MP E Ahamed's death betrays absence of critical healthcare expertise

Kozhikode: The recent death of former external affairs minister E Ahamed which kicked up a political row still has its reverberation among medical fraternity as the lack of critical care expertise was evident throughout the onsite attention, emergency transit to the Ram Manohar Lohia Hospital and the ethical violations there. According to the available visuals and reports, the ambulance used was not at all equipped with the state-of-the-art emergency care facilities and instead of a rolling stretcher, essential in critical care, a manual stretcher was used they said.

Emergency medicine expert at MIMS Hospital Dr P.P. Venugopal,  executive director of ANGELS (Active Network Group of Emergency Life Savers), a prominent NGO imparting emergency medical care to accident victims, said lapses were evident from the video of the transit itself. “If there was a real emergency unit the external defibrillation machine to revert the cardiac condition could have been given at the Parliament itself,” he told DC. "Not even an Ambu bag (a manual pump device used by doctors to force air through a mask and into the lungs to keep an unconscious patient alive) for artificial respiration was absent during the transit.”

“To my information in 2010, there was a proposal to buy 20 automatic external defibrillators (AED) to the emergency unit of Parliament. Either the plan failed to materialise, or there were no trained experts to operate.” The situation points out to three possibilities- the emergency medical care unit at parliament was defunct, the staff were not at all trained, or the trained staff were absent at the point of time. With some 800 MPs in the two Houses, VVIPs and high profile staff, there should have a well-qualified team of at least five doctors supported with critical care facilities, trained staff and fully equipped ambulances with ventilation facilities there.

Many members have cardiac diseases, diabetes, hypertension and are haunted by other stress factors. In the case of Mr Ahamed, on-site critical care quality was a minus, without an advanced ICU ambulance, critical transport care was of poor standards and augmentation care at the emergency department at the hospital not up to the mark. Dr M.R. Rajagopal, chairman of Pallium India based in Thiruvananthapuram, said he was upset at the “very inappropriate treatment that was meted out to Mr Ahamed and his family”.

“If the reports are correct, he was on external cardiac compression with a device for many hours. In a man of 78, this cannot possibly result in recovery with any reasonable quality of life. The hospital protocol should have known when to stop such aggressive interventions,” he told DC. “The reports said the process started without the permission of the next of kin, which is a violation of the fundamental ethical principle of autonomy.” "Science has to be used on human beings with humanity. Death is the inevitable consequence of life, and there is a time at which a gentle touch of a loved one, a few drops of water down the throat and religious rituals become more important than the latest technology,” he added.