The death of two brothers aged seven and four ---the only children of a poor couple ---following oral administration of Napa syrup (generic name Paracetamol) is a stark reminder of 28 children's death from intake of toxic Paracetamol produced by a pharmaceutical company named Rid Pharma in 2009. This time it happened in Durgapur under Ashuganj Upazila of Brahmanbaria. Used for treatment of headache and fever, Napa syrup has, however, no record of causing death to children before this tragedy. Reportedly, the syrup's bottle shows the expiry date in 2023. The bottle has been seized for examining it and its content.
Before laboratory tests come up with results, any comment on the quality of medicine will be premature. But there is a need for ascertaining if the particular Paracetamol bottle is genuine or not. Clandestine business of spurious medicine is ripe particularly in small towns and villages. The busting of underground drug manufacturing facilities by the law enforcement agencies speaks volumes for the malpractice.
However, a thorough probe will be necessary to pinpoint the exact cause of the siblings' death. Other points are suspect too and, therefore, cannot be overlooked. First of all, there was a symptom of fever but no recognised physician was consulted before administering the syrup. The mother of the boys procured the syrup from a local pharmacy on the assumption that her sons were taken ill by fever. Immediately after taking the medicine, the two boys vomited and then on the advice of the owner of the pharmacy, the two boys were taken to Ashuganj Health Complex where the doctors referred to Brhmanbaria District Hospital because the health complex had neither paediatrician nor a system for bowel washing.
Accordingly the two sick boys were taken to Brahmanbaria District Hospital where physicians gave them primary treatment and were sent home. Evidently, the upazila health complex suspected presence of toxic substance in the two boys' stomach. They did what was needed to be done. Here the patients were given oxygen support as their oxygen level was low. However, they could not manage an ambulance for sending the patients to Brahmanbaria. If it was deliberate, the physicians there are to blame for the lapse. But if there is no ambulance, it shows the deplorable state of the particular health complex or even other health complexes.
However, the primary treatment received by the two boys has not been elaborated. Were their bowels washed? The higher authority has promised investigation into the matter categorically mentioning every attempt to be made to find out why the children were not admitted to the hospital and instead sent home. The question is, did the attending doctor/s give proper attention to the sick boys. That doctors from the health complex sent the boys for better treatment should have been enough to give a closer look into their cases. Rather, the cases were seemingly taken lightly.
If the mother was at fault initially for not consulting a doctor, she did everything right afterwards. In the absence of her husband who works at a brick kiln in Sylhet, the woman, a labourer at a local rice mill, had to rush from one hospital to the other. When no ambulance was available, the poor mother had to hire a CNG-driven auto-rickshaw to take her sons to Brahmanbaria District Hospital. Without keeping the boys under observation, they were sent home. What was the level of medical wisdom that prompted the attending doctor to send the patients home?
It is a common complaint that doctors in this country hardly give time to patients. Their commercial considerations get the better of a thorough inquiry into patients' health condition. At times near and dear ones even cite negligence of medical professionals for the death of patients and go berserk or physically assault doctors. Such developments are unfortunate and can be avoided if physicians are as much attentive and caring as the cases demand.
In the 2009 renal failure of children on account of contamination of Rid Pharma Parcetamol, diethylene glycol, a raw material of leather industry, was used instead of propylene glycol to cut production cost. That was responsible for children's death. Hopefully no such tinkering was done in case of Napa. However, if the medicine is found to be responsible for the two boy's death, Napa syrup has to be withdrawn from the market.