Arrested Indian Doctor Says Toxic Pills Killed 13 Women

The Indian doctor under fire after 12 women died among the 83 he sterilized on a single day last week blamed their deaths on toxic medicine before he was arrested late last night.

R.K. Gupta, 63, said the victims showed no symptoms of infection from dirty equipment and were vomiting before they passed away, a version backed by another surgeon who had a patient die in a separate incident. Police arrested Gupta in the central Indian state of Chhattisgarh, according to S.N. Shukla, an officer in Bilaspur, where the procedures occurred.

“They can’t blame me for murder,” Gupta, who said he’s done more than 50,000 sterilization procedures since 1987, said in an interview yesterday at his office before his arrest. “But the government will never acknowledge they procured toxic medicines, so they’ll pin the blame on me.”

Female sterilization remains the most popular method of population control in India, where public health facilities often lack funding and fake medicines are rampant. The Chhattisgarh tragedy is one of the worst in recent memory from the one-day sterilization drives India regularly holds to keep its 1.2 billion population from growing too fast.

A team of doctors from Delhi has arrived in Bilaspur and is taking care of patients, according to M.K. Raut, Chhattisgarh’s acting health secretary, who confirmed the death toll. Sixty women are still in the hospital.

Second Incident

Preliminary post-mortem results show no sign of infection from poor sanitary conditions, said Promod Tewari, the top government medical official in Bilaspur. That points to flawed antibiotics and painkillers that were given to patients after the surgery as the cause of death, he said.

Gupta also received backing from K.K. Sao, another doctor who had a similar experience on the same day at a separate sterilization clinic in Chhattisgarh. That incident left one woman dead while 17 others are still in critical condition.

Those women received the same batch of Ciprofloxacin and Brufen as Gupta’s patients, said Sao, who said he’s done more than 70,000 such procedures in his career.

“The patients who got medicine from the same batch are either in the hospital or dead,” he said.

R.K. Bhange, the chief medical officer for Chhattisgarh, didn’t answer a call to his mobile phone yesterday.

High Suspicion

“If there have been multiple deaths, and at different sites, and the common factor is the use of the same batch of a particular drug, then the index of suspicion should be very high as to this being a cause,” Bobby John, a physician who advises New Delhi-based Global Health Advocates, said in an e-mail.

Sterilization mishaps are common in India. From April 2010 to March 2013, the government paid about 510 million rupees ($8 million) for 15,264 deaths or failed surgeries, Harsh Vardhan, who was India’s health minister at the time, told parliament on July 18. Sterilizations are voluntary and couples choose between a tubectomy or vasectomy, he said.

Laparoscopies are routine procedures typically performed on the abdomen to diagnose patients and conduct minor operations. No more than eight women in every 100,000 undergoing laparoscopic sterilization die as a result of complications, according to Ernest Hung-Yu Ng, a clinical professor at Hong Kong University’s Li Ka Shing Faculty of Medicine.

Gupta said he conducted the 83 operations over about six hours, with each one taking about five minutes. He blamed the government for making him breach guidelines that limit a doctor from performing more than 30 in a day.

“I am bound by a government order to do as many cases as possible,” Gupta said. “And if I don’t, then patients may shout or threaten to physically hurt me. I have no choice.”

Bird Droppings

Bird droppings covered hospital beds and vines from outdoor plants climbed in through open windows at the Nemichand Jain cancer center in Bilaspur, where the sterilizations were conducted. Piles of discarded medicine lay outside the building, some of which was partially burned.

A local medical official has alleged Gupta failed to comply with guidelines that say the laparoscope -- a camera attached to a cutting tool -- should be disinfected after each use. He said he swapped the laparoscopes after about five to seven procedures so they could be sterilized.

“We do as much sanitation as possible -- the guidelines say to clean as necessary,” Gupta said. Contaminated instruments played no role in the deaths, he said.

“If there had been an infection, there would’ve been symptoms,” he said. “Death wouldn’t have happened so suddenly.”

‘Negligence’

After the procedure, patients were told to lie on mattresses spread across the floor of the otherwise deserted hospital, according to Bharatlal Kaushik, a security guard who was present on the day of the sterilization surgeries.

Gupta failed to follow government guidelines, Chhattisgarh Health Minister Amar Agarwal told reporters in Raipur today.

“We have protocols for all of our family planning activities, but in this tragedy the evidence shows that the protocol was not followed,” Agarwal said. “At a glance, it appears that there has been negligence on the part of the doctor.”

Gupta’s patients said they became ill after the surgeries had ended.

Soni Jangde, a mother of three who received 600 rupees ($10) to become sterilized, said the operation room was tidy and the procedure went smoothly. She said she suffered a headache and vomiting three hours after arriving home from the surgery.

Clear Conscience

Shiu Kumari Yadav, 23, had a similar experience. The procedure was “normal” and took five minutes, she said. Even so, she’s done with government-run hospitals.

“I will go to a private hospital,” she said. “There we may spend a little more money, but our lives will be secure. I will tell everybody not to go to any government hospital for an operation.”

In 2007, India increased incentives for women to undergo sterilization, and focused efforts on Chhattisgarh and other underdeveloped states. India now has the world’s third-highest female sterilization rate after the Dominican Republic and Puerto Rico among more than 180 countries tracked by the United Nations.

“I’ve committed no mistake,” Gupta said. “My conscience is clear.”

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