The CAG report said the quality of medicines were not ensured during procurement. (Representational)
The Comptroller and Auditor General of India (CAG), in its latest report on Wednesday, rebuked the Jharkhand Health Department for administering expired and substandard vaccines to children in some district hospitals.
It also indicted Jharkhand Medical and Health Infrastructure Development and Procurement Corporation Limited (JMHIDPCL) -- an entity under the state Health Department -- for inordinate delays in meeting the quality test formalities that led to the expiry of medicines worth Rs 82.40 lakh.
A performance audit of district hospital outcomes in Jharkhand, covering the period 2014-19, was carried out during 2019-20 with the objective of assessing the quality of medical services and patient care being provided by the district hospitals in the state.
"In district hospital (DH), Ramgarh, 410 doses of Hepatitis-B vaccines with shelf life up to October 2018 were administered to children between November 2018 and January 2019," the CAG said in the audit report tabled in the assembly.
It said that when questioned, the deputy superintendent of the hospital stated in a reply that wrong expiry date was recorded by mistake in the vaccine stock register.
"The reply is not acceptable as the same expiry date (October 2018) of the vaccine with the same batch number was also found recorded in the stock register of DH, East Singhbhum. The department did not furnish replies to the audit observation," the report said.
It said that the quality of medicines were not ensured during procurement as required and instances of spurious or expired medicines being administered to patients were noticed.
Further it pointed out that in DH, Ramgarh, Acyclovir 200 mg tablet (Batch T-15818), supplied (on August 31, 2018) through JMHIDPCL, was reported (on March 15, 2019) as "not of standard quality" by the State Drug Testing Laboratory, Jharkhand.
"However, 140 out of supplied 5,000 tablets of the same batch were distributed (between November 23, 2018 and March 27, 2019) to OPD patients and remaining 4,860 tablets were lying in store as of February 2020," the report mentioned.
Likewise, the report pointed out that CS-cum-CMO (civil surgeon cum chief medical officer) issued (between July 25, 2018 and January 23, 2019) 17,500 vials of Dexamethasone Sodium Phosphate (Dexona) 2 ml injections to DH, Deoghar.
The drug inspector, Deoghar collected (on July 30, 2018) samples of the injection of the same batch from the store of CS-cum-CMO which were found (on March 8, 2019) spurious by the Regional Drug Testing Laboratory, Guwahati.
The samples were re-tested by CDL, Kolkata on the orders of the Civil Court, Deoghar and were again found (on September 11, 2019) "not of standard quality", it said.
It was noticed that 4,185 out of 17,500 vials of injections were issued (July 28, 2018 to March 12, 2019) to different wards from the store of DH, Deoghar and were administered to patients till March 2019.
"Audit further noticed that 309 vials were administered (between March 12 and March 31, 2019) even after the injection was detected as spurious by the Regional Drug Testing Laboratory, Guwahati as intimated (on March 12, 2019) by the drug inspector, Deoghar.
"The injection was further declared 'sub-standard' by the Central Drug Laboratory, Kolkata on September 11, 2019," the report stated.
The CAG said that purchase order for supply of 24.71 lakh tablets of Amoxicillin with Potassium Clavulanate 625 mg valued at Rs 1.11 crore was issued (in March 2017) to a vendor that supplied (in June 2017) 24.47 lakh tablets in five batches, bearing manufacturing date of May 2017 and expiry date of October 2018 along with the quality certificates.
As per the provision of the contract, JMHIDPCL got the sample tested from an empanelled laboratory which found (on July 27, 2017) all the batches "not of standard quality".
JMHIDPCL, however, intimated (on September 11, 2017) the un-satisfactory test results to the vendor after a delay of 45 days. The vendor contested (in September 2017) the test report and the samples of all five batches were sent (in December 2017) to the Central Drug Laboratory (CDL), Kolkata for re-testing by JMHIDPCL again with a delay of three months. CDL, Kolkata declared (in July 2018) all the five batches were of "standard quality".
"Ultimately, only 6.08 lakh tablets with shelf life of remaining three months were issued to the districts and balance 18.39 lakh tablets valued at Rs 82.40 lakh expired in October 2018 and were lying in the warehouse (June 2020), CAG report added.