Srinagar, August 28, KDC: An official inquiry into the death of a 29-year-old woman during an elective diagnostic procedure at a private hospital in Srinagar has recommended that authorities consider exhuming her body for a post-mortem examination, after finding discrepancies in laboratory records, gaps in CCTV footage and significant omissions in her documented medical history.
The seven-member inquiry committee, constituted after the death of a 29-year-old woman, also recorded discrepancies in the timings of her movement to the operation theatre and raised questions over the availability of the anaesthesiologist before the procedure.
The report, accessed by news agency Kashmir Dot Com, has recommended cyber-forensic examination of the original digital storage systems at Medlyn Hospital and SMHS Hospital, verification of the electronic laboratory records of Shifa Hospital and an independent assessment by specialists in anaesthesiology, gynaecology, critical care and forensic medicine.
The report was submitted by Srinagar Chief Medical Officer Dr Rubina Maqbool to the Director of Health Services, Kashmir, on Thursday (August 27).
Separately, the health authorities have sealed the operation theatre at Medlyn Hospital and barred the treating gynaecologist, Dr Syed Basit, and anaesthesiologist, Dr Javed Naqshbandi, from undertaking operative, clinical or anaesthesia-related procedures in private healthcare institutions across Jammu and Kashmir, pending further proceedings.
The inquiry does not conclusively determine the cause of death. It says the circumstances require further clinical and forensic examination.
Woman suffered cardiac arrest during procedure
According to the inquiry report in possession of Kashmir Dot Com, the woman, a resident of Shalimar, Srinagar, had a history of endometriosis (a condition in which tissue similar to the lining of the uterus grows outside the uterus) and had previously undergone hystero-laparoscopic surgery (a procedure combining examination of the uterus through the vagina with keyhole surgery inside the abdomen).
She had also undergone IVF treatment (in-vitro fertilisation, in which an egg and sperm are fertilised outside the body) earlier this year. In May, she suffered a pregnancy loss at about 20 weeks.
On July 4, she returned to a fertility centre while planning another IVF cycle. An ultrasound reportedly showed a left hydrosalpinx (a fallopian tube blocked and filled with fluid), following which she was referred to Dr Basit for diagnostic hystero-laparoscopy.
The procedure was scheduled at Medlyn Hospital on August 5.
Hospital records show that the woman reached the facility at around 2.50 pm and was shifted to Room 310 at 3.10 pm. The inquiry, however, noted a discrepancy over the time she was taken to Operation Theatre 1: her husband said this happened at around 4.10 pm, while theatre records put it at 4.30 pm.
The husband told the committee that no anaesthesiologist had examined her before she was taken into the operation theatre and that the family was not aware of who would administer anaesthesia.
According to statements recorded by the committee, Dr Naqshbandi was not present in the theatre when the patient arrived. The anaesthesia team then sought fresh baseline blood tests, despite earlier blood investigations having reportedly been conducted at Gousia Shifakhana and shared with the treating doctor on WhatsApp.
The inquiry says the patient remained in the operation theatre awaiting the reports for more than an hour.
The anaesthesiologist reportedly accessed the laboratory results on WhatsApp at around 5.30 pm, reached the theatre at 5.35 pm, conducted a pre-anaesthetic check-up and administered general anaesthesia (medicines that make a patient unconscious during surgery) at about 5.40 pm.
Cardiac arrest during hysteroscopy
The laparoscopic component of the procedure, including bilateral tubal clipping (blocking both fallopian tubes to prevent the passage of an egg), was completed before hysteroscopy (examination of the inside of the uterus using a camera) was begun.
The report says the surgeon was considering resection of a suspected uterine septum (a partition of tissue inside the uterus that divides its cavity) when the anaesthesiologist noticed a sudden deterioration in the patient’s vital signs.
The procedure was stopped and the patient suffered cardiac arrest (when the heart suddenly stops pumping blood effectively).
The family, according to the report, noticed unusual activity outside the operation theatre at around 6 pm but were initially told that the patient was doing well. At 6.38 pm, Dr Basit informed them that she had suffered a cardiac arrest and that resuscitation (emergency measures to restore breathing and circulation) was under way.
She was shifted to SMHS Hospital at around 6.50 pm and reached its emergency triage at 7.05 pm.
At SMHS, doctors continued advanced resuscitation. A central venous line (a tube inserted into a large vein to give medicines and monitor circulation) was placed in the right internal jugular vein because of suspicion of an air embolism (a blockage caused when air enters a blood vessel).
The inquiry records that no air was aspirated through the line.
Blood-gas testing showed severe metabolic abnormalities, including lactic acidosis (a dangerous build-up of lactic acid caused when tissues are not receiving enough oxygen), with lactate levels of around 12 mmol/L. The blood pH was below 7.1, indicating severe acidosis, while potassium was reported to have risen to about 12 mmol/L, a level associated with potentially fatal disturbances of the heart rhythm.
The patient was declared dead at 7.48 pm.
The SICU consultant recorded the probable cause of death as cardiac arrest due to suspected air embolism following diagnostic laparo-hysteroscopy. The inquiry committee, however, has recommended further expert and forensic assessment before the cause of death is conclusively established.
Inquiry flags laboratory record discrepancies
One of the key issues identified by the committee concerns the fresh blood investigations ordered before surgery.
The committee compared laboratory records supplied by Medlyn Hospital with the primary electronic records obtained directly from Shifa Hospital in Magarmal Bagh, where the samples had reportedly been processed.
According to the inquiry report, the records differed in barcodes, formatting and timestamps. The primary Shifa records showed the samples as collected at 8.50 pm and reported at 9.30 pm on August 5.
The patient had, however, already been declared dead at SMHS Hospital at 7.48 pm.
The committee has therefore recommended forensic examination of the laboratory information system metadata (digital information showing when a record was created, modified, accessed or processed) to determine how the entries were generated and whether the electronic records accurately reflect the sequence of events.
The finding does not by itself establish that laboratory results were fabricated, the report notes in substance; rather, the committee has sought technical verification of the electronic trail.
CCTV footage raises further questions
The inquiry also examined CCTV footage and other electronic records.
Medlyn Hospital told the committee that surveillance footage from before August 5 had been overwritten as part of its normal seven-day recording cycle. The hospital also said that no surgical video had been preserved on the Stryker laparoscopy recording system.
The committee further examined CCTV footage from SMHS Hospital while attempting to establish Dr Naqshbandi’s movements.
According to the report, analysis of files from a CP PLUS network video recorder showed digital splices and missing intervals during the period when the anaesthesiologist was recorded as walking towards vehicle JK01AD2220.
The report identifies gaps between 4:11:03 pm and 4:11:23 pm, 4:11:23 pm and 4:11:43 pm, and 4:11:43 pm and 4:13 pm.
The Medical Superintendent of SMHS Hospital also confirmed that Dr Naqshbandi had availed half-day casual leave for the second half of August 5.
The committee has recommended a cyber-forensic examination of the original storage systems rather than drawing a final conclusion from the available footage.
Medical history allegedly missing from hospital file
The committee found that the Medlyn Hospital clinical file classified the patient as ASA-I (a classification generally indicating a healthy patient without significant systemic disease) and recorded no co-morbidities (other existing medical conditions).
The inquiry said the file did not adequately reflect several conditions documented elsewhere.
These included symptomatic bronchial asthma (a condition causing narrowing and inflammation of the airways) for which she was using inhalers, subclinical hypothyroidism (an underactive thyroid condition with limited or no symptoms) for which she was taking thyroxine, severe allergies to certain fluoroquinolone antibiotics such as Ofloxacin and Norfloxacin, and a history of portal cavernoma (abnormal blood vessels that can develop around a blocked portal vein).
The committee also found no evidence in the hospital file of mandatory or expected pre-operative investigations such as an ECG (electrocardiogram, a test recording the heart’s electrical activity) or chest X-ray.
It also raised questions about the timing of the procedure, given that the patient had suffered a second-trimester pregnancy loss less than three months earlier.
Another issue concerned the suspected uterine septum. The committee noted that previous three-dimensional scans had reportedly not shown such a septum.
The report also pointed to a discrepancy between the operative note, which described a closed Veress needle entry (a technique in which a needle is used to introduce gas into the abdomen before laparoscopic surgery), and an audio recording in which the surgeon reportedly described an open entry technique.
Family raises questions over injuries, death records
The patient’s husband and family members told the committee that blood continued to ooze from puncture sites on her neck and hands after death and alleged that there was a large transverse abdominal wound below the umbilicus.
Dr Basit denied making such an incision and maintained that only standard laparoscopic ports had been used.
The committee said it could not independently determine the nature of the abdominal wound because no initial autopsy had been conducted. It also noted that SMHS Hospital had not furnished a final authenticated death certificate to the committee.
Exhumation among five recommendations
Against this backdrop, the committee has made five principal recommendations.
These include cyber-forensic examination of the original storage systems at Medlyn Hospital and SMHS Hospital; forensic verification of Shifa Hospital’s electronic laboratory records; requisitioning complete medico-legal documentation and an explanation from SMHS Hospital regarding the CCTV footage; and constitution of an independent expert panel comprising specialists in anaesthesiology, gynaecology, critical care and forensic medicine.
Most significantly, the committee has recommended that the competent legal authorities consider exhumation of the body for a formal post-mortem examination to determine the cause of death and assist in fixing responsibility, if any.
The recommendations come even as the health department has already sealed Medlyn Hospital’s operation theatre and prohibited Dr Basit and Dr Naqshbandi from undertaking private clinical, operative or anaesthesia-related procedures anywhere in Jammu and Kashmir pending further proceedings.
The authorities have also directed the hospital administration to preserve physical and electronic evidence connected with the case.
The inquiry report, while recording several discrepancies and recommending further forensic examination, does not by itself establish criminal liability or conclusively determine the cause of death. The final findings will depend on the outcome of the recommended forensic, clinical and legal proceedings. (KDC)
The death of a 29-year-old woman during or following treatment at Medlyan Hospital is a deeply disturbing matter that deserves a transparent, impartial, and thorough investigation.
This incident also raises a broader concern about the growing corporate culture in healthcare. Hospitals may operate within a corporate structure, but healthcare must never become solely an administrative or commercial enterprise. The central principles must remain patient safety, medical ethics, professional responsibility, compassion, transparency, and respect for human life.
Patient safety must remain above institutional reputation, commercial considerations, or administrative convenience. Where a life has been lost under circumstances raising legitimate questions, those questions deserve honest answers and an independent investigation.
We may have infra structure money but we don’t have human resource well trained staff and brain to run and monitor it
Kashmir lack approach presentation and
There is no team work , commitment , integrity , mutual respect , and leadership in Kashmir health care
Kashmir health care stand static , absolute lack of vision and mission
No clear plan to attain goal infact no goals exist or ever framed I mean not constructing and opening of medical colleges or mushrooming of private hospitals , I mean quality human resource development leader ship development skill building so that they can deliver
Kashmir health care is huge mess comparing to to other comparative areas of India in that matter doctor are not to blame they are at receiving end
It is lack of political will , and excellent leadership in health care
Their are many examples to quote but it will initiate huge online discussion
Nut shell
Kashmir health care governance leader ship has to introspect they Incompetent lacks the ability skills to lead effectively and this leadership has time again proved and produced poor results and running defunct system .