Kerala Girl Undergoes Arm Amputation After Alleged Negligence at Palakkad District Hospital

On September 24, 2025, a nine-year-old girl named Vinodini was admitted to the Palakkad District Hospital in Kerala with a fractured forearm. Her family alleges that what should have been routine treatment went awry due to medical negligence, ultimately resulting in the child’s arm amputation at Kozhikode Medical College. The case has triggered an official investigation ordered by the state government.

Initial Treatment and Deterioration

According to statements by the girl’s mother Praseeda, they visited Chittor Taluk hospital after the girl fell while playing with her brother at home on September 24. She was referred to the Palakkad district hospital on the same day and the doctors reportedly aligned the bones via a closed reduction and applied a plaster cast. They were asked to come for a review after 5 days but returned in a day due to severe pain and swelling. After further investigations, the hospital advised them to wait until the scheduled follow-up. By September 30, her arm was swollen, discoloured, and in a weakened state. At this point, a Doppler scan (ultrasound evaluation of blood flow) revealed blocked blood vessels. The mother recalls when they removed the cast for the scan and investigations, there was a horrid smell resembling to dead animals. The hospital asked them to consult private hospital for further treatment since further care wasn't available in district hospital. But the family had no means to approach a private facility, so they enquired, and she was transferred to Kozhikode Medical College for plastic and cardiothoracic evaluation.

Despite advanced intervention, the vascular compromise was severe and irreversible, leading surgeons to amputate the forearm.

Allegations, Hospital Response, and Government Action

The child’s parents have formally blamed the district hospital for failing to anticipate or respond to complications, alleging a delay in diagnosis and inadequate follow-up care. They argue that the hospital should not have instructed them to wait several days given the risk of vascular injury in such fractures.

In response, the hospital superintendent, Dr. P. K. Jayasree, denied negligence. She stated that the hospital provided appropriate treatment upon admission, and asserted that the outcome was due to a rare complication arising from unpredictable causes. According to her, initial blood flow checks and plaster application were done per protocol.

Following media attention, Kerala’s Health Minister Veena George ordered that the Director of Health Services initiate a probe into the case and take suitable action.

Medical Issues in Fracture Management & Risks

Forearm fractures, particularly in children, require careful management—ensuring alignment of bones, securing stable immobilization, and periodic monitoring of blood circulation, nerve function, and swelling. In some cases, swelling or internal bleeding may compress vessels, leading to vascular compromise. If blood flow is obstructed for too long, tissues can become ischemic (lack oxygen) and necrosis (tissue death) can set in, necessitating surgical intervention or even amputation.

Doppler ultrasonography is a common noninvasive tool to assess arterial flow; when it reveals vessel blockage, urgent surgical evaluation is critical. Delays in identifying vascular injury or compartment syndrome (increased pressure in a closed muscle compartment) are recognized clinical risks.

In this case, the timeline suggests a delay in detecting vascular compromise. Whether the delay was avoidable depends on whether warning signs (pain out of proportion to injury, increasing swelling, change in skin color) were present and appropriately acted on.

(Rh/Eth/TL)