Times of India
01 February 2011
By Sumitra Deb Roy
Mumbai, India

Patients Pay With Their Eyes For Poor Hygiene Of Equipment At Hospital
At least four people lost their vision permanently after a cataract surgery at a specialized eye–care centre at Chunnabhatti while five others are still fighting to regain their eyesight. Preliminary examination of the eye swabs has established the presence of highly infectious bacteria, indicating that the equipment used for the surgeries was not sterile.

On January 19, around 24 patients underwent cataract surgery at Pramukh Swami Hospital in Chunnabhatti, nine of whom developed complications soon after. While some returned to the hospital complaining of redness, swelling and watering of the eye the very next day, others started trickling in with similar problems over the next few days. According to these patients, the hospital had initially ignored their complaints of discomfort which led to further delay in arresting the infection.

By Friday, five patients were rushed from Pramukh Swami to P D Hinduja Hospital in Mahim while another two were taken to Lilavati Hospital in Bandra. J J Hospital dean Dr T P Lahane, also member of Bombay Ophthalmologists’ Association, told TOI that the vision in four patients could not be regained. "But efforts are on to salvage the eyesight of the five others. Three of them may get back good vision, but the remaining two will probably get only partial vision restored," he said.

TOI has learnt that swabs collected from the operation theatre and tested at P D Hinduja Hospital had no traces of the infection. "But swabs collected from the eyes had a high pseudomonas infection," said a source. This was also confirmed by the trustee and spokesperson of Pramukh Swami Hospital Dr Kiran Doshi. A leading eye surgeon said that the infection could have been caused by the machine for cataract surgery or the probes used.

Meanwhile, the patients alleged that the hospital refused to take cognizance of the incident initially. Like, in the case of Hansidevi Bisht (65), who had travelled all the way from Ranikhet in Uttarakhand for the surgery and has now completely lost vision in her right eye.

"She must have vomitted about 40 times on the night of the surgery, and had fever and complained of giddiness," said her nephew Shyam Singh. The family is angry that when they went to the hospital the next day, the doctors merely said these were post–operative complications that heal naturally. Families of patients further alleged that the operating doctors did not see them even once after the surgery.

Similar was the case of retired army personnel and Kurla resident Harichandra Yadav (77) who said that he was uncomfortable within a few hours of surgery. "There was total darkness in front of my eyes and I could see nothing," said Yadav, who claimed that after treatment at Hinduja Hospital, he could at least see something.

Just lying on the bed next to him is Mohammed Naeem Khan, whose left eye is fully damaged.
Retina consultant at Hinduja and associate professor at J J Hospital Dr Pritam Sawant, who is treating the patients, said that he was trying hard to save vision in the five patients.

"We hope to restore at least 5–10% of their vision. The rest are in a bad shape," he said. Pramukh Swami Hospital agreed to compensate patients after insistence from Shiv Sena MLC Deepak Sawant. To this, Doshi said the hospital was taking immediate corrective measures and patients will be adequately compensated.

"We have ensured that every patient is transferred to a good hospital. So far, we have spent more than Rs 50,000 on each patient and we will ensure that they get the best care," said Doshi.

He said that the other two patients who are still admitted at Pramukh Swami Hospital will soon be moved out for better care.

Another eye surgeon, who did not wish to be named, said that it was possible that the same machine was used for operating upon all the patients. "Also, most of the times, probes are known to cause infection if not sterilized properly," the doctor said.

"There has been negligence. And, immediate precautions should have been taken," said the doctor.
This doctor, also a member of the Bombay Ophthalmologists’ Association, said similar complaints of complications post–cataract have been reported from the hospital before. "But, the numbers were never this huge," the doctor said.

Through The Lens
In cataract surgery, damaged lens of the eye is broken down into tiny pieces
The pieces are then removed through a small cut in the eye
The lens is replaced with an artificial one
Problems can occur due to poor surgical technique, hygiene of equipment and insertion of inappropriate lens types
Incompetent pre–operative assessment or post–operative care can cause complications too