Who will take responsibility for death from adulterated anaesthetic

The death of three children with hearing impairment after being administered spurious general anesthesia at Bangabandhu Sheikh Mujib Medical University (BSMMU) is tragic.

Prothom Alo reported quoting BSMMU source that three hearing-impaired children were implanted cochlear devices. The university’s ENT (Ear, Nose and Throat) department has a programme, ‘Cochlear Implant’ for providing cochlear devices to hearing impaired children. The device is implanted after the children are administered general anesthesia. The three children were administered general anaesthesia Halothane. The first one died on 9 December and the others on 10 January and 30 January respectively.

After death of three children within a short period of time, the sample of Halothane was sent to BCSIR for examination. The test revealed that the Halothane used for anesthesia did not have proper ingredients. That means that the halothane used was adulterated. Debashis Banik, chairman of the department of Anesthesia, Analgesia and Intensive Care Medicine, also admitted about finding various chemicals in the sample.

In last several months, children died in different hospitals in Dhaka during circumcision, several people died while undergoing tonsil surgery in Narayanganj and one death took place in Tangail. It is suspected that Halothane might be responsible behind these deaths.

ACI Pharmaceuticals Limited produces anaesthetic drug Halothane in Bangladesh. ACI on 15 June last year said the Halothane is no longer a choice for anesthesia globally and there would longer be any commercial of the drug in future. The ACI said it will discontinue the production line of the Halothane and requested the physicians to use alternative anaesthetic drug. Within just four days, ACI on 19 June wrote another letter to Directorate General of Drug Administration (DGDA) that it cannot produce Halothane due to lack of supply of raw materials.

It is alarming that despite two letters by ACI, none looked into the market situation and the source of Halothane in the market. After several deaths, it is now being suspected that there are expired or adulterated Halothane in the market. On 27 March, the health ministry ordered all public and private hospitals not to use Halothane and use isoflurane or sevoflurane as an alternative. The ministry also asked the authorities to ensure that the newly procured anesthesia machines are specifically meant for isoflurane or sevoflurane use.

Directorate General of Health Service’s director general Abul Bashar Mohammad Khurshid Alam told Prothom Alo, “We have taken several steps. We’ve sent letter to DGDA to ensure that there is no Halothane in market and no Halothane can be smuggled in the country,”

ACI has stopped production of the drug in June last year. Yet, it took DGHS eight months to send letters to DGDA and civil surgeon in this end. What took DGHS so long to act? DGHS and DGDA officials have clear negligence here. And, how could an institution like BSMMU use adulterated anesthetics? This whole saga needs proper investigation.