Gurugram Fortis hospital stares at license cancellation

The Haryana government has recommended cancellation of recognition to Gurugram’s Fortis Memorial and Research Institute (FMRI) following the death of seven-year-old Adya Singh due to alleged medical negligence.

A letter in this regard was sent to chairman of National Accreditation Board for Hospitals and Healthcare Providers (NABHHP) by the director general of Haryana health services on December 9. MAIL TODAY has accessed a copy of the letter, in which the DG has pointed out negligence found during an investigation by a three-member committee headed by the additional director of the health department.

The panel’s report accuses the hospital of removing Adya from ventilators without any substitute arrangements and sending her in an ordinary ambulance despite the fact that her condition was very critical.

“Removing Adya from ventilator was a serious lapse done by hospital,” the letter said. The institute is also accused of overcharging by using expensive medicines.

“The hospital could have used generic medicines for the treatment of Adya instead of expensive allopathic medicine,” the letter also said. The DG also urged presidents of the Indian Medical Association and Medical Council of India to act against the hospital.

He has also written a letter to the Haryana Urban Development Authority (HUDA) for cancellation of the hospital’s land lease over violation of terms and conditions of allotment. According to health department guidelines, if any hospital is found guilty of flouting norms and negligence leading to death, there is a provision for licence cancellation.

When contacted, HUDA administrator Yashpal Yadav said did not receive any official copy from the state health department regarding the cancellation of land lease, assuring that once he receives the same, action will be taken accordingly.

VIMSAR doctor caught on camera working in pvt clinic

Image result for Veer Surendra Sai Institute of Medical Sciences and Research

A doctor posted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla has been caught on camera while working in a private diagnostic clinic during duty hours.

Director of VIMSAR, Aswini Pujahari, first noticed the doctor of Radio-Diagnosis department, B B Panda on Sunday engaged in the malpractice.

“I had gone to the department on Sunday. There was no consultant doctor at the department. Only a PG student was on duty. I made call to the doctor who was on duty to come to department. Though I made the call at 11 AM, the doctor did not come till 1 PM. Later, I got information that the doctor was in a private diagnostic centre,” Pujahari said.

Stating that he personally visited the private diagnostic centre and found the doctor working there, Pujahari said “I video-graphed the activity of the doctor at the private diagnostic.”

He said action will be taken against the doctor so that such activity is not repeated by other doctors. The matter will also be placed before the disciplinary committee of VIMSAR.

The accused Dr Panda, however, said he was at the diagnostic and claimed since it was Sunday and a holiday, he worked there for some time.

“I had visited the department on Sunday morning and inquired whether there was any case. And when I found that there was no case, I went to the market. Subsequently, I went to the private diagnostic,” Dr Panda clarified.

AIIMS-Patna to be ready by Dec; health secy reviews project

AIIMS

Union health secretary CK Mishra (centre) is flanked by director Dr PK Singh (left) and medical superintendent Dr Umesh Bhadani (right) at AIIMS-Patna.

After three missed deadlines, the Centre has given agencies engaged in the construction of AIIMS-Patna an ultimatum to complete the project by December, this year.

Union health secretary CK Mishra asked construction firms to complete all work by December. He was here to review the progress of hospital construction on Wednesday. The project had to be completed by October 2012.

Mishra also passed explicit instructions to the superintending engineer to camp here, sort out issues with the agencies, and submit him a report within a week.

The construction firms — BL Kashyap & Sons Ltd., Nagarjuna Construction Company Ltd and the Ahluwalia Contracts (India) Ltd — had complained that their bills were pending in absence of a regular superintending engineer. The superintending engineer of AIIMS Jodhpur has been given additional charge of Patna after the previous incumbent left in October 2014.

“Our bills worth Rs 14-15 crore are pending with the AIIMS,” said PN Pandey of the BL Kashyap & Sons Ltd. The firm has to construct the 960-bed hospital and infrastructure, besides estate services, like internal roads, etc. It is this package, which has been inordinately delayed, as nearly 30-40% work still remains.

BL Kashyap & Sons was given the Rs 351-crore hospital package in October 2010, with a completion deadline of two years. However, the firm claimed that it got the project drawings and maps a year after it was handed the project.

The Nagarjuna construction firm has completed the construction of the medical college building and is now engaged in auditorium work. Ahluwalia Contracts is undertaking electrical work, even as basic hospital services have been initiated with 200-odd beds.

The AIIMS-Patna project has four packages, all of which are running behind schedule. Since December 2012, the deadline has been revised thrice – January 2014, December 2014 and now December 2017.

Private hospitals reuse disposables, make you pay for them

Disposables like catheters, guide wires and balloons used in every angioplasty are reused and billed repeatedly in many private hospitals.

Adding to the risk of infection, you could be paying for something that has already been paid for. And the hospital may be making a profit of Rs 20,000 to Rs 30,000 on every procedure with simple reuse and rebilling, say industry sources.

The practice is so rampant that the health ministry has issued an office memorandum warning against reuse of disposable surgical items, particularly in cardiology, when they are meant for one-time use.

“The items after one procedure are sterilised and reused and (patients) are charged full amount of these items,” stated the memo dated December 21, 2016. The matter had been “viewed by this ministry seriously”, it said, and clarified that “reuse of disposable items, particularly in cardiology and other specialties, is not permitted in healthcare organisations empanelled under CGHS (Central Government Health Scheme)”.

It goes on to warn of “suitable action including withdrawal of CGHS empanelment” against defaulters. It is silent on action against big corporate hospitals that are not empanelled under CGHS.

“Most private hospitals, especially hospitals chains, insist that cardiologists reuse these items. While reusing these items a couple of times might be justified in some cases where you want to help bring down costs for a patient, in most of these hospitals, not only do they reuse four or five times, patients are also billed afresh for each of these items, helping the hospitals make a profit of Rs 20,000 to Rs 30,000 on each procedure or patient,” explained a cardiologist who has worked in several leading private hospitals.

All disposable items have clear instructions on the packaging saying they should be used only once and cannot be resterilised. Some cardiologists in private hospitals admitted that reuse was common but said it was not a problem if the items were properly resterilised. Companies, they said, insisted on single use to sell more of their products.

Cath lab technicians and dealers who sell disposables and stents to hospitals also confirmed that such reuse was common. Hospitals like AIIMS and PGI hardly ever reuse these items as there is no pressure to cut corners to make profit.

“In the US, solid catheters or catheters without holes can be resterilised and reused but only once or twice. But reuse of catheter with holes like a guide catheter used in angioplasty is not allowed as it is difficult to clean the insides where blood residue might remain. This is to prevent any chance of HIV and Hepatitis B infection. Also, resterilising affects the quality of the item as it hardens the plastic, making it less flexible,” explained a senior AIIMS cardiologist.

Chain hospitals are the worst offenders, according to a cardiologist who has worked in one such institution. “If doctors in one hospital in the chain reuse an item five or six times, that is lauded as a great example of cost saving. It is pushed as standard operating procedure across the entire chain, putting enormous pressure on doctors who try to resist such unethical overuse of a disposable item,” explained the cardiologist.

“Reuse is bad and doing so without the patient’s consent is criminal,” said another cardiologist. “And charging for resued items is fraud of the highest order being done in most elite hospitals to push up profits. It is easy to investigate and expose this. The government can get the number of angioplasties done in a hospital and ask for proof of purchase of the disposables for the last two years. There is a formula for how many disposables are needed for each angioplasty. They will find that far fewer disposables have been purchased than the required number, which will show clear reuse. Such hospitals should be prosecuted,” he said.

However, reusing of items with patients’ consent to reduce costs for the poor should not be treated as criminal acts, he added.