The Telegraph
Monday , June 30 , 2014
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Bitten by cobra, killed by antivenin crunch at hospital

An 11-year-old Hazaribagh schoolboy, bitten by a snake while helping his mother in the field on Sunday morning, died on his way to Ranchi because the local hospital ran out of antivenin.

The incident, which once again mirrors the deplorable state of healthcare in Jharkhand, triggered angry protests till late afternoon, with bereaved family members stone-pelting the OPD of Hazaribagh Sadar Hospital into shutdown and BJP heavyweights threatening indefinite closure of the heal hub if anti-venom vials weren’t procured immediately.

Brajesh Yadav, a Class VI student of Rajkiya Utkramit Madhya Vidyalaya in Mangarpatta village of Churchu block, 30km from town, suffered an Indian cobra bite around 9am.

His poor farmer father Loknath Yadav and mother Panwa Devi hired a three-wheeler and rushed him to hospital around 10.25am. But, OPD doctors Gobind Narayan and R.N. Singh referred the boy to RIMS in Ranchi because they did not have the life-saving anti-venom serum or AVS.

A snakebite victim may need six to 15 vials of antivenin, depending on the nature and intensity of poison, and each costs around Rs 900, which is supposed to be administered for free at any government hospital like the one in Hazaribagh.

Brajesh was way too unlucky. While the sadar hospital did not have the lifesaving injection, his parents did not find a single vial in retail medicine stores despite having rustled up the money. The boy died on NH-33, barely 2km from the Hazaribagh hospital, around 11.05am.

Angry family members returned to the hospital with his body around 11.40am, charged doctors with negligence and ransacked the OPD. Patients were chased away by the stone-pelting mob and doctors on duty were taken to task for not storing adequate vials of AVS when snakebite cases were routine every monsoon. Agitating relatives also demanded that deputy commissioner Sunil Kumar take punitive action against doctors of the sadar hospital.

Protests quelled after BJP district president Tunnu Gope and senior party leader Anil Sinha arrived at the hospital and directed the authorities to make the antivenin available within 12 hours or face indefinite closure. They also pushed for adequate compensation for Brajesh’s bereaved parents.

“Deputy commissioner Kumar has assured us that AVS would be available at the sadar hospital by today (Sunday),” Gope told the protesters who withdrew from the premises at 2.30pm after the hospital issued the death certificate.

Dr Narayan, who had referred Brajesh to Ranchi, pleaded not guilty.

“Doctors do not look after medicine stocks. It is the job of the deputy superintendent. I had informed him in the morning that we had run out of AVS. Besides, the boy’s condition was critical and we deemed it right to refer him for better treatment. This is not negligence,” he said.

Confronted by The Telegraph, sadar hospital deputy superintendent S.R. Dangi claimed antivenin crunch in the entire market.

“There is a crisis of AVS in Hazaribagh. It happens because snakebite cases swell during the rainy season and one victim can need up to 15 injections. However, we have ordered 100 vials from a supplier in Ramgarh. The consignment will reach us by tomorrow (Monday),” Dangi said, adding that the cost of the anti-venom serum had doubled from Rs 450 in a year and funds were often a constraint too.

Hazaribagh civil surgeon Dharmveer termed the incident unfortunate, but ruled out funds crunch. “The Indian cobra is common in wheat fields and snakebites are regular every monsoon, which leads to antivenin crunch. We have ordered supplies,” he said, refusing to comment on why the vials weren’t procured on priority basis and in adequate quantities before the rainy season.

What penalty should hospitals pay for lifesaving drug crisis?