Bengaluru: On January 1, 2015, Poonam celebrated her 28th birthday with family and friends. Since then, for the past five years, the most important day of her life has been celebrated amidst antiseptic, pungent disinfectants, with undertones of artificial fragrance of soaps and cleaners; on a white sheet beside an array of medicines and IV tubes hanging around her.
For an abdominal pain checkup, a hospitalisation that happened 1,920 days ago (till January 29, 2021), still remains an admission with no sign of either recovery or discharge – she has gone through multiple complications leading to a comatose state.
This is perhaps one of the longest hospital admission stories in India that is quietly playing out in the upmarket Manipal Hospital in Bengaluru.
And the bill? It has crossed Rs 6 crore, and counting. While Poonam’s medical summary itself runs into 11 pages including a long panel of 20 plus doctors’ names who have been attending on her since over 5 years, her four-page treatment bills with 63 particulars, are mind-boggling for her family and friends.
Now, 33-year-old Poonam lies in a vegetative state. A once-healthy, happy-go-lucky business reporting analyst with Accenture, she can barely move or talk today. Though doctors at the institute had "written her off" five years ago and had reportedly asked the family to "take the body home", the family is still hoping that if treatment as per rehabilitation protocols is administered, Poonam can be out of hospital.
Numerous representations to the hospital, complaints to police and different government bodies including NHRC hasn’t helped in this case, relatives say.Poonam with her husband before hospitalisation.
Family blames hospital
The family blames the hospital for Poonam’s condition and her husband Rejish Nair, a native of Kottayum, sums up the 5.4 years this way: "From severe stomach pain leading to emergency surgery due to leakage in intestine, multiple-organ failure, asking the family to take the 'body' home, to continuous renal replacement therapy, brain damage, irreversible deep coma to artery burst."
"I mean isn’t it murky?" he asks. "On October 3, 2015, Poonam had walked into the hospital with stomach pain and today, she is a vegetable." The family has so far managed to pay Rs 1.34 crore through health insurance and its own resources. Nair, had to give up his IMB and Microsoft jobs and settle for a consultancy role to give time to his wife, hospital and all the work.
Multiple communications on mail sent to Manipal Hospital’s media manager for the doctors’ opinion about the case went unanswered. However, News18 was able to access Poonam’s comprehensive medical summary and the bills.
Recalling the most horrible five years of his life, Nair said, "Poonam was a perfectly healthy girl, who went to Manipal Hospital, merely for a stomach ache, is reduced to a comatose, bedridden state, due to wrongdoings committed during surgery on the pretext of clipping a leak in the intestine. The fact that Poonam was absolutely conscious and appropriate was documented by the hospital itself in the first medical summary post surgery. But as soon as the hospital realised that they have been caught in the wrong, they fabricated medical summaries, to claim that Poonam was extremely serious when she came to the hospital, which is contradictory to their own earlier statements. This is basis documented evidence."
"In October 2015, the hospital constantly told us that Poonam will not survive beyond the three weeks of hospitalisation. The hospital was proven wrong multiple times by the sheer grit, conviction and determination of Poonam’s brave fight for survival. She came out of the initial comatose state. By January 2016, She started obeying commands and was assessed at M6 (GCS - Glasgow Coma Scale) which is the highest level of consciousness on the GCS. Poonam’s consciousness got a tremendous boost, and she was breathing successfully, on ventilator-support mode, which was an excellent feat, because this indicated that she can come out of the ventilator, Nair said.
However, when the hospital stopped the medicine (amantadine), that had improved her condition, she started crumbling. From then on, she suffered multiple complications. Nair said,"There have been no efforts from the hospital side to make her better. The doctors wrote her off five years ago but Poonam is still surviving. What she needs is protocols of rehabilitation for neuro, sensory regeneration. She cannot survive at a home set up with her current frail health."
The excruciating anguish is visible on Poonam’s father’s face when he talks about his daughter’s struggle. A retired army veteran, Hem Bahadur Rana has been making daily hospital visits for over five years now. "I am proud of Poonam. She is putting up a brave fight. The medical negligence, cover-ups by the hospital, inaction by the state machinery is appalling. It has happened to my daughter and it can happen to anyone," says Rana.
Doctors call for higher investigation
News18 spoke to a few well-known, senior doctors in the city for their take on this case. On the condition of anonymity, they expressed shock over this long-term hospitalisation, terming it as the rarest of rare cases.
"Any young person between 20 and 40 who has had a blunt injury on the stomach resulting in intestine leakage and sepsis will recover in one to three months maximum. It cannot take five years or so. Here we are talking about a then 28-year-old young woman. And hospitalisation for more than five years is a never-heard-of case. There is something that has gone majorly wrong here and it calls for higher investigation. It is also a rarest case of neuropathy," said a renowned doctor and surgeon.
Poonam's clinical summary from the hospital record reads:
# Background – Blunt trauma abdomen with perforation with faecal peritonitis shock; septic shock with multisystem organ failure. # Diagnosis – Prolonged weaning- ventilator dependant, severe critical illness polyneuropathy, recurrent gram negative sepsis (urine/chest), laxative dependant constipation. In layman’s jargon, it translates to a stomach injury with a blunt object resulting in large intestine injury that led to leakage of stool inside abdomen. This caused bacterial infection which spread all over the abdomen. When a patient is on a major surgery, they are put on a ventilator. Muscles and nerves will be affected with the infection – the gram negative bacteria entering the bloodstream resulting in recurrent infection.
Hospital denies family's allegations
Manipal Hospitals responded to the News18 article saying that whatever treatment Poonam received was done with concurrence with her family. The hospital said in a statement,
"Mrs. Poonam is presently at Manipal Hospitals Old Airport Road under the doctor's observation and continues to fight for her life under ventilator support. We would like to categorically deny the allegations made by the spouse of Mrs. Poonam Rana against the medical team at Manipal Hospitals. Every clinical decision taken on Mrs. Poonam Rana has been done in complete concurrence with the family member (patient’s father) who is well aware of the unique nature of this case."
The hospital said that they provided the best possible treatment to her despite the problems they faced from her family. "As a patient centric hospital and given the fact the patient is young and showing signs of resilience, the quality of treatment provided by our team of medical experts and the entire nursing staff has been best-in-class notwithstanding the constant abuse and non-cooperation from the family members."
The hospital is also has also sought legal opinion and support from the investigating authorities the statement said.
According to the hospital Poonam was admitted with "delayed blunt injury of the abdomen resulting in small intestine perforation and severe abdominal sepsis with multisystem organ failure."
They said she developed a catastrophic bleeding from the trachea leading to a critical condition."With the dedicated efforts of our doctors, we were able to successfully perform the surgery" the hospital said.