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India - Post-Mortems of Victims Point to Tainted
Medication in India Sterilization Deaths
By SUHASINI RAJ and ELLEN BARRY
- NOV. 13, 2014
Relatives of a woman who died after sterilization surgery
took part in her funeral on Thursday. Credit Anindito Mukherjee/Reuters
NEW DELHI — Post-mortem examinations of several women who
died after surgery at a
government sterilization camp last weekend in central India
suggest that tainted medications might be to blame, rather than the unsanitary
conditions or the assembly-line haste of the operations, a district medical
officer said Thursday.
Initially, health officials suspected that 12 women
succumbed to septic shock from infections contracted during their tubal
ligation operations on Saturday, in the state of Chhattisgarh. The surgeon who
operated on most of them, Dr. R. K. Gupta, was arrested on Wednesday on charges
of culpable homicide.
However, the district medical officer, Dr. M. A. Jeemani,
said Thursday that tainted medicines might be to blame. “Our earlier claim that
the deaths were due to septicemia seem to be coming off,” he said. Instead, he
added, “What I have gathered after the first few post-mortems is that it could
be due to the administering of spurious medicines.”
The deaths have drawn international attention to the
practice, common in India,
of offering women cash and other
incentives to be sterilized at “fairs” or “camps” where surgeons
operate one after the other on large numbers of patients. At the Saturday fair,
a surgeon was reported to have operated 83 times in one day.
Sterilization Surgeon Defends Himself
Dr. R. K. Gupta, who performed sterilizations on at least
12 Indian women who later died, says it was tainted medication that killed them
and not complications from the procedures he performed.
Video by AP on Publish Date November 13, 2014. Photo by
Anindito Mukherjee/Reuters.
But in recent days, the investigation has focused on the
two packets of pills sent home with each patient after surgery, one containing
ciprofloxacin, an antibiotic, and the other containing the anti-inflammatory
and painkiller ibuprofen.
One clue pointing to the pills was another death and
scores of hospitalizations from separate sterilization clinics overseen by
another surgeon two days later. That surgeon, Dr. K. K. Sao, said there was a
third set of patients as well, people who did not undergo surgery, but were
given medicine from the same batches for other reasons. One such patient who
died on Thursday was a 75-year-old man, he said.
State officials in the district have confiscated
shipments of ciprofloxacin and ibuprofen.
Roopchand Siras, a barber from the village of Amsena
whose wife died on Monday after undergoing sterilization, said health officials
had “ordered that the medicines should be seized,” and came to his house to
collect the remaining pills. Another resident, Bedan Bai, said her
granddaughter began vomiting an hour after taking her first dose of
ciprofloxacin and later died.
The Chhattisgarh state government said it had halted the
distribution of drugs made by two Indian pharmaceutical companies, Medisafe
Spirit and Medicare Spirit. “Complaints were received against the two
companies for supplying substandard medicines,” a statement posted on Twitter
by the state government said.
Echoes of India's Painful Past
· During a two-year state of emergency that began in 1975,
Prime Minister Indira Gandhi led an aggressive campaign of
sterilization that was later deemed to be a violation of human rights.
o In 1976, she announced that ''strong steps which may
not be liked by all'' were under consideration. More than six million sterilizations, many forced, were
performed. Violent protests ensued.
o After Mrs.
Gandhi's resounding election defeat in 1977, the new government shunned old measures and
sterilizations declined to 188,000 in 1977 and 1978.
In a field outside the abandoned cancer clinic where the
sterilizations took place, there were signs on Thursday of a recent fire, where
someone had apparently burned a large number of medicine vials, packets and
syringes.
Most of the affected patients experienced vomiting and
abdominal pain, followed by a feeling of dizziness and chest pains. In the most
serious cases, the patients deteriorated very rapidly and died within 48 hours
of the onset of symptoms.
A clinician at a private hospital, who requested anonymity
because he is not authorized to speak publicly, said that in severe cases,
patients were experiencing cardiomyopathy, in which the heart is dilated and
its pumping action fails.
Dr. Sao, the surgeon, said he had reviewed some of the
first post-mortem reports on the women who died in Chhattisgarh. No evidence of
surgical injury on the bodies was reported, he said, and the cause of death was
given as cardio-respiratory failure in one case and renal failure in another.
The surgeon who was arrested on Wednesday, Dr. Gupta,
said in a telephone interview before his arrest that the ciprofloxacin and
ibuprofen used at the fair were distributed by a regional health official to
patients and their caregivers. He said they were “clearly spurious medications”
and expressed frustration that scrutiny had fallen immediately on him.
“If somebody has to be made a scapegoat, it is the
surgeon,” he said. “The entire blame is on me.
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