Tanta prosecution is still reviewing the case of seven patients who lost their eyesight following intravitreal injections of Avastin in early February, according to doctors under investigation at Tanta Ophthalmology Hospital.
The hospital director and three others — including Eslam Rafaat, who injected the patients — were suspended by the health minister on February 8, pending investigations. The four were referred to the province’s public prosecution, who subsequently ordered samples of the medicine be sent to the Health Ministry’s central laboratories for analysis.
“Raafat injected seven diabetic retinopathy and macular edema patients with Avastin,” Sayeda al-Nagger, a retina specialist at Tanta Ophthalmology Hospital, told Mada Masr. “Five of them suffered post-operative complications, which is normal for diabetic patients. We managed to assist two of them at the hospital, but the other three had to undergo urgent surgery. Our hospital is not equipped to perform such surgery, so we referred the five patients to Tanta University Hospital, and all hell broke loose.”
Following the incident, several local news outlets picked up the story, accusing the doctors of using “an internationally banned medicine that causes post-operative blindness,” a claim endorsed by Mohamed Sharshar, deputy minister of health for Gharbiya.
“The incident was taken out of context by mainstream media,” Nagger stated. “They accused the hospital’s doctors of medical malpractice and of using an internationally prohibited drug.”
According to 32-year-old Ahmad al-Gazzar, whose mother is one of the patients who lost sight in her left eye after the injection, “The medicine is tainted. Maybe they replaced the real medicine with a cheaper alternative, maybe it’s a mistake with the injection.”
Gazzar used to take his mother Hoda Abdul Rafea regularly to one of the governmental hospitals for a Cortisone injection to control her diabetic retinopathy, but the treatment’s efficacy diminished.
“She used to be injected with Cortisone, but when it stopped being effective, our health insurance referred us to Tanta Ophthalmology Hospital to get Avastin instead. After the injection, she suffered complications. The next day I took her to a private clinic and the doctor told me she has to remove her eye because it is infected,” he explained.
Gazzar filed a report against the hospital and Rafaat, who declined to comment.
The Faculty of Medicine at Tanta University released a statement signed by professors assuring patients that Avastin is legally and safely used in a number of Western countries, and that it costs only 10 percent of what its alternatives — Lucintes and Eylea — cost in Egypt. The statement demanded “a halt to the media’s smear campaign, which could intimidate patients in need of the medicine, and push them to stop using the drug for fear of complications.” The faculty recommended the Health Ministry oversee the injection process in public hospitals, suggesting complications may have been the result of malpractice or the sterilization process.
Tanta University’s statement was echoed by the Egyptian Ophthalmological Society, which clarified that the medicine is FDA approved for cancer treatment, and can be used “off label” for the treatment of neogenesis following ischemic diseases like Diabetic Retinopathy and Central Retinal Vein Occlusion.
The Minister of Health has since affirmed that Avastin is not the reason behind the complications inflicted on the patients, alluding to a technical report by a committee of ophthalmology professors, which showed a mistake in the sterilizing of the drug packages. The minister subsequently ordered the importing company be shut down.
According to Ahmad Gamal, a resident at Tanta Hospital, “The medicine has been used in Tanta Hospital for years, and it never caused such complications. My colleagues might face legal repercussions for using a drug that is not registered with the Health Ministry, yet is neither legally prohibited nor dangerous.”