LARKANA: Two senior doctors — the additional medical superintendent (AMC) and chief medical officer (CMO) — of the Chandka Medical College Hospital (CMCH) are facing dismissal from service after an inquiry into the death of a six-year-old dog-bite victim found them guilty of misconduct and negligence.

They have been given seven days to explain why they did not respond to a final show-cause notice, issued to them a week ago, within the stipulated time.

Chief Secretary Mumtaz Ali Shah had issued the final show-cause notices to AMC Dr Mohammad Saleem Shaikh (BPS-19) and CMO Dr Rabail Noonari (BPS-20) but they failed to respond within the given time.

The final show-cause mentioned that the doctors had nothing to say in their defence and “are guilty of the charges”. It informed them that “it is proposed to impose upon them the major penalty of dismissal from service under Rule-4 (1) (b) (iv) of the Sindh Civil Servants (Efficiency & Discipline) Rules, 1973”.

Six-year-old boy remained under treatment at Karachi’s NICH for 28 days before his death

The notice gave them seven days to submit their replies to the respective show-cause notices.

According to the findings of the inquiry instituted against them, both doctors were found involved in misconduct in performing their duties during treatment of the dog-bite victim, six-year old Hasnain, son of Ghulam Hussain Bughio, a resident of Habib Bughio village located near Larkana.

The boy was shifted to the CMCH on Nov 14, 2019 and after initial treatment he was rushed to the National Institute of Child Health (NICH) in Karachi where he remained under treatment for 28 days but could not survive.

After the boy’s death, an inquiry into the whole episode was instituted.

In its findings, the inquiry committee mentioned that “very weak data management system was observed, bio-data of vital signs, general examination, description of injuries, treatment given and referral process was not recorded on the data tool. No consultant except the maxillofacial surgeon had attended the patient. Only MLOs/SMOs working in sub-specialities had attended the case”.

The committee also observed that no standard operating procedures (SOPs), including infection prevention protocols, were observed during the case management.

The first aid management was given at the casualty department in the presence of a mob of irrelevant persons, including media persons, it noted, and observed that most of the time the doctors, media personnel and other people, including the patient’s relatives, were found discussing referral of the case to Karachi.

The stock register was not maintained as a valid stock record. “The immunoglobulin for rabies was shown without the date of expiry and batch number ... sources of receiving and delivery were not properly documented,” the committee’s report said.

It further stated that the duty roaster and record of leave were not maintained. Consultant roaster indicating the responsible specialist for the subject on the emergency duty was not available, it said, adding that reconstruction surgical departments like plastic surgery and vascular surgery were not available [at the hospital].

Dr Shaikh and Dr Noonari were suspended on March 18, 2020 to face the inquiry into the charges of negligence in performing their official duties.

The services and general administration (S&GA) department had directed the CMCH medical superintendent on Sept 15, 2020 to relieve the doctors but no such letter was issued and they continued to work at the CMCH till date.

Published in Dawn, February 10th, 2021