Malvani hooch tragedy: Did lack of planning lead to too many deaths?

Mass consumption of spurious liquor and lack of planning in treatment of Malwani hooch tragedy victims could have led to high number of casualty, say experts.According to doctors, methanol toxicity (spurious liquor consumption) needs acute management where apart from stabilising the patient, removing metabolic acidosis- toxin build up in the body plays a crucial role.Dr Khusrav Bhajan, intensivist at PD Hinduja Hospital-Mahim said, "While treating methanol toxicity patients, stabilising then is priority. These needs to be immediately followed by steps to remove metabolic acidosis where ethanol needs to be given."Bhajan said methanol toxicity can lead to brain damages, convulsion, liver failure if not treated on time. "A person having methanol toxicity needs dialysis with ICU management despite no kidney failure. This is to help the body throw out the toxins that build up in the body. Depending on the levels of toxicity, hemodialysis has to be repeated," said Bhajan.As per the treatment protocol for methanol toxicity, a person with 30ml+ methanol presence in blood, needs to be put on dialysis at the earliest. According to sources at Shatabdi Hospitals, almost all the victims had more than 30ml of methanol in their blood stream. "Apart from stabilising the patient, the patient should be put on dialysis at the earliest," said Dr Bhajan.During the outbreak of Malwani hooch tragedy, most of the patients were rushed to Shatabdi hospital in Kandivli while few were taken to nearby private hospitals. "We got 129 patients affected with methanol toxicity. While most of them were transferred to tertiary care hospitals, four are still with us who are critical and two are in wards," said Dr Krishna Pimple medical superintendent of Shatabdi Hospital.While Shatabdi Hospital authorities said that they didn't have team to carry on dialysis in their hospital, experts say such a huge turnout of methanol toxicity patients in one hospital is impossible to manage. "These patients needed repeat of dialysis in every 5-6 hours. Managing all of them in one hospital wasn't possible. Even a tertiary care like us wouldn't have been able to handle. We have four dialysis machines," said a senior doctor from Sion Hospital which is presently treating three of them.Of the 124 people brought to various public and private hospitals, 97 died by Sunday. Nearly 70 per cent of all the patients, doctors said, have died within 72 hours of consuming the methanol-tainted liquor."There was a lack of planning. These patients should have been distributed to different hospitals who have ICU beds with dialysis option. Once severe metabolic acidosis sets in, it is difficult to save the patient," said Bhajan.