4 who caught infection post-surgery unlikely to regain sight in affected eye

“I had gone there to get a motiya (cataract) operation done, and now I have lost my left eye,” said Parmar. He is among the 11 people, out of a total 32, who suffered post-operative bacterial and fungal infections following their cataract surgeries at the hospital run by Netra Raksha Charitable Trust (NRCT) in Virnagar village of Jasdan taluka of Rajkot.

Doctors at the M&J Institute of Ophthalmology, Ahmedabad, where the patients were referred to, said at least four of them are unlikely to get back their sight in the eye affected by the Hospital Acquired Infection (HAI).

Sequence of events
Just days after the surgeries, several patients began having problems like swelling, heightened pain and secretion of liquid from their eyes, which were operated upon. Samples tested at Rajkot Civil Hospital found them positive for severe infection. Of these, eight patients are men and three women.

Of the 11 patients who were referred to M&J Institute of Ophthalmology in the Medicity Campus in Ahmedabad, only one reached on September 28 while others received treatment at a private hospital. They moved to the Medicity campus on October 3, said Resident Medical Officer (RMO) Dr Umang Mishra.

Four of these patients had very critical infections, said Dr Swati Vijay Ravani, the Director of the Institute. “While their sight in the affected eye is unlikely to return now, we are trying to salvage the organs so that there is no need to eviscerate (remove) them.”

Nature of infections
While 10 patients developed bacterial infection, one suffered fungal infection. Ten victims have been diagnosed with the bacterial pathogen Pseudomonas Aeruginosa while one contracted fungal infection caused by the pathogen Candida Auris. Notably, both these pathogens normally infect human beings in medical settings and thus come under the category of HAI.

Fight for justice
While four patients have been discharged from the Ahmedabad hospital, seven patients remained under treatment.
At Gita Mandir bus stop, while waiting for a bus to take him back to Rajkot, Parmar told The Indian Express that he was worried if he would be able to resume driving the auto-rickshaw now. Nevertheless, he is adamant on seeking justice. While he was under treatment, his relatives filed a written application (complaint) with Atkot police station in Rajkot; Parmar said the officials sought proof in the form of his medical reports. “I will submit them after returning home,” he said.

At the hospital
All the operation theatres (OTs) of the Shivanand Mission Eye Hospital have been shut down and sealed by the authorities following reports of the infections. Dr Nilam Patel, Additional Director of Public Health, said, “Lacunae were found in the infection-control practices at the OTs of the hospital. There was no problem in terms of medical manpower at the hospital but infrastructural problems were noticed. These may have led to the lapses on the day these particular surgeries were carried out. While the OTs remained shut, further investigation is underway.”

Earlier, Ashok Mehta, joint managing trustee of NRCT, said, “The Trust and we trustees are pained beyond measure over what has happened. This has never happened in the long history of the hospital and we are extending all help (to the affected patients).”
The trustee further said the hospital was also trying on its own to identify the source of infection.

Third such case this year
This is the third major case of HAI in cataract operations in Gujarat in 2024. In both the earlier cases, expert panels of doctors investigating the cases had found lapses in infection prevention and control (IPC) measures at these hospitals.

The first incident took place at Shri Ramanand Eye Hospital in Mandal village of Viramgam taluka of Ahmedabad. On January 10, 29 patients were operated upon; 21 of them developed post-operative infections in their eyes by January 15. Of these, only one patient recovered completely while three others have “near-complete” recovery.

However, three patients had near-complete loss of sight in their operated eye following which doctors removed the infected organ in two patients. The other 12 patients recovered in various stages. The Gujarat Medical Council (GMC) suspended the licence of Dr Jaimin Pandya, the ophthalmic surgeon at Shri Ramanand Eye Hospital, for a year in February.

Notably, after the Gujarat High Court took cognisance of the incident, the state government tightened regulations of manpower and other rules for hospitals under the Gujarat Clinical Establishments (Registration and Regulation) Act 2021.

The second incident took place at Sarvodaya Eye Hospital in Radhanpur town of Patan district. As many as seven patients complained of blurriness in vision and swelling of eyes during the postoperative period following cataract surgeries on February 2.

Earlier, in November 2022, 12 patients — 11 with cataract and one with glaucoma — who had their operations carried out at Shantabaa General Hospital in Amreli district, reported severe infections. The state government cut Rs 5 crore from the grant of this trust-run hospital and gave compensation of Rs 10 lakh and Rs 5 lakh depending on degree of injury to the victims, after National Human Rights Commission (NHRC) took cognisance of the case. In February 2024, the GMC suspended the ophthalmic surgeon licence of two doctors for a few months. Dr RM Jitia, Medical Superintendent of Shantaba General Hospital, was suspended from his post by the council for a period of six months.