Three doctors on the Maharashtra state authorisation panel for transplants are to be questioned regarding a kidney transplant from an unrelated donor. Dr Mridula Phadke, then director of medical education and research and currently vice chancellor of the Maharashtra University of Health Sciences, Dr Subhash Salunke, then director of health services and currently WHO representative in Indonesia, and Dr Y R Bhutada were on the panel that approved what turned out to be an illegal transaction.
In 2003, Dinesh Suryavanshi complained that his kidney had been removed without his consent and transplanted into one Rajendra Thakur. The transplant had taken place in 2001. A government investigation concluded that Suryavanshi had agreed to the sale. The committee urged prosecution of the donor, recipient and middleman for participation in the illegal organ trade.
Doctors at Mumbai’s Hinduja Hospital where the transplant took place said the transplant was done after clearance from the authorisation committee. It was only after the donor complained that they learned the truth.
Dr Phadke said, “I have now retired. Whatever documents needed to be scrutinised are in my previous office. I am ready to cooperate with the probe.” The other two panel members were not available for comment.
A three-day-old baby boy died in an Ahmedabad municipal hospital and a five-day-old baby girl died in a Delhi government hospital when the incubators that they were in caught fire. In both cases the fire is attributed to short circuits. The Ahmedabad hospital lacked fire fighting equipment. In Delhi, the government suspended three hospital staff and the police have registered a case of negligence against the hospital.
The Delhi consumer commission has directed the Ramlal Kundan Lal Orthopaedic Hospital and its senior surgeon, Dr SP Mandal, to pay Rs 60,000 compensation to the family of 33-year-old Narendra Batra who died on February 1, 1999, within four hours of a hip joint surgery. “Whenever a hospital undertakes to treat a patient or conduct any surgery, it is expected to anticipate all future complications and keep the arrangement of all experts in the field ready,” the court said. “We hold the hospital and the doctor guilty jointly and severally for limited negligence, for the lack of post-operative care and for not making available the services of a doctor immediately.”
The police filed a charge sheet against Dr Megha Mane and staff nurse Polay Joshi of Hiranandani hospital in Mumbai for negligence leading to the death of Shobhana Khanwilkar who died on December 16, 2006, following surgery at the hospital. Dr Alankar Khanwilkar, the patient’s son, filed a complaint that Ms Khanwilkar died because she was not given immediate medical care when her condition worsened. Three doctors and the nurse were booked in April 2007. The charge sheet was filed in April 2008.
More than seven million people across the globe suffer from preventable surgical injuries every year, a million of them dying during or immediately after surgery, a study by the World Health Organisation published in the medical journal Lancet concluded. According to “An estimation of the global volume of surgery”, 234 million surgeries take place every year globally. China performs the highest number followed by Russia and India. WHO’s Safe Surgery Saves Lives initiative is meant to make anaesthetic procedures safer, avoid infections and improve communication between members of the surgical team – all of which could half the rate of complications. The 24-point checklist includes steps such as marking the correct surgical site, checking for allergies, and counting sponges and needles before closing up to make sure that none are left behind.
Advocating the cause of Marathi manoos (sons of the soil) is a matter of fierce competition among political parties in Maharashtra state. The Shiv Sena announced that it would uphold the cause of Maharashtrian doctors and paramedical staff who are being discriminated against at their workplace. Their target was the Asian Heart Institute and Research Complex in Mumbai where Sena legislator Deepak Sawant claimed about 80 Maharashtrian doctors and paramedical staff had been laid off in the last year. “This is a conspiracy to drive out the sons of the soil,” said Sawant. “We have asked the state government to take corrective action failing which we will have to take the matter into our own hands.” Supporting Sawant, Dr Sandeep Rane, founder of the institute, claimed that the hospital had been functioning arbitrarily and “Maharashtrians being targeted”. Dr Rane was fired by the hospital in January.
The Ahmedabad Medical Association (AMA) is promoting the Swastika symbol in place of the Red Cross. Arogya Bharati, an outfit of medical practitioners associated with the Rashtriya Swayamsevak Sangh, started the campaign for the use of this Hindu sign at its national convention in 2007.
This is not compulsory, said Arogya Bharati’s treasurer, Pravin Bhavsar. “Doctors associated with the RSS are free to use it.” According to him, 10,000 doctors across the state are expected to use this sign. MC Patel, AMA president, said the swastika was used “for something auspicious and there is nothing wrong in it.”
The president of the Indian Medical Association, SN Mishra, said, “Swastika is a symbol associated with a religion and as a doctor is not supposed to be associated with any religion he can’t use this symbol.” He warned that action would be taken against whoever was using it.
More than one month after the inauguration of the new operation theatre in Nagpada police hospital, Mumbai, the first cases of narco analysis were taken up. According to Dr SM Patil, police surgeon in charge of the hospital, the two cases that they handled had come from Sholapur and Pune. “We only had to provide the anaesthetist for the narco analysis procedure, and the rest of the staff as well as equipment were provided by the forensic science laboratory in Kalina,” he said. The entire procedure was conducted without any problem and the police do not have to depend on the OT facilities at JJ hospital any more, he said. Also, the cases would not have to be taken to other places like Bangalore and Ahmedabad.
Narco analysis is an interrogation technique that has been equated with torture. It requires the involvement of the medical profession. The increasing use of narco analysis is cause for concern.
Barely 62 km from Mumbai at a primary health centre (PHC) in Thane district’s Padgha, medical officer Ishwar Thite is a busy man. Apart from handling nearly 80 patients and conducting four deliveries on an average day, the ayurvedic doctor handles the occasional autopsy. “Since the health centre is on the highway, accident cases regularly come in. I’m the only doctor to conduct the autopsy here,” he said. Dr Thate does not remember conducting a single autopsy in his college. His medical qualification is Bachelor of Ayurvedic Medicine and Surgery. For him to conduct autopsies is not permissible. Hindustan Times surveyed 12 PHCs in Thane district and found that qualified state appointed doctors reused disposable needles or asked patients to buy their own needles. Surgical gloves were in short supply, and so was water. Basic emergency medicines for cardiac arrest or hypertension were missing and so were ambulances and their drivers. Patients paid for treatment that is supposed to be free. The PHC in Safale did not have anti-rabies vaccine. “It is easier for me to say which medicines are available than which are not,” said medical officer Kishore Gulalae, pointing to the stock register that showed only three ampoules of snakebite injection; at least three patients visit the PHC every day with snakebite. State authorities were aware that biomedical waste was dumped in the trash but passed the buck to the pollution board. About the autopsies: “Ayurvedic doctors cannot perform a post-mortem and it doesn’t happen,” said PP Doke, director general of health services.
Shortly after the newspaper article, an inquiry committee was set up and visited the PHCs mentioned in the article. The committee that included Shomita Biswas, joint secretary, public health and family welfare, and Dr MV Karnataki, joint director of the directorate of health services, recommended intensive training for doctors posted at the centres, and also issued instructions on various medical procedures. “We visited the PHCs mentioned in the report and found that many problems that were written about did exist,” said Biswas. “Though life-saving drugs were available when we visited the centres, on observing the drugs registers and interacting with doctors, we realised that drugs could be missing at times due to gap in supply chain,” said Karnataki.
Four children died after being administered the measles vaccine in Tamil Nadu on April 23. The government of Tamil Nadu recalled 4 million doses of the vaccine and suspended the measles vaccination programme. An investigation concluded that the vaccine itself was safe but concluded that either it was mixed with a different chemical instead of saline water or it was contaminated from being kept in the open for more than three hours after being reconstituted. The government denied negligence but the committee on immunisation of the Indian Academy of Pediatrics has stated that the deaths seem to be due to human error and therefore preventable. Also, it would have been possible to resuscitate the children if the equipment had been on the site and the team had been trained to use it.
Seema Bano from Bandra was nine months pregnant and in labour when she went to Bandra Bhabha hospital in Mumbai. However, hospital employees were on strike and directed her to another hospital. Seema Bano subsequently delivered a baby in the taxi on the way to the hospital. “It is understandable if a six-month pregnant woman is asked to come later because of a strike,” says Advocate Mihir Desai, “But in the case of a full term pregnant woman the hospital is obliged to examine and admit here.” A doctor at Dr Jagtap’s nursing home where Seema was admitted after she delivered her child stated that if the Bhabha doctors had conducted a vaginal examination they would have realised that she needed urgent medical attention.
Over the last eight years up to 4,000 post-mortems have been conducted in northwest Delhi’s Sanjay Gandhi hospital: an astonishing feat given that the post of forensic expert has been lying vacant since 2000. This came to light when a police officer went to get the doctor’s opinion in a medico legal case and the doctor let slip that the hospital did not have a forensic expert at all.
During an investigation, the court stated; “The post-mortem report is a material piece of evidence for any criminal trial. The fate of many cases depends on the report of the forensic expert. It is very strange that a large number of post-mortems have been conducted without qualified and competent experts.”
The hospital’s medical superintendent informed the court that none of the doctors in the hospital had the necessary qualification but added that they “were trained and experienced in the field of forensic medicine.” The Delhi government stated that only supervisors need to specialise in the subject. For the doctors performing the autopsy, an MBBS degree is enough. However, the deputy secretary of health and family welfare assured the court that the vacancy had been advertised and the recruitment process would be over by the end of July.
The police arrested a resident medical officer and a ward boy attached to Masina Hospital on charges of molesting two patients while their burn injuries were being dressed. The men were reported to be drunk at the time. “Dr Balu Sahini and Ramesh Chavan have been arrested and are being questioned,” confirmed Assistant Commissioner of Police Nisar Ahmed Shaikh. Following news of the molestation more than 100 youth smashed the hospital’s windows, broke down doors, and assaulted the chief executive officer. The hospital’s union struck work in response. V Gode, leader of the hospital union, said: “No one at the hospital drinks during work. We will not let the hospital function till our colleagues are released.”
The Delhi police have arrested seven people including four doctors for appearing for the Foreign Medical Graduate Examination under false identities. Doctors who were to write the exams paid between Rs 3 lakh and Rs 15 lakh to get a “stand-in” to write the exam in their place.
Identifying quality human resource as an immediate need in health care, the Planning Commission recommended opening up the medical education sector completely to private participation. The report stated that companies should be allowed to establish medical and dental colleges just as they have been allowed to open nursing colleges. Entry barriers such as land and built-up space should be lowered to realistic levels.
A sting operation by Mumbai reporters exposed a sophisticated system of buying medical college seats. The investigation was launched after Raj Tapaswi of “Education Solutions” promised a student a seat at the MGM College, Kamothe, Navi Mumbai, for Rs 17 lakh. The college is owned by Kamal Kishore Kadam, a former state education minister.
“Touts no longer hang around outside the college gates like blackmarketeers outside movie halls,” note the reporters. “They operate under the guise of vocational counsellors, advertise in newspapers, drive big car and stride down the corridors of the college greeting professors and students in a familiar fashion. One tout is actually a doctor with a small nursing home.”