The Telegraph
Since 1st March, 1999
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Hours that could’ve masked drugs

New Delhi, June 5: The treatment that Rahul Mahajan received between 2:55 am on Friday when he was wheeled into emergency and 6 am when his first urine sample was drawn for drug screening might have influenced test results, doctors have said.

The tests had revealed faint traces of several illicit drugs including cannabinoids, cocaine and opiate.

The level of cocaine, for instance, was 3.9 while the level of opiate was 8.5. Apollo Hospital doctors had said as long as the levels of cocaine and opiate are below 300, they can be described as “within limits”. However, medical experts have expressed surprise at that statement because, they say, residual products of cocaine and opiates should not be present in people who have not consumed them.

A senior official at the pathology laboratory where the tests were done told The Telegraph today that the reference range mentioned in the results signify the limit above which the level is “clinically significant” or “toxic”.

“The reference range denotes values below which the level becomes clinically significant or toxic,” the official said, adding that the laboratory had no role in interpreting the test results. “It’s doctors treating the patient who’re supposed to interpret the results on the basis of the symptoms and history of the patient,” said the official who requested not to be named.

Delhi police today quizzed the team of medical doctors who had treated Rahul about the treatment that he had received and the test results.

The doctors “are extending their full co-operation in the investigative process and all queries regarding the treatment have been duly furbished,” the hospital said.

Doctors not connected with this case have said the infusion of intravenous fluids into the body during the three hours of treatment before the first urine sample was taken could have influenced the test results.

“It’s part of the medical drill. When you get an unconscious patient, you infuse intravenous fluid and use a catheter for urine to be excreted,” said Dr Chandra Gulhati, editor of the Monthly Index of Medical Specialities, India.

“When large amounts of urine are produced, the time at which the sample was drawn for testing is crucial to interpret the results,” Gulhati said.

As intravenous fluid is infused into the body, urine constantly drips out of the catheter, potentially diluting the level of any residues of toxic substances in the body. “Such treatment can change the test results, but only to a certain extent. The results won’t be negative. There is always a time lag between fluid infusion and urine formation,” an internal medicine specialist said.

An Apollo Hospital spokesperson said the first urine sample for the toxicology screen was taken at 6 am. He said the focus of the medical team was to revive Rahul from the dangerous situation that he had been brought in. Rahul had no recordable blood pressure and only a feeble pulse. “We stabilised him, and drew the urine sample for screening only at 6 am,” he said.

Some doctors are also surprised that Apollo chose to reveal detailed results of the tests. “We don’t discuss test results to anyone other than the patient or the doctor who’s requested them,” the official at the pathology laboratory said. A senior doctor at the Apollo Hospital said the decision to reveal test results was taken only after consent was obtained from Mahajan family.

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