Mumbai Mirror
01 August 2008
By Sunil Tinani

Even top notch hospitals are guilty of gross negligence and wrong diagnoses
James H. Boren once said, “I got the bill for my surgery. Now I know what those doctors were wearing masks for”. That was Boren, now listen to this true story, which reflects how gruesome and careless a high–quality top hospital can be.

Two years ago, a woman got admitted to a leading hospital to treat her persistent back pain. The institution is a leading hospital in the country with state–of–the–art equipment, ISO certificates and leading surgeons. The surgeons at the hospital opined that two stones in the gall bladder and another stone that had dropped off into her bile duct were the culprits. She needed to go through two procedures – endoscopic removal (ERCP) of the stone in the bile duct and cholecystectomy for the stones in the gall bladder.

There exists a chance that a patient may contract acute pancreatitis after the ERCP procedure. Sound medical practices also say that such procedures must be conducted within three to four days of each other. (Surely, we can assume that two experienced and renowned surgeons knew these facts).

On June 21, 2006, the ERCP procedure was performed on her, and after 24 hours, a cholecystectomy was performed. Three days later, her health began to deteriorate drastically – she experienced bre­athlessness, sweating, low–back pain, and sluggish bowel movements – and the doctors could not figure out what was wrong. They transferred her to the ICU.

On June 29, she was shifted back to the general ward although the transfer–out noting mentioned “Inflammatory changes in the pancreas tail noted”. The woman had indeed contracted acute pancreatitis, but it wasn’t diagnosed by a top notch hospital staffed with best–in–the–business talent. Between June 29 and July 5, she went through hell – abdominal and back pain, breathlessness and intense weakness. The orthopaedic surgeon even hinted she might need a disc surgery but her family refused. On June 4, her legs were swollen, there was fluid in her lungs and all the above conditions were still present.

Yet, on June 7, the hospital considered her fit for discharge although she was indisposed. There was no mention of acute pancreatitis at any time during her stay or at the time of her discharge.

Back home, her condition worsened; she was on her death bed. Desperate and untrustworthy of this hospital, her family took her to another top hospital, which fortunately was staffed with caring professionals. Acute pancreatitis was diagnosed and she was operated upon with the surgeons cutting out a major chunk of her infected pancreas.

She survived with only the tail of the pancreas intact, a weak body, a deficient immune system and a mind that can never forget the nuclear blasting received at the hands of top surgeons. She sued the hospital. The hospital refuted the charges and filed an appeal. The court dismissed the hospital&s appeal and in early 2008, found it guilty of gross medical negligence and asked it to pay up Rs 2.65 lakh – a pittance compared to the crime committed.

The hospital has coughed up the amount in mid–2008 but not apologised, nor has it punished the negligent doctors. If this can happen in a high–quality, ISO–certified hospital, can one imagine the condition of smaller private and government hospitals?

Is there also any death–audit procedure in place in government hospitals? Shouldn’t deaths of not–so–seriously–ill patie­nts in hospitals be checked by a government department? Forget dea­ths, shouldn’t the Centre set up a hospital–practices–and–processes agency reporting directly to the state health minister? Shouldn’t laws be passed that penalise and revoke licences of negligent hospitals?

Shouldn’t the government supervise activities of small hospitals mushrooming in every Indian suburb? Maybe, all this will happen. Until then we can only pray that if we are hospitalised, we won’t be involved in the one–off game of human Russian roulette that may be played regularly at small and government hospitals and occasionally at quality hospitals. Or, we can eat an apple everyday.