Father blames Kerala hospital for refusing anti snake venom to 10-yr-old Shehla

10-year-old Shehla was bitten by a snake at her school in Sultan Bathery on Wednesday, and succumbed to her injuries the same day.
Father blames Kerala hospital for refusing anti snake venom to 10-yr-old Shehla
Father blames Kerala hospital for refusing anti snake venom to 10-yr-old Shehla
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The father of 10-year-old Shehla Sherin is blaming the doctors at Sultan Bathery Taluk hospital for refusing to administer Anti Snake Venom (ASV) to his daughter, while one of the accused doctors issued a clarifying statement to peers over WhatsApp. The unidentified doctor stated that ASV was not refused, but only sought permission from the father to administer the anti-venom and “intensely” monitored the child. 

The doctor further stated that the hospital was not informed that the school teachers had tried to clean the snake bite ‘thoroughly.’ They were also not told that the child was taken to other private hospitals before being brought to the taluk hospital.

It was on Wednesday that 10-year-old Shehla Sherin, a student at Sarvajana HSS, in Sulthan Bathery, of Wayanad district of Kerala. was bitten by a snake in her classroom sometime around 3:15 pm. The school administration informed her father between 3:30 pm to 3:40 pm that his daughter had sustained a wound on the leg.

The father first rushed Shehla to a private hospital, from where she was referred to the Sultan Bathery Taluk hospital at 4:09 pm. The father accused the hospital staff of refusing to administer anti-venom to his daughter at the taluk hospital. 

According to the 10-year-old's father, the doctors at the Sultan Bathery Taluk hospital stated that there was a significant amount of due process that had to be conducted before the administering anti-venom. Since Shehla was a child, it also added to the process. The father stated that it was this doctor who referred Shehla to the Kozhikode Medical College hospital.

As Shehla’s condition deteriorated, the ambulance was diverted back to Vythiri Taluk hospital. But the doctors there allegedly expressed their helplessness, and referred Shehla to Good Shepherd Hospital in Chelod, where she died. 

"In the Sultan Bathery Taluk hospital, I told them that I suspected it to be a snake bite. Her leg was turning blue and her eyes were shutting. The junior doctor told me that if the hospital had to administer anti-venom to the patient, they would first have to place her under observation. For around 45 minutes, the child was under observation. Her blood was drawn and tested. It took 20 minutes to get the test report. When I went to collect the report, she had vomited once,” he said. 

He continued, “Then the junior doctor told me that the hospital could not help us and that we had to leave to Kozhikode Medical College immediately. They called an ambulance and wrote a reference letter. I compelled them to administer anti-venom as the child was in a bad condition already but they refused, citing processes.” 

The family then attempted to rush to the Kozhikode Medical College hospital. However, by the time the ambulance reached Kalpetta, the 10-year-old's health condition was already deteriorating, her father told the media. 

"When we saw that she was sinking, the ambulance driver called up the Sultan Bathery taluk hospital. They asked us to go to the Vythiri Taluk hospital. When we reached there, the doctors there too, told us that they were helpless. They referred us to the Good Shepherd Hospital in Chelod. The doctors in Good Shepherd tried their best to revive her but she had succumbed by then,” he added.

The State Human Rights Commission has also initiated a probe with regard to the series of lapses that led to the death of Shehla.

What the doctors say

In a statement to peers over Whatsapp, one of the doctors refuted media reports, which had claimed that the hospital staff had denied administering ASV to the child.

The doctor stated that the Shehla was unsure if she had been bitten by a snake and that the staff only sought consent from the father to administer the ASV. The doctor pointed out that this has been “portrayed in media” as the doctors ‘fear’ of giving ASV to the child. The father of the child, however, blames the hospital staff for not administering the ASV citing “process”.

The doctor explained to peers that the child herself was not sure whether she was bitten by a snake or if the cause of the injury had been caused by a stone while trying to remove her foot from the hole. 

The doctor wrote that there were no signs of neurotoxicity or hematoxicity at the time of admission except two abrasions (not proper fang marks) with surrounding erythema. Bleeding Time (BT) and Clotting Time (CT) tests were normal. As per procedure, a blood sample was sent for a whole blood clotting test (WBCT).

The doctor who gave the unofficial explanation observed that by 4.35 pm, Shehla had developed minimal ptosis (drooping of the eyes) but had no signs of respiratory distress or other signs of neurotoxicity. The doctor immediately explained to the child’s father in Malayalam that they needed to administer the ASV, and sought his consent. However, the doctor claims that the father was in a complete state of panic. “My explanation is now portrayed in media as my ‘fear’ of giving ASV. I have just explained the consent for ASV,” wrote the doctor explaining to peers, “I never told that I wouldn’t give ASV. I told I have to intensely monitor while ASV is being administered,” clarified the doctor.

“I have done everything I could in 20 minutes,” the doctor wrote, adding that the child had only minimal ptosis with increasing erythema on local site at the time of referral but had suspected neuro and haematotoxicity from this and thus advised ASV. 

The doctor then pointed a finger at the lack of adequate infrastructure at the hospital stating that there was no ventilator facility at the hospital. The Sultan Bathery Taluk hospital has only 2 adult ventilators which were not working, the staff had for the past one year even made repeated requests to authorities to get the equipment repaired. The doctor revealed that there were only six vials of ASV at the hospital. 

The doctor also stated that it was the child’s father who opted to take her to Kozhikode Medical College hospital.

The WBCT results were made available only after the doctor had referred Shehla to the Kozhikode Medical College hospital. The doctor insists that the staff had made every arrangement for a referral only after the child’s father had opted for it. The doctor also stated that the opinion of a senior also sought at that time and was directed to proceed.

“I have given all explanations to authorities but alas I am cornered, telling that even if there was no ventilator facility, even if WBCT not available, even if no consent from father, I had to give ASV to child because of minimal ptosis,” said the doctor who added that he/she did not get an authentic history of snakebite from the child. 

(With inputs from Sreedevi Jayarajan) 

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