Teen loses arm and leg thanks to hospital apathy

Sep 11, 2012, 11:45 IST | Naveen Nair

Mahavir Singh Devra (19) came under a train on Saturday. Within 30 minutes, the GRP had admitted him to Nair Hospital and submitted his severed limbs too.

What started out as a regular commute to office for Mahavir Singh Devra (19) has left him scarred for life. The young man slipped on a wet platform while alighting from a train at Grant Road station, and went under the train. And if the tragic accident wasn’t enough, the apathy of doctors and surgeons at Nair Hospital has now left him maimed, costing him his left arm and left leg. 

Pic/Chetna Yerunkar

Even as the government railway police (GRP) personnel showed their presence of mind by carrying Mahavir and his severed limbs all the way to the hospital, it took more than 24 hours for the surgeons to operate upon the victim after the accident.

GRP officers had put his severed limbs in an icebox and delivered it at Nair Hospital within 30 minutes of the accident. file pic

GRP officers had put his severed limbs in an icebox and delivered it at Nair Hospital within 30 minutes of the accident. Orthopaedic surgeons admitted that under normal circumstances, if the patient is fine and his severed limbs are stored in ice, it is well within the range of possibility to reattach it to the body within two hours of the accident.

Mahavir was admitted to the casualty ward of the hospital at 2.35 pm on Saturday, where the doctors provided him with first aid and bandaged his wounds afresh. He was later moved to the emergency ward and kept under observation. His relatives alleged that though the operation was scheduled for Saturday evening, Mahavir was not operated upon for over 28 hours and was made to wait on a stretcher for 12 hours at the corridor outside the operation theatre (OT), before he was finally taken in.

His uncle Vikram Singh said, “After admitting him to the emergency ward the doctors kept assuring us that Mahavir would be operated upon soon. Even after several hours had passed, the hospital staff only gave him an anti-viral injection and postponed the surgery. Later in the evening they conducted blood tests to confirm the amount of blood loss. The entire night passed and my nephew remained in pain. It was only on Sunday morning at 5 am that he was taken to the OT, and finally the surgery was performed at around 5 pm on Sunday evening.”

The accident
Mahavir works with his uncle Vikram Singh Devra for an electronics business in Grant Road. On Saturday, Mahavir was travelling by train to work, and when he reached the Grant Road station at around 2 am, he moved to alight from the train. This is when he fell on the platform, his left limbs sliding into the gap between the platform and the train. A shocked Mahavir saw his own severed leg and arm lying on the tracks, till GRP personnel rushed to help him and preserve his limbs in ice.

Orthopaedics speak
An amputated limb can be reattached to the body if it is kept in a frozen state and brought to the hospital within two hours. Medical equipment required for micro-surgery has to be available in the hospital to check the damage caused to the blood vessels and veins. Wound contamination, blood loss and bacterial infections have to be considered before putting a patient onto the operation table. After thorough examination and blood tests a patient is taken up for an operation.
Dr Ratan Pal, MS (Ortho)

An amputated limb can be reattached after a maximum of six hours from the accident. If the surgery is delayed then the limbs won’t survive. In case of an accident, first the life of the patient has to be saved, and only after stabilising the patient can a doctor go ahead with a surgery to reattach the limbs. In case of multiple injuries an immediate operation is not possible until all other risk factors are sorted out. A vascular surgeon, cosmetic surgeon and an orthopaedic surgeon are usually involved in a surgery performed to reattach an amputated limb.
Dr C P Manwani, MS (Ortho)

HC guidelines for railway accident victims
Railway station staff should render first-aid to the accident victim
Station master should call an ambulance or taxi as required
Accident victims should be shifted to nearest private or government hospital within golden hour
The railway should pay private hospital bills

The Other Side
Doctors however had to offer a different version of the story. They claimed that they couldn’t perform any surgery as Mahavir was under polytrauma and his blood pressure and pulse rate were very high.

Dr Minoo Sanjana, acting dean and head (dept of General Surgery) at Nair hospital, said, “The victim was admitted to the hospital on Saturday afternoon and we immediately attended to the injuries. Our cosmetic surgeons inspected the wounds and confirmed that the limbs were not fit for joining. The patient was under polytrauma and we had to wait for him to stabilise before we could operate on him. On Sunday, the orthopaedic surgeon was operating on another case of bone fracture, which led to the delay in Mahavir’s surgery. Even the blood required for the surgery was not available at our blood bank.”

Sanjana added, “We performed the CT scan of the brain to check for any internal head injuries. Ultrasound was also performed to detect any abdominal injuries. They found that the patient also suffered from injury to his maxilla, the facial bone. Around 3 am on Sunday the orthopaedicians took over the case and Mahavir was taken to the OT at 5 am. But before the surgery they realised that one of his blood tests was not conducted.” 

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