Tamil Nadu: No diagnosis or cause of death in P Jeyaraj’s case sheet

CHENNAI: No referral was made to a bigger hospital, no specialists called for consultation, no diagnosis or cause of death — the case sheets of P Jeyaraj, the direct eyewitness to the custodial torture death of his son Beniks, raise more questions than answers.
The two key elements of a usual case summary — diagnosis and cause of death — have not been derived although patient Jeyaraj spent at least seven hours at Kovilpatti hospital.
Jeyaraj and Beniks were arrested by the Sathankulam police on June 19 and taken to Kovilpatti subjail on June 20. On June 22, Beniks died within 75 minutes of admission at Kovilpatti government hospital.
Documents available with TOI show Jeyaraj was admitted at the hospital at 10.45pm on June 22. This was an hour and 45 minutes after the death of his son Beniks at the same hospital.
The casualty medical officer, Dr T Balasubramanian, had told health department that it was too late to refer Beniks to Tirunelveli Medical College and Hospital. But the case sheets of Jeyaraj do not show any attempt by the medical team to transfer him for higher level of care. Dr Balasubramanian, who holds a diploma in ENT, did not even call for a specialists’ opinion. “He could have called for a doctor from the same hospital who has seen these patients in the sub-jail or a senior physician. That is the normal protocol,” said a senior doctor. However, when TOI contacted, Dr Balasubramanian said: “I have given my response to the government in writing. I have no comments.”
Beniks was taken to the Kovilpatti GH at 8pmwith difficulty in breathing, palpitation and sweating by two warders – Marimuthu and S Velmurugan. Dr Balasubramanian attended on him. Beniks had high pulse, mildly elevated BP and low oxygen saturation. Examination found nearly foot long -- 25x20cm and 20x20 cm – wounds on both buttocks. He called for an ambulance to transfer him to Tirunelveli Medical College and Hospital. But at 9pm, he was pronounced dead.
In less than two hours, Jeyaraj was brought to the hospital with fever, body ache but no “breathlessness”. He too was attended by Dr Balasubramaniam, who noted similar wounds on his buttocks. Jeyaraj had a high blood pressure (170/110 mmHg against normal 120/80), high blood sugar (437mg) and mild fever (98.4F). He was known diabetic, as per the case sheet.
“In normal circumstance, when there are two people from the same case brought one after the other for unknown medical reasons, they are transferred to higher centre for better care,” said a senior government doctor.
Jeyaraj was shifted to the ward, and prescribed intravenous fluids, insulin, antihypertensive medications, drugs to bring down fever and other supportive drugs. In one hour, at around 12am on June 23, Jeyaraj’s blood sugar dropped to 258mg% and his BP was 140/100mmHg.
Hospital Superintendent A Kamalavasan has told the joint director of health services that “a sudden cardiac arrest was noted by the staff nurse and the duty doctor rushed to the ward and team coordinated to resuscitate him.”
This, according to the patient chart happened at 5.20am on June 23.
The summaries sent to health department late last month did not mention what happened between midnight and the cardiac event. But, on July 3 (Friday), doctors had sent an hourly update which showed no abnormal changes in blood pressure or blood sugar.
It said that after the cardiac arrest, Jeyaraj became unconscious, and was not responding to stimuli. He was gasping, his blood pressure could not be recorded and his pulse was feeble. The team performed a cardiopulmonary resuscitation, pumped oxygen using ambubag, gave him injections such as adrenaline and steroids to revive him. He died at 5.40am.
Their bodies were sent to the medical college one after the other on “oral” inquest from the police.