This story is like a fairy-tale and
like most memorable love stories; it also has a tragic end, at
least in this world. Anuradha Saha was born in Calcutta in a middle-class
family, only daughter with two other siblings. A rare combination
of angelic beauty and simmering grace. Anuradha was also an exceptionally
intelligent student. After graduating in the top of her class
from the Modern High School in Calcutta, she got a scholarship
to study in the USA – a rare feat for the Indian students.
She left India at a very young age soon after finishing high school
to achieve the best education and build a productive career in
the Home of the Braves and Land of the Free.
Kunal Saha was also born in a middle-class
family at Halisahar, a suburb of Calcutta. With 11 siblings and
a doctor-dad, “education” was the central theme of
his family. But Kunal was one of the most gregarious and jovial
member in his large family with an impeccably open minded for
the outside world. Six feet tall with a typical TDH (tall-dark-handsome)
look; Kunal was also a fanatic cricket-lover and an astute student
with remarkable ability to overcome academic challenges. He graduated
from a local high school as a “National Merit Scholar”
and was offered admission in almost all top academic institutions
in India including the IIT-Kharagpur, Birla Institute of Technology,
Presidency College, Jadavpur University and even the Pune Film
Institute. But he eventually followed the foot-steps of his father
and elder brother to study medicine and joined the NRS Medical
College in Calcutta to become a doctor.
The way this love-story between Kunal
and Anuradha started would astound even a frequent watcher of
Yash Chopra’s romantic Hindi films. As Kunal completed his
medical education at NRS in the mid-1980s and was all set to join
most of the rest of his family who had already migrated to the
USA, Anuradha came to Calcutta after graduating from the Southern
California University to visit her parents. Kunal was supposed
to go to Delhi on the first week of January 1985, but missed his
train for the first time in his life as he got trapped in one
of the famous traffic jams on Mahatma Gandhi Road. Anuradha was
supposed to return to California the very next week. They would
have never met, had that horrendous traffic jam in Calcutta, for
once, not played the role of Cupid and forced Kunal to miss his
train to Delhi to stay back in Calcutta.
Frustrated for missing the chance
to go to Delhi, Kunal returned to House-staff quarter at the NRS
Hospital. To compensate his loss of fun in Delhi, Kunal and some
of his close doctor buddies promptly arranged a picnic the very
next day at Kunal’s family house – a gorgeous bungalow
near the Ganges some 50 kilometers from Calcutta. Anuradha also
had a school friend, Madhumita, who was a dental student at the
R. Ahmed Dental School and was also a common friend of Kunal.
Madhumita was invited for this picnic at Kunal’s family
bungalow. Having heard that her school friend was visiting from
USA and would return to America next week, they also invited her
to join the picnic. Sunday, January 6, 1985 is a red letter day
for Kunal and Anuradha. This was the day of the picnic when the
eyes of Kunal and Anuradha met for the first time and this “love
story” began. Was it love at the first sight? Kunal always
said, “Anu (abbreviated name of Anuradha that Kunal used
to call her) you are more than just a love for me - you must be
my angle. Otherwise, how I could have ever missed the train for
Delhi only to meet you”. Anu quipped, “I had to be
with you, Kunal. I am right in your center. Look at K-U-N-A-L;
A-N-U is right in the middle. Our names were chosen at our birth
by our parents. How could they put me right in the middle of you
when we were born?” Kunal and Anuradha always celebrated
January 6, 1985 as their true “anniversary” day even
though they actually did not get married until 27th July, 1987
(see below the anniversary wishes written by Anuradha on January
6, 1989).
The love between Anuradha and Kunal
flourished in a spectacular manner despite a huge physical distance
in America. Anuradha went back to California to join a new graduate
program (she initially wanted to become a lawyer in the USA) and
Kunal started his new life in USA, first as a research trainee
at the Lousiana Medical Center in Louisiana and then as a graduate
student at the University of Texas-MD Anderson Cancer Center in
Texas. Although Anuradha had been living in the USA long before
she met Kunal, she had a tough existence as a young, Bengali student
without any family around, trying to build a career in the hustle
and bustle in an exotic place in a foreign land, the city of the
Angles (Los Angeles). Kunal was living in the deep South trying
to cope up with the drastically different life style in America
even though he had the support of other family members who were
already settled in America. But the distance of more than 3000
kilometers between California and Louisiana was hardly a barrier
for these two young lovers who always felt that their match was
made in the paradise. Anuradha would drive on the busy highway
in California or stroll on the glistening beach of the Pacific
Ocean and block out all sounds except the sound of the waves as
she engaged in an endless imaginary conversation with Kunal who
was living thousands of miles away. Anuradha was blissfully happy
by falling in love with Kunal as she wrote in one of her numerous
enchanting love letters to Kunal, “If I ever make you, a
fraction as happy as I was today, I will say, “Koonal, you
are one lucky guy!” Couldn’t I stay, that way, for
a long, long, time, perhaps even for ever?”
Their love story soon had a happy
turn of event - Kunal and Anuradha decided to return to Calcutta
and get married. They eventually got married on 27th July, 1987.
Despite a difficult situation as a young couple with limited money
and an uncertain future, they enjoyed every minute of their life
together as a married couple (pictures below).
Marriage
of Kunal & Anuradha, 1987
But the difficult journey towards
the “American Dream” started soon for Kunal and Anuradha.
While Kunal returned to Texas to resume his medical career, Anuradha
had to stay back in India for almost two years before she could
return to the USA because of the regular waiting period for visa
as the wife of a permanent resident of USA. Anuradha eventually
joined Kunal in USA and took the LSAT (entrance test necessary
to get into law schools in the US) and prepared herself to get
into a law school. She obtained high grades in almost every test
that she took and was offered admission from many top law schools
in America including a full scholarship at the Baylor Law School
in Houston. In the meantime, Anuradha was also working with abused
children at the “Texas Department of Children’s Services”.
While working for the abused children, she was shocked to find
the unscrupulous ploys routinely adopted by the lawyers (mostly
in custody battles for the children). She was tormented to find
the mental pain and suffering of the abused little children. She
changed her mind to become a lawyer and instead, she wanted to
be a Child Psychologist to help the hapless children of child
abuse. Anuradha applied for graduate programs in “Child
Psychology” and was accepted by “Columbia University”,
the prestigious Ivy League school in New York City. In the meantime,
Kunal also completed his study at the University of Texas and
was offered a lucrative fellowship from the “Aaron Diamond
Foundation” for conducting HIV/AIDS research at the Columbia
University Medical Center. They moved to New York City in 1993.
Life was still a busy and hectic struggle. While Anuradha was
a studying as a full time graduate student at the expensive Columbia
University and also working part time for the children at the
Archdiocese of New York, Kunal was busy with his AIDS research
at the Columbia Presbyterian Medical Center in upper Manhattan.
Despite a very busy life and hard struggle in New York (as most
young couple must go through to reach the American Dream), love
between Kunal and Anuradha only grew stronger everyday. With little
time and money in hand, they still tried to extract time for fun
activities in the New York City and often drove long distance
to see the rest of the beautiful country of the United States
of America
The script of this scintillating love-story
looked almost picture perfect towards the end of 1997. Anuradha
completed all requirements for becoming a “Child Psychologist”
from Columbia University while Kunal finished the fellowship from
the Aaron Diamond Foundation for AIDS Research and published his
HIV research in the top medical journal “Nature Medicine”.
As Anuradha and Kunal planned all along, they were now ready to
start a family of their own. They decided to move to a new place
because despite the glitters and fun of New York City, both thought
that this was not an ideal place to raise a child. Anuradha would
take a break from study and practice for a couple of years to
raise the child. Kunal also got the “First Innovative Grant
for AIDS vaccine” from the National Institute of Health
(NIH) and was offered faculty position from top universities across
the country. Eventually they chose to accept the offer from the
Ohio State University (OSU) and Children’s Hospital in Columbus
because of its peaceful location and mid-western tradition. Both
Anuradha and Kunal visited Columbus at least four times before
making the final decision to move there. They applied and obtained
a joint mortgage to purchase their first house - a beautiful lake-front
mansion compared to their apartment in New York City. A big, new
“house” in USA for the first time after years of hard
struggle together – a house with big back yard and front
lawn with plenty of space and of course, a very large kitchen
with all the modern amenities (Anuradha’s special wish for
many years for her love of cooking). She also decided to buy a
new car – a Mercedes sports utility vehicle because she
thought a regular car is not suitable when you have a family.
Kunal signed a lucrative contract to join OSU from June 1, 1998
as a regular tenure-track assistant professor. They packed all
their belongings from the New York apartment and shipped it with
the movers for Columbus.
One final wish Anuradha also had –
to collect the blessings of her mother in Calcutta before she
starts this new phase of their life. So, Anuradha and Kunal planned
for a short trip to India just before starting their new life
in Columbus. They landed at the Calcutta Airport on April 2, 1998
– the happiest couple ever to land at the DumDum Airport.
But they could hardly wait to go back to their new, dream home
in Columbus, Ohio. Destiny willed otherwise!!! Anuradha never
left the soil of her motherland again to get back to their dream
house in Columbus. From a simple skin rash (as allergic reaction
to some drugs), she eventually died in India because of the rash
and grossly negligent medical therapy by three senior Calcutta
doctors, Dr. Sukumar Mukherjee (Medicine), Dr. Abani Roychowdhury
(Medicine) and Dr. B.N. Halder (Dermatologist). The next chapter
of Kunal-Anuradha love story started with the incomprehensible
death of Anuradha as Kunal raged an unprecedented legal as well
as social war to bring justice not only to his beloved wife but
also for the thousands of defenseless patients who are dying everyday
in India only because of medical negligence and an absolute lack
of regulation over the practice of medicine in India.
-------------------------
Anuradha had severe skin
rashes and some fever- died from an act of gross medical negligence.
Dr. Sukumar Mukherjee who first treated Anuradha in his chamber
at Nightingale Diagnostic Center in Calcutta in the evening of
7th May, 1998 when Anuradha had severe skin rashes and some fever.
Dr. Mukherjee’s choice of “Depomedrol” was his
selection of its astronomically high “dose”.
- He injected Anuradha with 80 mg
“Depomedrol” straight away in his chamber
(“stat”; as written in his prescription) in the
evening of 7th May, 1998 and asked her to continue the same
injection at 80 mg twice daily for the
next three days.
- The maximum recommended dose of
“Depomedrol” for any clinical condition is 40-120
mg at least 1-2 weeks or longer intervals
Anuradha was admitted in the AMRI Hospital in Calcutta on 11th
May, 1998 in a serious condition at the advice of Dr. Sukumar
Mukherjee. But after Dr. Mukherjee left for America later on the
same day, Dr. B.N. Halder (Dermatologist) and Dr. Abani Roychowdhury
(Medicine) jointly took over the charge for treatment of Anuradha
(although after the criminal case was filed, Dr. Ro chowdhury
has claimed that he never knew or treated Anuradha). Dr. Halder
first examined Anuradha on 12th May, 1998 and correctly diagnosed
TEN. He also wrote a prescription (in consultation with Dr. Roychowdhury)
which was basically followed during Anuradha’s entire stay
at the AMRI hospital. Although Dr. Halder stopped the long-acting
“Depomedrol” which Anuradha had already received for
the past 7 days at 80 mg twice daily dose, he added a different,
albeit “quick-acting”, steroid (“Prednisolone”)
without considering the devastating residual effect “Depomedrol”
which was already pumped into the body of Anuradha. More importantly,
Dr. Halder did not advise any of the mandatory treatment, i.e.
“supportive therapy” which is essential for TEN patients.
There were absolutely no specific instructions Dr. Halder/Dr.
Roychowdhury for any IV fluid administration, care of the skin
wounds or monitoring for any developing infection (through regular
blood and swab tests) which are crucial for proper care of TEN
patients. In fact, Dr. Halder and Dr. Roychowdhury advised not
to “prick any needle” to Anuradha (with an obsolete
and baseless fear that needle pricking might introduce infection)
thus, totally ruling out possibility of administration of any
IV fluids or blood tests. The hand-written prescription of Dr.
Halder as present in AMRI hospital record is (shown in the next
page) is a glaring example of gross medical negligence. First,
Dr. Halder has not recorded a single clinical feature (e.g. pulse,
respiration, physical description etc.) of the patient. Anuradha
was very sick at this stage with large portion of her skin becoming
loose or peeled off resulting in the loss of tremendous amount
of body fluids through the denuded skin surface like in a “burn”
patient. And there was absolutely no specific direction for replacement
of the lost body fluid or monitoring of evolving infection. In
fact, this same mode of therapy was basically followed for Anuradha
until she became completely moribund and was shifted to the Breach
Candy Hospital in Mumbai on 17th May, 1998.
Evidence of reckless practice
of medicine
Being a physician born and raised in India, Kunal was well aware
about the seemingly impossible task of bring the doctors who were
responsible for the untimely demise of his beloved wife to justice.
All of Kunal’s close doctor friends in India were also of
the opinion that despite an absolute brazen act of medical negligence
that took Anuradha’s life, there is no chance to bring justice
for these “top” doctors responsible for Anuradha’s
death. Although Anuradha was an India-born naturalized US citizen,
the case for medical negligence had to be fought and won at the
scene of the alleged crime – the City of Joy where this
angelic love story between Kunal and Anuradha started almost 13
years earlier. Even though legal provision for “criminal
prosecution” of a doctor causing death of a patient through
reckless treatment (“manslaughter”) exists in the
Indian Penal Code (IPC) for almost 150 years (under IPC Section
304A), not a single registered, allopathic doctor has ever been
convicted under this law in the history of Indian medico-legal
jurisprudence until 1998. Kunal started this “crusade”
for justice against the negligent doctors in Calcutta by contacting
the very top medical experts in different countries in the relevant
fields (dermatology and pharmacology) for their opinions about
Anuradha’s treatment because opinions from medical experts
play a crucial role for establishing a case of “medical
negligence”.
The reckless therapy that eventually killed Anuradha started
with Dr. Sukumar Mukherjee who first treated Anuradha in his chamber
at Nightingale Diagnostic Center in Calcutta in the evening of
7th May, 1998 when Anuradha had severe skin rashes and some fever.
Dr. Mukherjee immediately injected her with 80 mg of “Depomedrol”
and advised that she must continue the “Depomedrol”
injection at 80 mg BID (twice daily) for at least the next three
days. He diagnosed Anuradha’s condition as “Angioneurotic
oedema with allergic vasculitis” and also prescribed some
other medicines. This was the beginning of a therapy unheard of
in the annals of medical science that eventually snatched the
life of young woman. As discussed previously, “Depomedrol”
is used as a steroid therapy only in some “chronic”
clinical conditions like “asthma” and “arthritis”
because of its “long-acting” role. Patients with “chronic”
conditions do not have to take steroid everyday since one injection
of “Depomedrol” lasts in the body for up to one month.
For “acute” clinical conditions where steroids are
recommended, only “quick-acting” steroids like “Decadron”
or “Solumedrol” are used for its fast action and quick
elimination from the body. This is why “quick-acting”,
and not the “long-acting, steroids can be repeated daily
or even several times a day. Frequent injections of long-acting
steroids like “Depomedrol” would cause a devastating
adverse effect (“suppression of natural immunity”)
in the body by accumulation of the drug to a very high level.
So why did Dr. Mukherjee choose to use “Depomedrol”
as a steroid to treat Anuradha on 7th May, 1998 when she came
with an “acute” skin condition? Dr. Mukherjee could
not answer this question when he was asked during his examination
in the court.
But even more shocking than Dr. Mukherjee’s choice
of “Depomedrol” was his selection
of its astronomically high “dose”. He injected
Anuradha with 80 mg “Depomedrol” straight
away in his chamber (“stat”; as written in his prescription)
in the evening of 7th May, 1998 and asked her to continue
the same injection at 80 mg twice daily for the next three days.
The maximum recommended dose of “Depomedrol”
for any clinical condition is 40-120 mg at least 1-2 weeks or
longer intervals. On Dr. Mukherjee’s advice, “Depomedrol”
was injected to Anuradha 160 mg everyday (80 mg twice daily) for
the next 7 days (Dr. Mukherjee repeated the same prescription
after Anuradha on 11th May, 1998 at after Anuradha was admitted
at AMRI hospital, see his second prescription in the next page).
So, Anuradha basically received a dangerous steroid preparation
(“Depomedrol”) at 20-50 times its maximum recommended
dose as prescribed by Dr. Mukherjee. As shown below, a plethora
of other documentary evidences including written experts’
opinions and direct testimonies were presented in this case to
establish the brazenly wrongful and reckless use of “Depomedrol”
by Dr. Mukherjee. On the contrary, not a single expert’s
opinion, either as a written statement or as a witness in the
court was produced in this case by any of the accused doctors
suggesting that “Depomedrol” at 80 mg twice daily
as Dr. Mukherjee prescribed could be given to any patient under
any clinical condition. A brief summary of the evidence showing
reckless use of far too excessive “Depomedrol” by
Dr. Mukherjee is presented below.
Apart from these evidences discussed above, many other medical
experts produced by the prosecution either as a witness in the
“criminal trial” or through written submissions including
Dr. Anil Gupta, Dr. Anil Shinde, Dr. Salil Bhattacharya, Dr. Kunal
Saha, Dr. Peter Fritsch (Austria), Dr. David Fine (USA), Dr. Gerald
Pierard (Belgium), and Dr. J.C. Roujeau (France) have all testified
about the wrongful use of “Depomedrol”. In contrast,
the accused doctors have failed to produce even a single MBBS
doctor to testify on their behalf that “Depomedrol”
at 80 mg twice daily could be used on any patient.
1) Prof. J.C. Roujeau from France : Prof. Roujeau
is probably the most well-known TEN expert in the world who has
published the highest number of scientific articles and major
textbooks on TEN. “Your wife was a victim of malpractice.
This is much more obvious in the way steroids had been used (and
also on the lack of supportive therapy) than on the principle
of treating with steroids”
2) Prof. Peter Fritsch from Austria : Prof.
Fritsch is also a highly respected TEN expert and the author of
the chapter on TEN in the well-known dermatology textbook “Dermatology
in General Medicine”. In email communication with Anuradha’s
husband, Prof. Fritsch has categorically stated, “It is
obvious that (Anuradha’s) treatment has not been appropriate
and that it did not conform to the principles that I outlined
in my chapter on TEN in the textbook” (see page 35). Prof.
Fritsch has also made a detail analysis of Anuradha’s treatment
from the AMRI hospital record and found glaring flaws in the treatment
as he has observed, “No hematocrit, blood gas analysis or
electrolyte values are recorded in the files. Fluid input/output
measurements are only recorded for May 12 and 13. Temperature
was recorded only on May 12 and 13. Although the last reading
(May 12, 10 pm, was 100.80F, there was no further monitoring of
body temperature… It is not even clear if a venous line
was installed to correct fluid and electrolyte imbalances and
to administer IV antibiotics”.
In the case of Mrs. SAHA, the corticosteroid doses were excessively
high (in view of her slim body weight; also, it is unclear why
slow release corticosteroids (“Depomedrol”) were used).
Finally, the hospital records are more than deficient by any standard”
3. Prof. David Fine from USA ): Prof. David
Fine is a highly accomplished expert on TEN at the University
of North Carolina and like Prof. Fritsch, he is also one of the
rare dermatologists in the US who still prefer to use some steroids
in the very early stage of TEN. ........“The treatment provided
to her (Anuradha) was clearly improper. Indeed, I would view this
as gross malpractice based on the considerable medical literature
on this subject, ....................……..Although
many authorities still use systemic corticosteroids in carefully
selected patients with early TEN, the manner in which treatment
was instituted in your wife certainly appears to be unprecedented”
Many other supporting experts’ opinions have been produced
in the court in the “criminal” case for the wrongful
death of Anuradha which are not shown here. In fact, apart from
expert dermatologists, the prosecution also produced witnesses
in the court during the criminal trial who were experts on “Pharmacology”
(e.g. Prof. Salil Bhattacharya) and “Medicine” (Dr.
A. Gupta and Dr. F. Udwadia). As mentioned before, Dr. J.S. Pasricha,
eminent dermatologist from India also provided his opinion in
this case in support of Anuradha’s husband, Dr. Kunal Saha.
In sharp contrast, not a single expert’s opinion was produced
by any of the accused doctors in support of their treatment of
Anuradha either during the “criminal” trial or in
the pending “civil” case for financial compensation.
Source; Dr. Kunal Saha/pbtindia.com
