New Delhi: While the number of children and infants who have died at the Baba Raghav Das (BRD) Medical College in Gorakhpur continued to mount—more than 40 deaths have been reported in the last 48 hours—a team of experts from the Centre said “prematurity", “asphyxia" and “sepsis" were the three main causes for the deaths at the hospital.

The three-member expert committee, which was sent to assess the situation at the tertiary care hospital following the deaths of 71 children between 7 and 11 August, has ruled out “Japanese encephalitis" (JE) as the cause of death among children. “There were hardly any deaths from JE as claimed," said one of the experts, requesting anonymity.

According to the report, “out of all the deaths, 49 per cent were neonatal deaths and 16 per cent were paediatrics death. The neonatal (for aged up to 28 days) deaths occurred due to prematurity, asphyxia and sepsis mostly occurring within 48 hours of admission. The deaths among paediatrics were the consequences of Acute encephalitis syndrome (AES)," stated the report, which was reviewed by Mint.

In fact, the experts didn’t find any significant difference in the number of deaths between 2016 and 2017. “There was no increase in deaths in July 2017 as compared to 2016. In fact in the month of July last year 292 children had died, whereas 200 died in July 2017," it further said. The hospital came in the spotlight in early August for the deaths of 30 children in a span of 48 hours.

The experts have also ruled out the possibility of children dying due to oxygen shortage. “As per data made available by the state, it was observed that there was no increase in number of deaths in the period 24 hours before and 24 hours after the alleged period of interrupted oxygen supply (from the evening of 10 August to the morning of 11 August)," the report further stated.

The team of experts comprises Dr M.K. Aggarwal from the Immunisation department of the ministry of health and family welfare, Dr Harish Chellani, professor and head-paediatrics, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, and Dr Sushma Nangia, director professor and head-neonatology, Lady Hardinge Medical College.

The committee found “gross overcrowding" in neonatal intensive care unit (ICU) of the BRD Medical College with 4-5 neonates on one bassinet. Enough care was not taken for cleaning of bassinets, hand washing and use of disinfectants, the report added.

The report said that the deaths in extramural admissions (those referred from adjoining districts) were found to be more as compared to those born within the hospital. “From Jan-June 2017 among all the deaths in babies, 42 per cent were the referred cases and 33 per cent of those who died were born in the hospital," it said, blaming poor “stabilisation facilities" for neonates delivered in adjoining areas. The referrals mostly came from eight districts—Khushinagar, Maharajganj, Deoria, Siddharthnagar, Sant Kabir Nagar, Basti, Ballia and Assamgarh. While about 1,500 admissions in neonatal ICU were from adjoining areas between January and June 2017, 540 neonates were intramural (born in BRD) in the same period.

In the report, which has been submitted to health minister J.P. Nadda, the experts also pointed at inadequate strength of faculty in BRD Medical College. “Only one third of the posts of senior respondents are filled. The strength of nurses are adequate. However only 15 per cent nurses are trained in facility based new born care," said the expert.

To improve quality care, experts have recommended death audits and better infrastructure in newborn facility care at the medical college.

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