MCH incident sparks call for urgent clinical, medical audit of patient care procedures

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The recent incident at Thiruvananthapuram Medical College Hospital (MCH), where a post-surgical patient developed maggot infestation on his leg after being moved from the ICU to the general ward, requires more than token disciplinary action against a single junior staff member.

It calls for a high-level medical and clinical audit that comprehensively examines all aspects of patient care in medical college hospitals – surgical protocols in operation theatres, post-operative wound care routines, scheduled clinical examinations, ward hygiene, and infection control standards, said B. Ekbal, public health expert and a former alumnus of the institution.

Expressing his anguish and acute sense of collective guilt over the incident, Dr. Ekbal, said that scapegoating those at the bottom of the hierarchy, while leaving the structural and systemic conditions that enable such neglect intact, is unlikely to bring in any change.

Normally, ward patients at a major teaching hospital like Thiruvananthapuram MCH are monitored by a dedicated medical team comprising house surgeons, postgraduate students, and junior doctors. This is supplemented by detailed daily ward rounds conducted by the unit chief, senior doctors, and nursing staff.

The fact that a patient’s wound deteriorated to the extent that it got maggot infestation and that it went unnoticed despite so many layers of oversight, reflects a systemic failure, Dr. Ekbal said.

Clear, enforceable protocols for post-operative follow-up care must be established, and the Health department must put in place robust monitoring and accountability mechanisms to ensure these standards are upheld at every level, he said.

While accountability is vital, the recurring incidents of so-called medical errors and negligence in the State’s government hospitals must be examined within the context of a highly complex, high-pressure environment where even the most competent professionals can falter.

In complex systems, excellence depends not just on expertise,