Doctor freed in Bilaspur sterilisation deaths case
Two years after 13 women died and 65 were impaired in a botched sterilisation camp, Dr. R.K. Gupta was acquitted by the Chhattisgarh High Court on technical grounds last week. The surgeon — accused of using the same gloves, syringes and sutures on all the 83 women, and causing life-threatening infections — was acquitted after the prosecution argued that the investigators did not have the State government’s sanction, necessary to prosecute a public servant.On November 8, 2014, Dr. Gupta, a surgeon at the Bilaspur District Hospital, conducted laparoscopic tubectomies on 83 women, within 90 minutes in an abandoned, unsterile building. Police investigation revealed that Dr. Gupta had spent approximately 3 minutes per patient, and not followed infection control protocols. Dr. Gupta was arrested and released on bail 27 days after the incident.Deaths at the Takhatpur sterilization camp were one the darkest chapters of India’s family planning programme since the policy achieved notoriety during the Emergency years (1975-77) when a compulsory sterilisation programme to limit population growth was introduced by the Indira Gandhi government.In a 16-page verdict, the court reasoned that, “the petitioner’s services were terminated on 13.11.2014 in respect of the offence which had occurred on 08.11.2014 and though the cognizance of which was taken later, it would still require sanction from the Govt. before the petitioner is prosecuted for those offences which clearly falls within the ambit of discharge of official duties. In the absence of obtaining prior sanction, the entire prosecution case becomes ab initio, void and becomes unsustainable.”The decision is likely to be challenged, said Colin Gonsalves, lawyer appearing in the case. “Sanction should have been granted by the state government for prosecution. Withholding sanction, simply, means the stategovernment is supporting the doctor. Sanction can be granted even now and the prosecution can be started again.If the state foes not grant sanction, then any of the affected women can go to the high court and file a petition to get the order of sanction. It is shocking that the state government is supporting the doctor in this case,” added Colin.A situational assessment report ordered by the State government that month established that the premises where the tubectomies were conducted had not been disinfected properly: “A sweeper had mopped the walls. None of the surgical staff changed their hand gloves. The same injection, needle and suture were used for all the women. Neither were they sterilised nor new needles taken for each case.” It further added that Dr. Gupta used only one laparoscope, without disinfecting it after each use. A laparoscopic surgery is a minimally invasive surgery where a thin surgical instrument is inserted into the abdomen. The report was authored by experts from PFI, Family Planning Association of India, and Parivar Sewa Sanstha. Investigations by The Hindu revealed that viscera reports — from the Central Forensic Science Laboratory in Ramanthapur, Hyderabad, and from the Central Drugs Laboratory, Kolkata, and from the State Forensic Science Laboratory in Raipur had indicated medical negligence by the doctor and his surgical staff. Even though 15 drugs and 18 medical devices were used during the surgery, only two drugs – Ciprocin and Ibuprofen- were tested for contamination. However, viscera reports from the State Forensic Science Laboratory in Raipur of all 13 women established categorically stating that no “raasaynic vish” (chemical poison) was detected from the two drugs.“I am stunned by the verdict. Every woman who died that day was a mother. She left a child motherless. It is disheartening that there will be no justice for these women. The message it sends out to the medical community is that these doctors- in government or private sector- can break rules and not be held accountable,” said Poonam Muttreja, Executive Director of the Population Foundation of India. In a double whammy, the State government has since discontinued all family planning services, leaving women with the choice of unaffordable private hospitals.The Hindu found that months before the deaths at Takhatpur camp, every district in Chhattisgarh was given a sterilisation target to meet, in violation of Union Health Ministry norms. Doctors in Bilaspur had an ‘ELA’ (Expected Level of Achievement) of 3,000 sterilisations and 3,000 Intrauterine Contraceptive Device (IUCD) insertions within a fortnight. For Takhatpur Nagar Panchayat, the doctors had to sterilise 300 women or risk losing the budget for the next year.When asked about targets, Dr. Gupta had told The Hindu last year: “If I am wrong, all my senior officials are also in the wrong. They gave me these targets. They knew exactly what was happening.”While Dr Gupta was suspended after the deaths, he continues to practice- and operate on patients- at a private clinic is a post area of the city.