FAISALABAD, Nov 15 The Punjab government and the Allied Hospital administration have not taken any action against the medics who committed negligence in operating on a constable injured during a raid at the hideout of alleged criminals in March this year and the negligence had caused his death according to the medico-legal report (MLR).

An inquiry instituted by the Punjab Medical College (PMC) principal and hospital chief executive, Dr Riaz Husain, also corroborated the findings of the MLR to the extent of cause of death, but it did not recommend any action against the responsible medics. However, it recommended adopting certain standard operating procedures (SOPs) to avoid such incidents in future.

Naveed Azam, an Elite Force constable of Khurrianwala, received bullets fired by another constable when the police raided the hideout of alleged criminals in Mamokanjan on March 15.

The constable was brought to Allied Hospital where Dr Zahid Imtiaz, assisted by two postgraduate doctors, Dr Fawad and Dr Asifa, and other hospital staff operated him. However, the constable expired on March 18 as, according to the MLR, the doctors had forgotten a piece of sponge in his abdomen before stitching up the wound.

Documents available with Dawn reveal that the PMC principal formed a five-member team consisting of Dr Zahid Yaseen Hashmi, the chairman, and Dr Javaid Athar, Dr Rauf, Dr Sajid and Dr Munawar Javid, which examined surgeon Dr Imtiaz, nurse Rukhsana, radiologist Dr Zahoor, district medico-legal officer Dr Khurram Sohail Raja and head nurse Safdar Ali Dogar to ascertain the facts causing the constable's death.

The committee agreed with the finding of the MLR that the cause of death of the constable was septicaemia (infection of the blood by harmful bacteria) and the complication was caused by the forgotten piece of sponge.

However, surgery department head Yousaf Shah Khagga, while giving his technical opinion solicited by the inquiry team, disagreed with the committee's finding and maintained that the patient had been extended all possible care and he (Dr Khagga) and his team minutely discussed Azam's condition during his every round to the ward considering all pros and cons of such surgical procedures.

He said the MLR's finding that a piece of sponge had caused the constable's death was regrettable as it might or might not have caused the death of the patient.

On the contrary, Dr Raja maintained that septiceamia was the cause of Azam's death.

The inquiry committee concluded that the nurse, who was assisting the procedure, had indeed miscalculated the sponge count that caused the complication, but, the surgeon could not be absolved of his responsibility being captain of the operating team. Additional factors leading to the commission of negligence included overwork of emergency theatre, multiple injuries to the patient, emergent nature of the operation and improper system of sponge calculation.

The committee suggested some recommendations to prevent such “ill-planned” operations in future that include using a whiteboard as the primary record of the sponge count; using a count worksheet when a whiteboard is not readily available, keeping distraction and interruptions to a minimum level during count process and precise count of sponges/soft goods for surgical procedures.

It further suggested consistent application and adherence to standardised counting procedures, performance of methodical wound exploration before closure of surgical site, use of X-rays to detect certain items in wound, maintenance of an optimum operating room environment to allow focused performance of operative tasks so on and so forth.

Sources said the proposed SOPs were yet to be adopted. However, whiteboards had been placed at operating theatres.

They said Dr Khagga had retired after attaining the age of superannuation. However, remaining doctors were still performing their duties at the surgery ward of the hospital without any action.

Medical Superintendent Dr Bashir Ahmad said no action had been taken against anyone. However, he said, it was prerogative of the provincial government to take any action against the accused doctors.