Times of India
By Malathy Iyer
Mumbai, India

Diagnostic reports getting exchanged between patients has been the stuff of some reel-life dramas but it was a serious situation at Parel’s Tata Memorial Hospital, when its doctors unravelled such a mix-up by a laboratory in Kalyan.

The hospital on Wednesday found that a report of Nerul resident Devaki Poojari, under treatment for breast cancer for six months, was “doctored”. This raises fears of Poojari being given excessive chemotherapy. TMH director Dr Rajan Badwe called it a “good piece of computer gimmickry” and said the hospital now plans to approach the police.

“As some breast cancer tests are done only by us, many private laboratories send samples to us. When Devaki came to our radiology department, we found through our in-house computer system that a report — though on our letterhead — had never been issued by us for her,” said Dr Badwe.

Sitting outside Tata Memorial Hospital on Wednesday, Nerul resident Devaki Poojari and son Rajesh were clearly confused. “My mother has undergone seven cycles of chemotherapy for breast cancer since September, but now we are not sure if her cancer was indeed serious enough to merit these high-dosage intravenous drugs,” says Rajesh.

The reason for their confusion is a diagnostic report meant to establish the cancer’s receptor status (ER, PR and Cerb B2). This report is conducted at the Tata Memorial Hospital and helps doctors plan the patient’s treatment. In Devaki’s case, Tata hospital insists it never issued a report in her name. And herein hangs the story.

It began on September 7, 2009, when she was operated for lumps in her breast. “The blocks and tissues recovered were sent to TMH by the Maxim Clinical Laboratories in Kalyan after surgery for breast cancer at Harish Hospital in Nerul. It showed two positive and one negative counts,” said Rajesh, who works with a multinational firm.

On the basis of this report, she underwent three chemotherapy doses in Harish Hospital before being referred to a private hospital for radiotherapy. “As we were worried about our finances, we came to TMH.” While checking her papers, doctors in the breast cancer unit felt she needed five more cycles on the basis of the report.

Devaki was scheduled to undergo her final chemotherapy on March 15 and radiation therapy thereafter. “When I took my mother to the radiation department for an appointment, the doctor there checked my mother and felt there was a discrepancy with her clinical status and the report,” said Rajesh.

The doctor immediately called up the pathology department to double-check. Said Dr Rajan Badwe, director of Tata Memorial Hospital, “With regard to samples that come from outside, we use two identification numbers. One is the case number and second is the acquistion number. Both these numbers listed in Devaki’s report showed up tests of two other patients, one identified as J Patil and another as Atiqua.” Worse, the report that the Poojaris had was an amalgamation of facts from the reports meant for J Patil and Atiqua.

A team from Tata Memorial Hospital then summoned Dr Ashhad Shaikh from Maxim Labs in Kalyan as well as several of their own doctors to investigate the case.

“Our lives were shattered by the news of the cancer itself. But for the last four days, we have seen further turmoil,” said Devaki’s son Rajesh. The woman herself is worried about her husband’s shooting blood pressure.

After deliberations between all the parties involved, it was established that, in all probability, the sample marked as J Patil was actually Devaki’s sample. A senior doctor from Tata Memorial Hospital said that it was quite possible that J Patil was just a fictitious patient and did not exist.

“The laboratory should have just told us that they had mixed up names and we would have made a note of it. Instead the patient has been issued a doctored report which has been prepared from two patient reports,” said Dr Badwe.

About the laboratory, Rajesh said that they got the report more than 20 days after the surgery. When TOI contacted Dr Shaikh, he only said that there only was a mixup in the patient’s name but her cancer treatment had not been affected by it.

When told that TMH was planning to file a police complaint, he said he would call back later. Dr Shishir Shetty from Harish Hospital, when contacted, said he would be call up in 10 minutes and refused to answer the calls thereafter.

Did Devaki Poojari Undergo Excess Chemotherapy?
Nerul resident Devaki Poojari and son Rajesh say the Navi Mumbai doctor who operated on her had only asked for three cycles. When they went to Tata Memorial Hospital for radiation therapy, she was asked to undergo five more cycles of chemo. “I fear what all the toxicity has done for my mother,” said Rajesh.

However, Dr Rajan Badwe, one of the foremost breast cancer surgeons, said that the only problem due to the report mix-up is that “we don’t know the extent of her cancer”. But the minimum chemotherapy protocol followed across the world is six cycles.

“If many of her nodes were cancerous, she would have needed eight cycles. So Devaki has got only one extra cycle and has been advised to undero one more cycle. But these extra cycles reduce the chance of recurrence by 8% and chance of death by 5%.”