Ensuring strict punishment for those responsible for Ayan's death is crucial

A committee formed by the Health Department to investigate the tragic death of child Ayan during circumcision at United Medical College Hospital has submitted an investigation report to the High Court. No one has been specifically held responsible for Ayan's death in the investigation. However, four points have been recommended to avoid such incidents in the future. However, observing these four recommendations, irregularities within the United Medical College and Hospital administration, as well as negligence by the medical professionals, become evident to the vigilant public.

In the first recommendation, it was suggested, 'Employ multiple anesthesiologists in the hospital.' This recommendation implies that United Medical College Hospital has not hired multiple anesthesiologists. According to the natural rules of medical science, it is emphasized that in any surgical procedure involving anesthesia or the use of anesthetic agents, it is imperative to seek the consultation of a specialized anesthesiologist in the relevant field.

Especially, the doctor should be informed about any prior illness or physical issues of the patient; this is the responsibility of the physician. In the first recommendation of the committee, it becomes evident that there were no specialized anesthesiologists at United Medical College Hospital.

There was only one person, who was not a specialist; otherwise, extreme negligence was exhibited in carrying out responsibilities. This becomes evident in the second recommendation of the investigation committee. Specialized doctors state that not knowing the patient's sensitivity in certain areas before surgery, and using general anesthesia, can lead to significant risks. This concern is right in front of our eyes.

In March 2013, while undergoing a piles operation at the Gastro Liver Hospital in the capital, due to an anesthesia error, Cardiologist Dr. A. E. M. Majharul Islam Imran lost his life. During that time, there were allegations that the details of Dr. Imran's previous operation were not taken into consideration before administering general anesthesia. Even in the case of post-operative care, the doctors and nurses at that hospital exhibited extreme negligence. Due to the inaccurate administration of anesthesia, Dr. Imran suffered a heart attack during post-operative care, and at that time, there was not even a nurse present until then. In the case of a specialist doctor, if an incident of negligence like this could occur, then the allegations of negligence in the case of child Ayan may not necessarily be groundless.

The second point of recommendation of the report of the Department of Health states, "The patient and the relatives of the patient should be well informed about the risks of anesthesia and operation. This means that the doctors and their assistants at the United Medical College Hospital did not adequately inform the relatives of Ayan before applying general anesthesia.

The parents initiated this allegation from the beginning. The Health Department's report states that Ayan had childhood asthma, and therefore, he was given inhaler. It is the responsibility of the treating physician to gather this information before administering general anesthesia. Physicians thoroughly examine various aspects before any operation and then make the final decision. Without obtaining a comprehensive medical history and conducting necessary examinations, any doctor who administers general anesthesia without consideration of the patient's previous medical conditions cannot be considered a specialist. Rather, questions may arise about whether the person is a doctor at all.

It is unfortunate that, in the report, the implicated doctors and their associates are accused of not taking responsibility. Instead, Ayan's parents are blamed, with an allegation that they did not inform the doctors adequately. The aspect of the inquiry report makes any conscious person concerned about the responsible role of the health department.

The third recommendation suggests, 'Maintain an Intensive Care Unit (ICU) in the hospital.' From this recommendation, it is clear that there was no ICU in United Medical College Hospital. How is surgery done with general anesthesia in a medical college hospital without ICU? In the opinion of specialist physicians, if a hospital has an operating theater, then postoperative care and an Intensive Care Unit (ICU) are essential for administering general anesthesia in that hospital. Because at any moment, a patient may face complications, and they might need emergency admission to the Intensive Care Unit (ICU). It is now known to everyone that there was no ICU in United Medical College Hospital. Therefore, after complications were detected, Ayan could not be admitted to ICU on an emergency basis. Taking an extended time into consideration, he was eventually transferred from Badda to United Medical College Hospital in Gulshan-2. In this case, the serious misconduct on the part of the United Medical College authorities becomes evident and is subject to disciplinary action.

The fourth recommendation suggests, 'Initiate the operations of any hospital after obtaining government approval.' This means that United Hospital started its operations before obtaining official approval from the government, which is also a significant irregularity. So, in essence, United Hospital was running medical operations without establishing appropriate healthcare infrastructure, employing specialist doctors, and without obtaining government approval! Despite three serious crimes, why is the report of the Department of Health not recommending strict punishment against the hospital authorities?

However, the United Hospital authorities tried to justify themselves by holding a press conference. They avoided the subject of Ayaan's tragic death and rather gave a plaintive account of the actions taken by the health department on their application for registration. This is clearly a kind of audacity, anyway.

Although no one has been specifically held responsible, the 15-page report of the Department of Health has made clear the serious irregularities and gross negligence of the United Medical College Hospital authorities and the concerned doctors from the four-point recommendations. In this situation, it is imperative to take appropriate measures to ensure the punishment of the United Medical College Hospital authorities and the concerned doctors by closely monitoring these four-point recommendations. If necessary, another highly authoritative investigative committee could be established to determine appropriate punishment. However, to ensure good governance in the country's healthcare system, there is no alternative to severe punishment for those responsible for Ayaan's death.