punishment is meted out to the guilty for causing insurmountable harm to human life.

If the probe ultimately concludes that wrong gas has been used and has somehow contributed to the deaths of patients, they must face the wrath of the law and those responsible must be prosecuted for culpable homicide. The officials who have given the contract to a company to supply pharmacological nitrous oxide to a company not licensed to produce it should also be prosecuted.

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UP: Probe Reveals At Least 3 Patients Died At BHU Hospital After Being Given Nitrous Oxide Instead Of Oxygen