Letters to the Editor

Indian Pediatrics 2001; 38: 1068  

Medical Negligence and Vaccine Associated Paralytic Poliomyelitis

The article by Drs. Tiwari and Baldwa on Medical Negligence was very informative(1). Under ‘Unexpected results’ it was stated "According to Sir William Osler (a USA Physician), medicine is a "science of uncertainty and art of probability".... A doctor can’t be held negligent only because there was unexpected outcome".

I seek clarification of law regarding occurrence of vaccine associated paralytic poliomyelitis (VAPP). Oral polio vaccine (OPV) is known to cause VAPP, though the incidence is extremely low (1 case per 2 million to 12 million doses of OPV administered). If an immunocompetent child develops VAPP after administration of OPV, it may be considered a case of ‘unexpected outcome’.

The risk of VAPP is 2000 times higher in immunocompromised children, and inactiv-ated polio vaccine (IPV) does not cause VAPP even in immunocompromised children. If an immunocompromised child is administered OPV and the child develops VAPP, what would be the stand of law if: (i) OPV had been administered in a clinic or hospital for routine immunization, and (ii) OPV had been adminis-tered during the National Pulse Polio Immu-nization Program?

Yash Paul,
A-D-7, Devi Marg
Bani Park,
Jaipur 302 016, India.

References

1. Tiwari SK, Baldwa M. Medical negligence. Indian Pediatr 2001; 38: 488-495.