WITH THE Mumbai Police and the Brihanmumbai Municipal Corporation beginning investigations into the death of a 32-year-old man after he was sucked into a Magnetic Resonance Imaging (MRI) unit at the BYL Nair Municipal Hospital Saturday, it has emerged that Rajesh Maru was pulled to the machine from a distance of three to four feet. Family members who were witness to the incident and hospital staffers said Maru was standing a little inside the doorway in the MRI room, holding an oxygen cylinder for his sister’s mother-in-law who was to undergo an MRI.
According to family members, the ward boy, one of the accused in a case of causing death by negligence registered by the Agripada police station, opened the door to the MRI room without warning and allegedly asked Maru to accompany. “He (Maru) vanished in a second as soon as he stepped in. We rushed inside after him. We could see him inhaling fumes from the mouth and nose after nozzle of cylinder broke open,” said Harish Solanki, his brother-in-law and an eyewitness. “Within 15 seconds, his body had bloated up and turned black,” he added.
A post-mortem revealed that Maru died of pneumothorax, a condition where excess air in the chest cavity causes the lung to collapse. Hospital sources also confirmed that the oxygen cylinder Maru was holding, almost half his height, had been damaged when Maru was pulled in. ‘He vanished in a second…his body had bloated up and turned black’. The police said Chavan had asked Maru to pick up the cylinder from the trolley and keep it on the floor while simultaneously opening the door to the main MIR room. An officer from the Agripada police station said, “The family has given us a sequence of events. We have been working on it. Every official who was present at the spot was nabbed.”
The three accused, Dr Saurabh Lanjrekar (24), ward boy Vitthal Chavan and attendant Sunita Surve, were booked under Section 304 (A) (negligence causing death) of the Indian Penal Code and granted bail on surety of Rs 5,000 each. Meanwhile, a BMC panel and the police will also investigate a series of apparent lapses at the MRI room of the municipal hospital.
While standard operating protocol mandate a radiology department ward boy, technician and doctor to monitor every MRI test, in this case ward boy Vitthal Chavan and Dr Saurabh Lanjrekar were both from the medicine unit. Only a Class IV helper and technician, the other two hospital employees present at the spot, belonged to the radiology department. While the police and the family confirmed the presence of a radiology department technician, hospital authorities said the on-duty technician was not present at that moment.
Maru, a Lalbaug resident, was visiting his elder sister Manisha’s mother-in-law Laxmi Solanki Saturday night. When she was being wheeled away for the MRI, he decided at the very last moment to assist. “My brother Tribhuvan and I were going to accompany our mother inside the MRI room. But Tribhuvan’s finger ring wouldn’t come off. As no jewellery is allowed inside, Rajesh volunteered to come instead of Tribhuvan. The ward boy asked him to carry the oxygen cylinder because my mother required ventilator support,” said Solanki.
The radiology department’s standard layout involves four zones. The first zone is open for the public where patients and their attendants are asked to remove all metal items on their person, including coins, belts and jewellery. The second and third zone form the radiology unit where a computer console controls the MRI machine. The fourth zone is the main room with magnetic field, also called the radio frequency room. A standard pre-fabricated model of this room measures about 600 square feet. As per protocol, the normal metal patient trolley cannot enter zone III. In this case, Laxmi Solanki was transferred from the medical intensive care unit’s trolley to an MRI compatible trolley in Zone III. The oxygen cylinder was also on the MICU trolley, which Maru picked up, also in Zone III.
“The radiology department’s helper Sunita Surve told us to ensure no metallic item went inside. But the ward boy said we will need the oxygen cylinder for my mother. He asked Rajesh to pick it up, claiming the MRI machine was switched off. My sister even asked if the cylinder was allowed inside, as we had left our purses, belts, coins and jewellery outside the ward,” Solanki alleged. Apart from four family members and the patient, the family claims, Dr Lanjrekar, ward boy Vitthal, and the radiology department’s technician were present in zone III. “The doctor did not protest. As soon as the ward boy opened the door, Rajesh was pulled in along with the cylinder by the magnetic force of the machine,” said his elder brother Yogesh.
The MRI machine generally has power of 0.5-3 tesla, which is equivalent to 5,000 to 30,000 of gauss magnetic field. “Even if the machine is off, the magnetic field is always present, which is immense,” said the radiology department head of a BMC-run hospital. Maru’s fingers got stuck in the MRI machine along with the cylinder. “The nozzle broke open and we saw fumes enter his body from everywhere. He started bloating up in seconds,” said Maru’s cousin Priyanka Solanki.
The Solankis and the ward boy together pulled Maru away from the machine after it was switched off.. “His finger remained stuck there,” said Priyanka. A little later, Maru was declared dead when he was taken to the hospital’s emergency ward. Lanjrekar, Chavan and Surve have told investigators the incident took place in seconds and they are not aware how Maru got pulled inside the main MRI room. The investigators have also called the technician to have a better understanding on the working of the MRI machine. “After we understand the working of MRI machine, we will be able identify the negligence of each person involved,” said an officer.
Deputy Commissioner of Police Virendra Mishra (Zone III) said, “Every individual who was present in the radiology department has been called to the police station tomorrow. We will be recording their statement again and will identify who was responsible for the mishap.” An inquiry by Deputy Municipal Commissioner Sunil Dhamne will also submit its report to the police. “Expert opinion on the case will be taken. CCTV footage of the passage where they stood will be studied,” said Dr Avinash Supe, director of the BMC’s tertiary care hospitals. “We don’t care about the compensation by government. What happened to my son should not repeat,” said Maru’s father Shyamji Maru.