Bihar: Death certificates mum on cause, ex gratia a far cry for kin of Covid dead

Death certificates of Covid-19 victims do not mention on it the cause of death, causing difficulty to family members in claiming government compensation

Death certificates of Covid-19 victims do not mention on it the cause of death, causing difficulty to family members in claiming government compensation.

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Bihar offers ₹4 lakh ex-gratia to the next of kin of a Covid-19 deceased through the Chief Minister’s Relief Fund. To get this compensation, there is a lot of paper work involved, and irrefutable evidence of Covid-19 death being just the first prerequisite.

With no mention about the cause of death on form 6 of the death certificate, issued by the department of planning and development, government of Bihar, relatives have to append Covid-19 positive test report along with the patient’s death summary in case of institutional death.

“A mere mention in the remarks column of the death certificate that the deceased was Covid-19 positive would have sufficed and dispensed with the requirement of a Covid-19 report as well as patient’s death summary in case of hospital deaths,” said Rajeev Ranjan, a resident of Danapur.

Rajeev had played a proactive role in helping his neighbour Shukla Sengupta get the government compensation of ₹4 lakh for her husband Sujit Krishna Sengupta, who died of Covid-19 last year.

Sengupta has two daughters, one in Pune, and the other in Patna, who is suffering from a genetic disorder. Rajeev had to make several rounds of government offices before the septuagenarian widow could get the government cheque.

“Sujit tested positive at Patna Medial College Hospital (PMCH) where he was initially admitted. He suffered a fall at the hospital and fractured his hip bone, after which the hospital referred him to a higher centre. His family then moved him to another hospital, which misplaced his Covid-19 test report. I had a tough time to convince the clerks in government offices that Sujit uncle died of Covid-19,” he recollects.

This is not an isolated case.

Ishani Lal (27), Stuti Lal (25), Aastha Lal (20), residents of Hanuman Nagar locality in Patna’s Kankerbagh, have lost their parents. While their father Anupam Kumar died a few years back, mother, Vibha Baxi, 49, succumbed to Covid-19 at the All India Institute of Medical Sciences (AIIMS) on April 27.

The daughters are now struggling with paper work, as the death certificate issued by AIIMS does not mention Covid-19 as the cause of death. Worse, the institution has misspelt their mother’s name in the death summary. Correcting it is taking them some effort and time.

“Neither has any of the three daughters nor I received any call from the government either to enquire about the delay in submission of claim or to guide us and facilitate the payment of compensation,” said Vishal Baxi, who got his elder sister admitted to AIIMS.

Most government medical colleges, which are authorised to issue death certificates on form 6 to relatives, said there was no provision to mention the cause of death on it.

“We do not write the cause of death on the death certificate issued to the relative, as the format is fixed by the government and there is no column to mention the cause of death on it,” said Dr Binod Kumar Singh, medical superintendent of the Nalanda Medical College Hospital.

Additional professor, forensic medicine and toxicology department of AIIMS-Patna, Dr Amit Patil, said doctors were supposed to mention Covid-19 as a cause of death in form 4, which is the medical certificate for cause of death.

“Doctors have to mention cause of death in the death certificate according to the international classification of disease. The WHO has given code U07.1 for Covid-19 disease. Relatives of patients have the right to access form 4 along with form 6, generally given to them as the death certificate,” said Dr Patil.

Mahesh Prasad, additional district registrar of births and death in Patna, said death certificates given to relatives were not supposed to mention cause of death on it.

“The format of death certificate is fixed and there is no provision to mention the cause of death in it. The data uploaded on the national portal of births and deaths, on the basis of information furnished by doctors in form 4, does mention the cause of death in it, but the certificate given to relatives does not capture it for confidentiality reasons. Any change in it has to be done as per the guidelines of the Registrar General of India,” Prasad said.

Meanwhile, considering the issues in compensation, the state government has decided to take up the issue with the Centre.

“We will take up the issue with the Centre and request it to mention the cause of death on the death certificate given to relatives,” said Pratyaya Amrit, Bihar’s additional chief secretary, health.

Of the 9,429 Covid-19 deaths in Bihar, as on June 9, the state government had released ex gratia funds for 3,737 Covid-19 victims so far of which around 2,000 had been paid till then.