Battle lines drawn, department versus department in AIIMS

DEATH OF PREGNANT NURSE

WITH THE AIIMS administration deciding to terminate the services of a senior resident of anaesthesiology over the death of pregnant nurse Rajbir Kaur on February 4, battle lines seem to be drawn between the anaesthesiology and the gynaecology departments.

It is learnt that the faculty at the department of anaesthesiology, pain medicine and critical care has submitted “suggestions” to the AIIMS administration, asking that it re-examine the incident that led to the termination order, and conduct a “fair inquiry”. The department also said that the “responsibility” on the resident of obstetrics and gynaecology had been “ignored”.

“Why was the consultant of anaesthesiology singled out even though the committee found clear lapses on the part of department of obstetrics and gynaecology,” the anaesthesiology department wrote to the administration.

The Indian Express had on Wednesday reported that the senior resident told the inquiry committee he was not present for Kaur’s delivery because he did not believe the call from the gynaecology team regarding foetal distress was “genuine”. The Indian Express had also reported that the inquiry committee concluded that an under-prepared OT and the absence of the senior resident of anaesthesiology were responsible for a failed intubation, which led to complications, including bradycardia or slow heart rate.

The AIIMS administration had decided to terminate services of the senior resident of anaesthesiology after finding him “guilty” of “wilful absence” of his duties.

To this, the anaesthesiology department has said, “The consultant on call, obstetrics and gynaecology, in spite of being informed, chose not to come. Is this not wilful absence? If she had been present, in view of her being more mature and experienced, she may not have pressured the junior resident (anaesthesiology) to induce the case, thereby preventing the course of events.”

“There appears to be undue bias in the committee, with an unfair focus on the absence of the anaesthesiology senior resident as the main cause. Whereas, the sound opinion of senior resident (anaesthesiology) of not operating on the other operating table, which is standard practice, was overlooked. Had his advice been heeded, Kaur may have lived,” the department has written.

The Indian Express had reported on Wednesday that the inquiry committee highlighted a number of lapses, including the fact that Kaur had been shifted to the back table of the maternity OT, which is typically not used for C-sections.

Although the committee was told this was done to save the baby, it pointed out that the back table did not have a ready stock of emergency drugs and the OT was not fully prepared to handle such an emergency under general anaesthesia.

“The panic decision for C-section in a poorly prepared patient and ill-equipped OT, with pressure on the junior resident (anaesthesiology), led to the unfortunate sequence of events. To this extent, the responsibility of intrauterine death on the residents of obstetrics and gynaecology has been ignored,” the department has said.

Rajbir Kaur and her husband; resident doctors protest at AIIMS