The truth of Gujarat’s Dhaman-1 ‘ventilator scam’

Jyoti CNC, a company based in Rajkot city of Gujarat, claims to have taken an initiative to fight COVID-19.

Ventilators were created with courage and foresight of the company’s CMD Parakram Jadeja to help Gujarat and others in the ongoing war against the Coronavirus.

The company explained:

The Dhaman-1 ventilators have been constructed keeping in mind the ‘Make in India’ mission and as many as 1,000 ‘ventilators’ can be donated to the Government of Gujarat to deal with COVID-19.

Jyoti CNC and 150 professionals from 26 other companies worked hard day and night to produce it within the specified timeframe.
Dhaman-1 is a Gujarati word that is synonymous with a blower that works to pump air.
The Dhaman-1 ventilator is priced at Rs 1 lakh, which is more than 20% less than other ventilators available in the market.

Amidst these claims, the company has written another line and that is that “We are not experts in making ventilators but we planned and manufactured this machine because of its current demand in the country.”

All these claims of ‘Jyoti CNC’ are present on the website of Dhaman-1, despite the controversy, due to which the politics in Gujarat is on the upswing even in the outbreak of a disease like Coronavirus.

But answers to 5 questions are still pending:

  • Why did the supply of Dhaman-1 start in hospitals only after a trial on a patient?
  • Why does Dhaman-1 not have a DGCI (Drug Controller General of India) license?
  • According to India’s Medical Device Rules, 2017, was the Ethical Committee formed for testing of Dhaman-1?
  • Out of the 866 Dhaman-1 machines supplied in Gujarat hospitals, how many patients have used in COVID-19 ICU, and how many people died of corona infection in those hospitals after the machines started being used?
  • If Dhaman-1 is really ‘an inexpensive but effective ventilator machine, then why is it not being supplied in other states of India now, while orders are being made to import ventilators from abroad?

Why ventilators?

By the end of 2019, the cases of the coronavirus started increasing from Wuhan city of China.

Apart from Asia, cases of corona infection were increasing in Europe, America, and South America, and on 30 January the disease knocked in India.

According to the World Health Organization, “There is currently no vaccine for the treatment of Covid-19, but most of the infected patients who need to be admitted to the hospital have increased breathing problems.”

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In all the countries of the world who were hospitalized patients of COVID-19, most of them needed ventilator-breathing and oxygen-assisted blood supply machines in the body’s parts.

So along with the coronavirus infection, the demand for ventilators also increased suddenly.

What is the matter?

A nationwide lockdown to combat the coronavirus was on and meanwhile, on 4 April, Parakram Jadeja, CMD, Rajkot-based company Jyoti CNC Automation Ltd, announced that “construction of Dhaman-1 ventilators has started, 1,000 ventilators to the Gujarat government will be given. On the same day, on Saturday, it has been successfully tested on a patient of Ahmedabad. “

The news spread like fire and appeared prominently not only in the local but also in the national media of India as Gujarat Chief Minister Vijay Rupani ‘inaugurated’ it at the Civil Hospital in Ahmedabad on the same day and its pictures went viral on social media.

After this, Vijay Rupani told reporters, “I am happy that our Gujarat industrialists also succeeded in making ventilators. It has been certified and since morning the machine is also working on a patient. This leads to the end on lack of ventilators in Gujarat. , apart from that, it will be supplied in other states of India as well. “

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A few days later, in a conversation with BBC Gujarati, Jyoti CNS head of corporate communications Shivangi Lakhani said, “Covid-19 patients need pressure-based ventilators and with this technology in mind, Dhaman-1 has been built in Maharashtra. The government has asked us for Dhaman-1 and the United States, Iran, Kenya, Portugal, Kazakhstan, and France have also contacted us. “

In this conversation on April 12, when Shivangi was asked about the testing of this ventilator, the answer was, “We put the ventilator in the Civil Hospital in Ahmedabad and before that for the quality certificate at EQDC (Electronics and quality development center) in Gandhinagar Was sent. After the certificate, it was kept in the civil hospital. We have got good responses from the civil hospital. The medical staff there has tested. “

Why dispute again

The controversy over Dhaman-1 has deepened when Gujarat Deputy Chief Minister and Health Minister Nitin bhai Patel visited Ahmedabad Civil Hospital on May 14 and a meeting with the doctors was also held.

On 15 May, doctors at the Civil Hospital (which is not only Gujarat but the largest government hospital in India) wrote a letter citing a meeting with Nitin bhai Patel and made an ‘urgent call’ to the government.

The letter read, “Dhaman-1 and AGVA (ventilators made by a Delhi-based company) were provided in the ICU for the treatment of corona-infected patients. Doctors in the anesthesia department of the civil hospital say that both ventilators are not proving successful. We need high-end ICU ventilators immediately. “

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This news published in the media quickly created panic and the Gujarat government immediately defended the Diman-1 ventilator in a press conference.

State Health Secretary Jayanti Rao said, “Dhaman-1 was found by a high-powered committee set up by the Government of India.”

He further added, “When Gujarat needed, the manufacturer of Dhaman-1 promised them 1,000 ventilators and gave 866. Work on ventilators is going on, but the existing ventilator is helpful to patients.”

However, rejecting the government’s claim, Ahmedabad Medical Association member and noted anesthetist Dr. Bipin Patel told senior journalist Bhargav Parikh, who wrote for the BBC, “Dhaman-1 ventilators are not right. There are no meters to set and the amount of oxygen the patient should give. There is no quantum of humidity in it. “

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He claims, “We use anesthetist ventilators whenever there is an operation or if the patient has difficulty breathing. This causes the muscles to relax during any operation or during the critical condition of the patient and the heart. There is no problem with getting oxygen easily. Due to the lack of such a facility in the Dhaman-1 ventilator, patients may face problems. Due to this, it can also be fatal for the patient. “

Allegations mounted that Dhaman-1 was “not a ventilator, but an AMBU (Artificial Manual Breeding Unit) machine.”

The state president of the opposition Congress in Gujarat, Amit Chawde, alleged, “Those who were used to treat patients as ventilators, are full of cheap oxygen bags and the Chief Minister has okayed this to benefit his acquaintances.” “

Opposition parties of Gujarat have consistently reiterated their demand for a judicial inquiry into the case.

Former state chief minister Shankarsinh Vaghela told the BBC, “The administrative negligence is visible in the way corona cases are rising in Ahmedabad. Differences within the government are also seen in dealing with such serious things. What is the meaning of messing up the lives of patients with ventilators made so cheap and fast “.

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However, Health Minister Nitin bhai Patel of the BJP government of Gujarat and the Health Commissioner of Gujarat cut off many of our phone calls saying, “We are in the meeting now, please talk later.”

But the government has previously denied all opposition allegations and described them as “politically motivated”.

Meanwhile, Puducherry Chief Minister V. Narayanasamy, who has ordered the Dhaman 1 machines, has decided to cancel his order after holding a press conference.

Dhaman – 1 AMBU or ventilator?

In Gujarat, the total corona cases have crossed 17,000 so far and the death toll from this virus is above 1,000.

Nearly 70% of the state’s cases have been reported in and around the capital, Ahmedabad.

But meanwhile, Dhaman-1 is not taking the name of ending the controversy over the usefulness and authenticity of ventilators.

Although it has not been proved that in reality, the Dhaman-1 is an AMBU bag or ventilator, medical experts think that there is a big difference between the two.

Dr. Minesh Patel is in charge of the COVID-19 ward of ICU of CIMS Hospital, Ahmedabad, and explains the difference between the two machines.

He said, “The AMBU bag is an oxygen dispensing machine for ordinary patients and it is usually given before a patient is put on the ventilator. AMBU bags are for oxygen support for only 3-6 minutes. But if you want to keep the patient on oxygen support for hours or a few days, then the ventilator is the only means. “

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However, the Gujarat government has repeated many times later that “the process of upgrading it after Dhaman-1 is in progress”.

Experts believe that “having the best of medical devices like ventilators is essential.”

Jitin Narula, Consultant Doctor of Cardiac Critical Care at Narayana Super Specialty Hospital, Gurugram, opines that patients who need ventilators have already had their lungs hardened and any lack of ventilator can cause further damage.

“Instead of easily or cheaply available ventilators, we should use ventilators that have been proven to be reliable,” he said.

It is also worth noting that after a big controversy over the matter, Jyoti CNC CMD Parakram Jadeja told the BBC, “We have followed all the standards in making Dhaman-1 ventilators. We have followed the ISO 86101 and IEC 60601 standards “We have taken all the necessary approvals based on a company based in Michigan, but the country’s import lobby is troubling us. They don’t want an indigenous company to come into this market.”

On the quality of ventilators, Dr. Minesh Patel, in-charge of ICU’s Covid-19 ward of CIMS Hospital, Ahmedabad, points to an important point.

He said, “Just as it happens with any medicine, it is also with the ventilator. Many times the drugs come into the market only after trials. They have to take the approval of the USFDA or ICMR etc.. A doctor cannot tell us what to use and what not to do. Generally, we use what everyone else does. “

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