A 23-year-old pregnant woman and her unborn baby died at JJ Hospital early Saturday morning after having made an eight-hour journey from Jalgaon to Mumbai to avail super-specialty treatment in Mumbai. Her case highlights the dearth of specialty-care services in rural and tribal areas, forcing patients to travel to the financial capital for treatment.
The issue was raised by MLA Eknath Khadse in the Legislative Assembly on Tuesday, raising concern over the lack of medical staff and facilities in the Jalgaon hospital.
Vaishali Nikam, who was eight months pregnant, suffered from lower respiratory tract infection and acute renal failure in Salsingi village, Jalgaon, following which her mother Meerabai Gaikwad and brother Mangal Gaikwad took her to Jalgaon civil hospital. She was living with her mother for the past five months.
According to treating doctors, her condition was serious, with multiple complications. Medical records show she suffered from severe anaemia, renal failure, respiratory infection, and disseminated intravascular coagulation, which can lead to excessive bleeding.
“We gave the family several options as our hospital did not have the specialisation to handle her case. The family was advised to take her to Aurangabad Medical College or to Mumbai’s JJ or KEM hospitals,” said Dr Nagesh Chavan, Jalgaon civil surgeon.
According to Nikam’s relative Kishor Gaikwad, she was brought to Jalgaon hospital at 3 pm on March 16. “The doctors only gave her a saline drip,” he said. The family left for Mumbai at 9.30 pm in a cardiac ambulance with oxygen support, and reached Mumbai on March 17 at 5.30 am. By then, Nikam had started gasping for breath.
“When we reached JJ hospital, doctors told us that no ventilator was free. We desperately started trying to reach out to people so that someone could help arrange a bed in JJ hospital,” Gaikwad said. By 6.30 am, Nikam’s condition had deteriorated and she was wheeled into the hospital for cardio-pulmonary resuscitation.
A senior gynaecologist from JJ hospital said, “Even on ventilator, her condition could not have been stabilised. Her haemoglobin count was 5.5, much under normal range of 12-18.”
Nikam’s platelet count had touched a significant low of 44,000. JJ hospital authorities claim that in such critical cases, an advance notification is given to keep a bed available for the patient. In this case, the patient came with a reference letter from Jalgaon.
Speaking to The Indian Express, Khadse said, “When the family reached out to me for a ventilator, I tried calling JJ hospital. But the ventilator was not available.” Maharashtra has 450 ventilators in its medical colleges. A proposal to add 50 more has been made this year, Dr Pravin Shingare, director of Directorate of Medical Education and Research, said.
“We do not know specific details of this case. No inquiry committee has been set up to investigate her death yet,” he said. An official from Directorate of Health Services said, “But no matter how many ventilators we have, there will always be a shortage simply because patient load is always high.”
The patient was referred from Jalgaon to Mumbai, even as Dhule and Nashik have ventilators. Nashik has six ventilators.
Doctors with JJ hospital claim that since she was eight months pregnant and a high risk patient, she should not have been forced to travel till Mumbai. “There was no chance of stabilising her when we saw her condition,” said gynaecologist Dr Preeti Lewis who attended to Nikam on March 17 morning.
A post mortem report on 23-year-old Nikam showed that she succumbed to renal failure in a case of respiratory distress.