Woman dies without treatment despite antivenom stock at Feni general hospital

A woman allegedly died due to negligence in treatment at Feni General Hospital despite sufficient antivenom being available at the hospital.

Hospital authorities have acknowledged the incident and admitted to negligence in treatment. A five-member investigation committee has been formed to look into the matter. The committee has been instructed to submit its report within three working days.

Acting superintendent of Feni General Hospital, Dr Mobarak Hossain Dulal, confirmed the information on Saturday (August 29) night.

The deceased, Nasima Akter, was the wife of Ahmed Karim of Abdul Hamid Moulvi Bari in Madhyam Dhalia village of Feni Sadar Upazila.

According to her family, Nasima went outside her house late Thursday night (August 27) to collect rainwater. As she approached the door, she was bitten by a snake. However, the family could not identify the snake. Her husband took her to Feni General Hospital for treatment at around 3:30 AM She was initially taken to the emergency department, where a blood sample was collected and she was kept under observation for about 20 minutes. Senior staff nurse Alo Rani Nath, who was on duty in the emergency department, said there were no visible signs of envenoming at the time. After her blood was found to be clotting, she was admitted to the medicine ward for further treatment and observation.

Senior staff nurse Shahinur Alam, who was on duty in the medicine ward that night, said the patient was brought to the ward at around 3:35 AM and was given all necessary medicines and care according to the treatment plan. She was also kept under close observation as a critical patient. Her husband was instructed not to let Nasima fall asleep and to immediately inform the nurses if she displayed any abnormal behaviour. More than 90 patients were admitted to the 26-bed ward that day. Despite the overcrowding, staff tried to prioritise critical patients, he said.

He said that around 5:30 AM to 6am on Friday, the patient's husband came and reported that Nasima was not opening her eyes. The nurses immediately went to her and informed a doctor. After checking her pulse, they found that she had already died.

Feni General Hospital Resident Medical Officer (RMO) Dr Roukoun Uddoula said, "the hospital had sufficient antivenom in stock. Two vials had been kept in the intensive care unit for emergency use. In addition, the hospital had enough antivenom for at least 20 patients."

Regarding the allegation of negligence, he said the patient's relatives could not clearly confirm that she had been bitten by a snake when they brought her to the hospital. There were also no signs of envenoming initially. She was therefore admitted to the medicine ward for observation. Signs of envenoming later appeared there, and the patient subsequently died.

Several attempts were made to contact Dr Chiranjib Sarkar, the physician on duty in the emergency department that night, for his comments, but he did not respond.

Acting superintendent Dr Mobarak Hossain Dulal said, "signs of envenoming do not always appear immediately after a snakebite. Antivenom is administered once symptoms appear. In Nasima's case, the treatment plan noted that antivenom should be administered if signs of envenoming developed, and she was admitted accordingly. However, after her condition deteriorated in the ward, the nurse on duty failed to immediately inform the doctor. As a result, antivenom could not be administered in time."

“Preliminary evidence of negligence by the nurse has been found in the incident,” he said. “If the investigation confirms the matter, necessary action will be taken.”

-MT