Chennai toddler’s arm amputation: Inquiry says no medical negligence

A three-member inquiry committee has concluded that the amputation of the arm of a 1.5-year-old toddler in Chennai was a result of bacterial infection and not medical negligence as alleged by the parents. On July 1, the right arm of the child named Mohammed Mahir was amputated by surgery at the Institute of Child Health (ICH) in Chennai’s Egmore. His parents alleged medical negligence, but the inquiry committee constituted by the Rajiv Gandhi Government General Hospital (RGGGH) submitted a report confirming that the amputation was due to infection.

The toddler was born pre-term in 2022 and was diagnosed with multiple health issues including hydrocephalus — a neurological disorder caused by an abnormal buildup of cerebrospinal fluid in cavities deep inside the brain. In May 2022, a ventriculoperitoneal (VP) shunt was placed in the child’s brain to drain out the excess fluid. On June 25, his mother noticed that the shunt had come out from the toddler’s body through his anus, following which he was rushed to RGGGH. The next day, another surgery was performed at the Egmore Hospital, and the child was kept under observation.

On June 29, a nurse from the hospital inserted a cannula (a tube inserted into a vein) into the right arm of the toddler. His mother, Azeesa Abdul, alleged that she raised an alarm about the child’s wrist turning red, but it was not checked on by the staff. She said that after a while, the entire arm turned red, and then black, adding that the child was then shifted to the operating room, where his right arm was amputated.

According to the report submitted by the probe team, an inquiry was conducted among all the staff, doctors, and postgraduate students present at the hospital at the time of the incident, as well as with the toddler’s parents. The report states that the cannula was removed as soon as the mother informed the staff nurse and that the child was attended to by a postgraduate student who was on duty. The next day, June 30, the child was diagnosed with thrombophlebitis (inflammation in the vein), and treated. However, on July 1, the hand of the child was amputated due to advanced acute ischaemia (decreased or restricted blood supply to cells).

The inquiry committee comprised Dr N Sritharan, Director of the Institute of Vascular Surgery, Dr PS Shanthi, Director (i/c) of the Institute of General Surgery, and Dr C Ravichandran, HoD of Pediatric Hematology. Their seven-point observation states that the surgery was performed without delay; the cannula was not wrongly inserted; doctors and nurses did attend to the patient; and that thrombophlebitis might be due to an infection caused by the bacteria named Pseudomonas.