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ASIA PACIFIC

Tainted Drugs Suspected in India Sterilization

Deaths
By SUHASINI RAJ and ELLEN BARRY

NOV. 13, 2014

A funeral in the
eastern Indian state
of Chhattisgarh for a
women who died
after undergoing
sterilization at a
government camp.
Anindito
Mukherjee/Reuters

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NEW DELHI Post-mortem examinations of several women who died

after surgery at a government sterilization camp last weekend in central
India suggest that tainted medications
RELATED COVERAGE
might be to blame, rather than the
Web of Incentives in Fatal Indian
unsanitary conditions or the assemblySterilizations NOV. 12, 2014
line haste of the operations, a district

Save
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medical officer said on Thursday.

12 Women Die After Botched
Government Sterilizations in India

Initially, health officials suspected that

NOV. 11, 2014
12 women succumbed to septic shock
from infections contracted during their
tubal ligation operations on Saturday, in
the state of Chhattisgarh. The surgeon
who operated on most of them, Dr. R.K. Gupta, was arrested on
Wednesday on charges of culpable homicide.

However, the district medical officer, Dr. M.A. Jeemani, said on

Thursday that tainted medicines might be to blame. Our earlier claim
that the deaths were due to septicemia seem to be coming off, he said.
Instead, he added, What I have gathered after the first few postmortems is that it could be due to the administering of spurious
medicines.
The deaths have drawn international attention to the practice, common
in India, of offering women cash and other incentives to be sterilized at
fairs or camps where surgeons operate one after the other on large
numbers of patients. At the Saturday fair, a surgeon was reported to
have operated 83 times in one day.

PLAY VIDEO | 0:39

Sterilization Surgeon Defends Himself

Dr. R. K. Gupta, who performed sterilizations on at least 12 Indian women who later died, says it
was tainted medication that killed them and not complications from the procedures he
performed. Video by AP on November 13, 2014. Photo by Anindito Mukherjee/Reuters.

But in recent days, the investigation has focused on the two packets of
pills sent home with each patient after surgery, one containing
ciprofloxacin, an antibiotic, and the other containing the antiinflammatory and painkiller ibuprofen.

One clue pointing to the pills was another death and scores of
hospitalizations from separate sterilization clinics overseen by another
surgeon two days later. That surgeon, Dr. K.K. Sao, said there was a
third set of patients as well, people who did not undergo surgery, but
were given medicine from the same batches for other reasons. One such
patient who died on Thursday was a 75-year-old man, he said.
State officials in the district have confiscated shipments of ciprofloxacin
and ibuprofen.
Roopchand Siras, a barber from the village of Amsena whose wife died
on Monday after undergoing sterilization, said health officials had
ordered that the medicines should be seized, and came to his house to
collect the remaining pills. Another resident, Bedan Bai, said her
granddaughter began vomiting an hour after taking her first dose of
ciproflaxin and later died.
The Chhatisgarh state government said it had halted the distribution of
drugs made by two Indian pharmaceutical companies, Medisafe Spirit
and Medicare Spirit. Complaints were received against the two
companies for supplying substandard medicines, a statement posted
on Twitter by the state government said.

Indias Painful Past

Associated Press

During a two-year state of emergency that began in

1975, Prime Minister Indira Gandhi led an aggressive
campaign of sterilization that was later deemed to be
a violation of human rights.
In 1976, she announced that ''strong steps which
may not be liked by all'' were under consideration.
More than six million sterilizations, many forced, were
performed. Violent protests ensued.
After Mrs. Gandhi's resounding election defeat in
1977, the new government shunned old measures
and sterilizations declined to 188,000 in 1977 and
1978.

In a field outside the abandoned cancer

clinic where the sterilizations took
place, there were signs on Thursday of a
recent fire, where someone had
apparently burned a large number of
medicine vials, packets and syringes.
Most of the affected patients
experienced vomiting and abdominal
pain, followed by a feeling of dizziness
and chest pains. In the most serious
cases, the patients deteriorated very
rapidly and died within 48 hours of the
onset of symptoms.
A clinician at a private hospital, who
requested anonymity because he is not
authorized to speak publicly, said that
in severe cases, patients were
experiencing cardiomyopathy, in which
the heart is dilated and its pumping
action fails.
Dr. Sao, the surgeon, said he had

reviewed some of the first post-mortem

reports on the women who died in Chhatisgarh. No evidence of surgical
injury on the bodies was reported, he said, and the cause of death was
given as cardio-respiratory failure in one case and renal failure in
another.
The surgeon who was arrested on Wednesday, Dr. Gupta, said in a
telephone interview before his arrest that the ciproflaxin and ibuprofen
used at the fair was distributed by a regional health official to patients
and their caregivers. He said they were clearly spurious medications,
and expressed frustration that scrutiny had fallen immediately on him.
If somebody has to be made a scapegoat, it is the surgeon, he said.
The entire blame is on me.

Suhasini Raj reported from New Delhi, and Ellen Barry from Amsena, India.

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