Sunday Times (Sri Lanka)

Bug-infested nebuliser solution not linked to child deaths

Health officials act promptly to recall the product; DG provides timeline to scotch rumours

- By Kumudini Hettiarach­chi

The whole batch of contaminat­ed solution meant for nebulisers sent to several state hospitals has been recalled and withheld with immediate effect, as soon as bacteria was found in it, assured a top health official, as rumour spread like wildfire that this contaminat­ion may be linked to the deaths of children affected by viral pneumonia in the South.

No link has been establishe­d between the deaths of these children and the bacteria- contaminat­ed nebuliser- solution, Health Services Director-General Dr. Anil Jasinghe was categorica­l, as he explained the time-line.

Nineteen children have succumbed to viral pneumonia in the South. A majority having been transferre­d from peripheral hospitals, the children died at the Karapitiya Teaching Hospital.

Seventeen children, unfortunat­ely, succumbed to illness in May, Dr. Jasinghe told The Sunday Times ria on June 7 during routine action to prevent secondary infections within the hospital’s seven Intensive Care Units (ICUs). The contaminat­ion results were later conf i rmed by the LRH Consultant Microbiolo­gist, following the Karapitiya findings and subsequent­ly by several other hospitals as well, the Sunday Times learns.

As soon as she reported the matter to the Karapitiya Teaching Hospital Director Dr. Jayampathy Senanayake, he promptly informed Health Services DirectorGe­neral Dr. Jasinghe.

Thereafter, Dr. Jasinghe along with the Director-General/Chief Executive Officer of the National Medicines Regulatory Authority (NMRA), Dr. Kamal Jayasinghe got into action promptly.

Explaining that samples of this batch have been sent for testing to the National Medicines Quality Assurance Laboratory (NMQAL), Dr. Jayasinghe said the report is expected soon. Once the NMQAL report is issued, it will be put to an Expert Committee and a decision taken with regard to this product.

“There is high transparen­cy in this process. It is not an individual decision, but the decision of experts with technical know- how after studying the NMQAL report,” said Dr. Jayasinghe.

Usually, if there are up to five batch failures of a particular product, it is the batch which is withdrawn, while if there are more than five batch failures, then the whole product is withdrawn and the licence is revoked for two years. However, going by criticalit­y and the severity of the quality issue, the whole product may be withdrawn without considerin­g the fivebatch criterion ( irrespecti­ve of whether the number of batches are fewer than five), he said, explaining the processes which are followed when quality issues arise.

Thereafter, the importing company will have to go through the full gamut of procedures to obtain the licence once again, by producing proof of Good Manufactur­ing Practices ( GMP) etc. The NMRA audit team will also pay a visit to the manufactur­ing premises to determine that GMP guidelines are rigorously followed, it is learnt.

Meanwhile, the Sunday Times understand­s that Consultant Microbiolo­gists conduct routine testing of samples to keep secondary infections within ICUs at bay and it was during such measures that Dr. Piyasiri of the Karapitiya Teaching Hospital came across the bacteria in the nebuliser-solution.

Samples from the Intensive Care Unit (ICU) and High Dependency Unit (HDU) as well as samples from oxygen outlets and humidifier­s, suckers, IV solutions and other medication­s like nebuliser solutions are checked for possible contaminat­ion, it is learnt.

The viral pneumonia outbreak has been investigat­ed and the patients were found to be having several viruses including Influenza A, sources said.

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