'Reused' Cannula Back from Incinators

By M H Ahssan

Corporate Hospitals Found Reusing Them Claiming Patients Can’t Afford New Ones

The plasma television in hospital suites could well be brand new, but the cannula pierced into the patient's body during a cardiac surgery could well be a reused one. Investigations conducted by this newspaper have revealed that some city hospitals are often making a rather unethical 'compromise' using medical equipment that as per law should be disposed after single use.

Cannulae (plural for cannula) are plastic tubes that come with a 'single-use device' label and are used to drain or inject fluid into a patient's body. It is reliably learnt that these devices are being "reused'' by some hospitals, a fact confirmed even by cardiac and plastic surgeons, who shockingly reason that patients may not be able to "afford'' new ones.

However, these cannulae are sterilised before reuse so that no trace of bacteria remains in them. "After gas sterilisation there is no chance of any infection passing on to the next patient," a cardiac surgeon says.

However, since cannulae are inserted into the vein or artery of the patient for the administration of intravenous fluids and medicines, or into the nose for the delivery of oxygen, the reuse of such devices is declared illegal as per the Drugs and Cosmetics Act of 1940. This was done after these devices were put in the category of "drugs'' in 2006.

This 'reuse' practice can lead to serious infections such as HIV, and sources in the health care sector note that other curable infections do occur among patients. "They are treated with antibiotics but this could lead to a longer stay of the patient in hospital and fat medical bill,'' says a hospital administrator. This added cost to treat infections rubbishes hospitals' claim that they do not use brand new cannulae as patients wouldn't be able to afford it.

Open heart surgeries, plastic surgeries, liver transplants are some of the procedures where this practice of using used cannulae is rampant. "The cannulae used for these surgeries are very expensive. A single piece can cost anything between Rs 2,000-Rs 3,000.

The use of new cannulae escalate the cost of surgeries by a good Rs 50,000 or more and many patients may not be keen on spending so much,'' says a senior official in a city hospital. However, further prob into the matter revealed that even smaller surgeries nowadays are not spared from this unethical practice either.

Though some medical experts agree that gas sterilisation is a nearly fool-proof method, they do not wash away chances of the patient suffering some infection. They point that the process of sterilisation is undertaken by ward-boys and nurses and not doctors.

‘Sickening’ practice by greedy hospitals in city
Reuse of Cannulae __ plastic tubes that come with a ‘single-use device’ label and are used to drain or inject fluid into a patient’s body __ by some hospitals can lead to serious infections, warn medical experts.“Even a slight mistake on their part could cost the patient dearly. Moreover, if a patient is shelling out Rs 1 lakh for a surgery, would he mind spending Rs 50,000 more if he is told it is for his safety,” says a physician who did not wish to be identified. He further stated that people do not compromise on their treatment. The import duty on medical equipment was reduced to 7.5 per cent in this year’s budget. Cannulae for major surgeries are all imported.

Health activists feel that patients opting for a surgery should at least be made aware of the two kinds of cannulae (new and sterilised) and allowed to choose for themselves.

But what do the law enforcers have to say? Officials of the Drug Control Authority admit that such violations are taking place in hospitals. “It is a punishable act and can lead to minimum one year imprisonment of the erring doctor, provided it is reported,” says an official of the department. “However, who can monitor what is happening inside the operation theatre? Even if the doctor is reusing a cannula on the patient, who will bring him to book?” he asks.