Despite clean chit given to RIMS, Shija Mystery hangs over Eliza's death case
Source: The Sangai Express

Imphal, August 10, 2014: Despite the clean chit given by the Special Medical Board to RIMS as well as JNIMS doctors, mystery still hangs over the death of Eliza.

Notably, the corpse of Eliza was cremated by the Government authority as an unclaimed body.

After delivering a child at RIMS on May 10 this year through cesarean section, Wahengbam (O) Eliza w/o W Dinachandra of Langol Ningthou Leikai died at Shija Hospital on July 14. Following Dinachandra's allegation of medical negligence on the part of the attending doctors, Medical Directorate constituted a Special Medical Board (SMB) on July 17.According to an enquiry conducted by the SMB, there was no sign of criminal negligence on the part of RIMS and Shija hospital doctors.

The enquiry report was signed by the SMB chairman and three members and a copy of the report is available in the office of The Sangai Express.

Even though the report did not mention the cause of Eliza's death, it recommended post mortem examination so as to identify the cause of death through relevant authority.

Health Director Dr A Bijoy was the chairman of SMB.

JNIMS Obstetrics and Gynaecology Professor Dr Indrakumar, JNIMS Forensic Medicine Assistant Professor Dr G Angam and JNIMS Medicine Professor Dr Y Iboton were the members of the board.

Talking with The Sangai Express, RIMS Obstetrics and Gynaecology Head Dr Nabakishore said that Eliza was brought to RIMS Emergency ward at around 1 am of May 10.She was observed till noon of the same day thinking that she could deliver without any external aid.

However, as she showed little progress on the possibility of natural delivery, she went underwent cesarean section and delivered a baby boy at around 1.30 pm.

Three days after she was brought to Gynae Ward, Eliza became feverish on May 12.Her condition became stable after administering paracetamol injection.

Next morning, Eliza's face was found swollen and she showed symptoms of jaundice.

Further medical investigation was conducted to check if her kidneys were infected.

On May 14, nephrologist was consulted.

But Eliza developed difficulties in urination.

Subsequently, dialysis was done on May 15, 16, 19, 21 and 22.She was taken to ICU on May 22. On May 24, Eliza started convulsing and she had breathing difficulties.

As a result, she was put to ventilator.

The changing health condition of Eliza was informed to her families.

Urea Creatinine of Eliza came down from 9.5 Mg(s) per cent to 6.5 Mg(s) per cent after dialysis.

With the creatinine per cent coming down and the patient starting urinating a little, attending doctors thought that Eliza was recuperating, said Dr Nabakishore.

Eliza got infected either due to kidney failure or Haemolytic Uremic Syndrome (HUS), he opined.

Eliza was brought to RIMS with her bladder already burst.

There have been cases of infection when bladder burst within womb.

What causes HUS is not known exactly, but some women get infected by HUS three days after child delivery.

Counting Eliza, there have been three suspected cases of HUS infection after child delivery at RIMS.

Cases of suspected kidney failure caused by infection can be remedied through dialysis.

But it often proves fatal if it has reached the stage of chronic renal disease.

Such cases require kidney transplantation.

Again, if kidney failure is caused by HUS, dialysis is ineffective and it also requires kidney transplantation in most cases.

Coming back to the case of Eliza, Dr Nabakishore said that it did not look like infection for she felt no pain when pressed on the abdomen even though her body was swollen.

She had appetite, no foul smell and she had no problem in defecation.

Her case looked like HUS.

Under such critical conditions, Eliza's family took her away from RIMS on May 29 on Leave Against Medical Advice.

Condoling the death of Eliza, Dr Nabakishore clarified that he never offered Rs 30 lakh or any amount of money to Eliza's family.

"Eliza's family could not understand fully all our efforts in the course of treating her", Dr Nabakishore said.

On the other hand, Shija Hospital Managing Director Dr Palin said that Eliza's creatinine was 5.8 when she was brought to Shija Hospital on May 29.Creatinine level for a normal person should be below 1.5. Her kidneys were severely affected when she was brought to Shija Hospital.

Despite repeated dialysis, there was no improvement.

She died in the night of July 14 due to acute renal disease.

Eliza's deteriorating health condition was informed to her mother regularly, Dr Palin said.

Most cases of acute renal disease are caused by infection.

Given Eliza's medical history, it looked like a case of infection and acute renal disease cannot be cured 100 per cent.

Yet, acute renal disease can be treated with dialysis.

After the infection is treated with dialysis, condition of kidneys can be brought to normal.

There have been many instances where patients suffering from acute renal disease left Shija Hospital after they were cured fully.

According to Eliza's medical history, her blood pressure went low at RIMS.

This can also cause infection, Dr Palin said.

He went on to clarify that he never claimed Eliza's kidneys were improving.

Dr Palin also decried all the allegations level against Shija Hospital in connection with Eliza's case.

WAD secretary S Sobita many poor patients have been victimized in Manipur because of the absence of a healthcare system/policy.

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