[Resolved]  Apollo Hospitals Bangalore — Hepatitis B Infection in Hospital

Address:

Bangalore, Karnataka

To Dr Umapathy
COO
Apollo Hospitals
Bangalore
Sub: Hepatitis B Infection caused to me from the Apollo Hospital during my stay as patient.
Patient details:
Name : Shahaji Bhosle
UHID : 256386
First Stay in hospital

Date of admission : 28/ 02/2011
Date of discharge : 02/03/2011
Admitted under : Dr Sridhar Reddy
Operated by : Dr Deepak Bolbandi
I underwent DJ Stenting for RIGHT RENAL CALCULAS. It was planned to remove DJ stent and ureteric stone after 2 weeks
Second Stay in hospital

Date of admission : 11/ 03/2011
Date of discharge : 13/03/2011
Admitted under : Dr Sridhar Reddy
Operated by : Dr Deepak Golbandi
DJ stent and stone was removed on 12/03/2011
As you are aware that on the of admission i was tested HBSAg NEGATIVE in Apollo hospital.
Proof : Blood test report
I never been to any hospital prior to this surgery for any blood tests or surgery and nor post discharge from apollo.
After discharge on 13/03/2011 for 5 weeks. Everything was normal. No pain in right side of abdomen.
On 29/04/2011 i called Dr. Sreedhar regarding mild pain on right side and radiating more towards back.
He told it could be sudden muscle spasm. I suffered from this pain for entire month May.
I took it as back pain due to daily 50 kms travel to office. I used to apply some ointments to get relief.
On Jun 06 i developed nausea, weakness, stomach pain and urine color turned yellow. On Doctors suggestion on 11 June 2011 i had liver
test and ultrasound done. Ultrasound reports mentions about Fatty liver and which is causing me pain in abdomen. I still have pain in liver and back region
Test reports clearly indicated high ALT,ALP and Bilirubing levels which indicates Jaundice.
On doctors suggestion following tests were done on 13 June 2011 at NH Bangalore
1. Anti HAV IgM - NEGATIVE
2. HCV Antibody - NON REACTIVE
3. Anti HAV-IgM - NEGATIVE
4. Anti HBC-IgM - Positive
5 LFT

Reports are already shown to you and copy of it is handed over to Dr Yatheesh on 25 June 2011.
Today on 23 July we had meeting with you and Dr Sreedhar Reddy , Dr Deepak, Dr Rai and Dr Yathessh and other experts over this issue. Instead of focusing on infection caused you people deciated the discussion on treatment of HB and it's current status.
Now let us focus on HBC Igm as you people have mixed opinion about Anti HBC-IgM Positive test.
HBcAb (normal value NEGATIVE)
Antibodies against HBcAg (HBcAb) appear at about 8 weeks after infection (they are the first detectable antibodies).
When HBcAb appears in the bloodstream the level of transaminases (AST and ALT) start to rise.
Initial antibodies response is of IgM class then, after about 2 months it switches to IgG class. Therefore we found HBcAb of
IgM class when there is a recent infection (acute phase) and HBcAb of IgG class when infection is resolved.
In chronic infection HBcAb IgM is persistently positive.
These antibodies don't neutralize HBV, but they reveal if there was an infection (they don't appear after vaccination).

Hepatitis B core antibody (anti-HBc) is directed against the hepatitis B core antigen (HBcAg) peptides (smaller pieces of the HBcAg)
The anti-HBc is the earliest antibody to develop in response to acute hepatitis B virus (HBV) infection,
appearing predominantly as IgM anti-HBc at about 6 to 8 weeks after infection
The anti-HBc typically persists for life, but after about 6 months the total anti-HBc mainly consists of IgG anti-HBc
For patients with resolved acute HBV infection, the IgM anti-HBc is not usually detectable after 6 months.
With chronic HBV infection, the IgM anti-HBc can remain detectable at very low levels, even years after infection.
Isolated anti-HBc is defined as the presence of anti-HBc in the absence of detectable h epatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs).
When routine HBV serology is requested, most laboratories report total levels of anti-HBc, which can consist of a combination of IgM and IgG antibodies.
Accordingly, providers must specifically request measurement of IgM anti-HBc if they suspect acute HBV infection
Now Let us focus on HbsAg Tests
The hepatitis B surface antigen (HBsAg) is most frequently used to screen for the presence of this infection.
It is the first detectable viral antigen to appear during infection. However, early in an infection,
this antigen may not be present and it may be undetectable later in the infection as it is being cleared by the host.
The infectious virion contains an inner "core particle" enclosing viral genome.
The icosahedral core particle is made of 180 or 240 copies of core protein, alternatively known as hepatitis B core antigen, or HBcAg.
During this 'window' in which the host remains infected but is successfully clearing the virus,
IgM antibodies to the hepatitis B core antigen (anti-HBc IgM) is the only serological evidence of disease
Above theory no can deny as it is written and reviewed by HB experts.
Today same thing was communicated to me during my consultation with Dr Gopal at Apollo
So my HBSAg and LFT status as on today is of no importance over here.
If you read this mail carefully with dates in mind it clearly indicates i got infection Apollo Hospitals Bangalore
Me and my family suffering since 3 month due to professional negligence during my stay at Apollos Hospitals Bangalore.

Awaiting your reply