Surgical wire stuck near heart: Patient and Health Services offer different versions

The Directorate of Health Services (DHS) on Thursday came up with a slightly different version of how a guide wire was spotted inside the blood vessel near the heart of a patient who had undergone thyroid surgery at the Thiruvananthapuram General Hospital in 2023.

The 26-year-old patient, Sumayya, had said that she had developed breathing problems and panting right after she was discharged from the General Hospital on March 30; her surgery was done on March 20.

She said her problems worsened to such an extent that she could not do her household chores. She even had to quit her lab job. She frequently visited doctors and took medicines, but her troubles kept escalating.

By March this year, she said her coughs turned vicious. It was then, two years after the operation, that an X-ray was done on her.

According to Sumayya, it was at the direction of the doctor at a clinic near her house that she did an X-ray that revealed the 50-cm guide wire inside her bloodstream.

However, the DHS said that the patient did not show any surgery-related problems at the time she was discharged from the General Hospital. Sumayya had a condition called multinodular goitre (associated with hyperthyroidism) and the DHS further revealed that it was cancerous.

"Cancer was confirmed when the surgically removed part of the patient's thyroid was examined at the Thiruvananthapuram Public Health Laboratory," the DHS said in a Facebook post on Thursday. For the last two years, Sumayya was taking follow-up treatment at the Regional Cancer Centre and the General Hospital.

Contrary to the patient's claim, the DHS said that the 'abandoned' guide wire of a central line was revealed during the X-ray analysis carried out as part of the RCC treatment this March. Sumayya had said that the X-ray was done at the behest of the doctor at a neighboring clinic. 

A central line is a long, thin tube placed into a large, central vein in the body, like in the chest or neck to administer medications. The guide wire is used to pull the central line into its correct position.

After the X-ray revealed the guide wire, Sumayya said that she met the General Hospital doctor who had performed the thyroid surgery. She said the doctor was surprised by the finding. "He asked me whether I had done any heart operation in my childhood," Sumayya said. 

When she replied in the negative, the doctor contacted the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST). She was told that the guide wire could be removed at the SCTIMST, as the General Hospital did not have the expertise for that. 

Before that, she had to do a CT scan. Sumayya said that the doctor had given her the money for the CT scan and also for other expenses. But when the CT scan results came, Sumayya was told that the instrument could not be removed as it had fused with the blood vessel, and a coating had also formed over it. 

The DHS, however, said "harmless" was the expert opinion received from the SCTIMST on the embedded guide wire. "Still, the General Hospital brought the issue to the notice of the Director of Health Services," the official DHS statement said. 

Following this, the Director of Health Services constituted an expert committee under the additional director of the Health Department in April itself. The committee has cardiovascular thoracic surgery, radio diagnosis, anaesthesiology and general surgery experts from both the Medical education and health departments.

The Committee had examined all relevant medical records related to Sumayya's treatment on August 14. However, the committee has still not been able to reach a "final conclusion". Meaning they have still not been able to figure out at which hospital, or during which treatment procedure, the guide wire got lost inside the bloodstream. 

"The committee has decided to check the details of treatments and tests done at the RCC and other hospitals," the DHS statement said. "Necessary action would be taken on the basis of the expert committee's final report," the DHS said.