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Private Mis-management: your misadventures at private hospitals and nursing homes

Hindustan Times's feature on negligence of private hospitals and non delivering in spite of over charging the patients, is highly laudable attempt to waken up the conscience of those who are indispensable to the society. We are humans first!

india Updated: Aug 21, 2009 21:08 IST

Hindustan Times's feature on negligence of private hospitals and non delivering in spite of over charging the patients, is highly laudable attempt to waken up the conscience of those who are indispensable to the society. We are humans first!

Ruchi Singhal

I lost my 16 years son in 2001, because of sheer negligence of the Apollo Hospital doctors. They are only after money. Treatment with transperancy is the least of their priorities.

Ravi Kant Gupta

I have a completely opposite views on hospitals. For some years I suffered from a perforated intestine and a faecal fistula (seven perforations). I was in a morbid state requiring the changing of an abdominal bag almost every day. I had lost all confidence and could not leave the house by myself (even in my car) for fear of a leakage of faecal matter. I had consulted many gastro intestinal surgeons both in India and abroad. Their verdict was unanimous “Carry on as you are. You have to live with it”. I longed for death. Then, as virtually a last resort, I went to Ganga Ram Hospital and consulted their HOD. Dr Samiran Nandi and his team carried out a complicated and long operation, full of confidence in their own ability. I am now cured and well. There are some niggling problems but I am freed of the accursed bag and am doing well. God bless them. But for them I would not have been around to write this.

Yours faithfully,
Mrs Indira Dandeker

I am working as Assistant General Manager with a nationalized bank. For the last nine months I was posted at Dehradun. My wife who also works in a nationalized bank, was living in Rohini, Delhi with my two sons aged 21 and 24 years. Recently I lost my young son aged 21 years due to gross negligence of the hospital staff and the doctors attending him. I would like to share my experience with a private hospital which gave a very rozy picture on the website.

On July 11, 2009 my younger son aged 21 years vomited 8-10 times since morning, had loose motion once and dreading dehydration, was admitted to Saroj Hospital & Heart Institute, Rohini, near Madhuban Chowk, Delhi at 5.04 pm on the same day. He had no history of any fever or chronic illness. He was admitted to a delux room and was attended to by Dr Rakesh Gupta MD (Medicine) and Dr Diwakar Jha MD at 6.30 pm he was given some treatment and made to undergo various pathological tests including Haemogram, Bio-chemistry, Haemotology, Hepatitis C, HIVI/II, Australian Antigen, X–ray chest, ECG under the advice and supervision of Dr Rakesh Gupta.

Next morning on July 12, 09, Dr Rakesh Gupta on his visit at around 10.00 am observed that the patient was sitting in forward bending position, was unable to open eyes, had slurred speech and was drowsy. The doctor in his wisdom recommended for Echocardiography test which was conducted on the bed side followed by EEG and CT–scan of the brain conducted in–house. CT-scan of the brain was conducted at 11.19 am as embossed on the CT Scan film. At 1 pm on the same day after observing that general condition of the subject was stable, the doctor wrote in the file that the CT Scan of the Head is done and referred to an eye specialist for examination who examined the patient at 1.20 pm and reported normal eye sight.

Dr Rakesh Gupta and Dr. Diwakar Jha attending the patient and charging for every visit, did not bother to enquire about the report of the CT-scan till 2.30 pm when he was informed on phone by the Hospital staff of the provisional CT-Scan report which showed “obstructive hydrocephalus; dilated ventricles, hydrodencity seen in the left cerebellum reaching upto vision, pressure effect over the left side...and the 4th ventricle ”.

It clearly indicated there was some blockade resulting in perpetual increasing brain fluid causing pressure in the brain. Dr Gupta, not being a neurologist himself, instead of scrutinizing the report and referring it to neurologist for any action, advised a further MRI test on phone. The hospital staff was aware that they do not have any facility of MRI test in house, and awaited the nature to take its own course. They did not inform the relatives of the patient to shift the patient to some other hospital with MRI facility nor themselves opted to do so. At 4.00 pm, Dr. Gupta noted that the patient had become reckless and is not responding to verbal commands. He didn’t check the CT scan report or take any action thereupon. At 4.30 pm, the situation aggravates, the patient became unconscious and was shifted to Intensive Care Unit.

Dr Rakesh Gupta nad Dr Diwakar Jha informed the attendants that the condition of the patient is very critical. Despite being aware of the report of CT Scan and the pressure built up in the brain owing to accumulation of fluids, he neither called a neurosurgeon nor took any step to reduce the pressure built in the brain by performing a small stunt surgery which can be performed by even junior doctors. He did not do anything when admittedly the CT Scan report screamed that the case warranted immediate SOS medical attention from a neurologist/ neurosurgeon.

At 5.30 pm , Dr Gupta put the patient on a ventilator whereby the subject is given artificial respiration. At 6.00 pm, Dr Diwakar Jha wrote a detailed two page report, with no promptitude for treatment, entailing therein that "the condition of the patient was very critical, let us pray to the god for recovery" as doctors, staff and ancillary staff are doing their best with support of medicine. The patient was admittedly sulking, vying for neurosurgery when the doctors gave up hope and recommended divine help.

Another two pages were written by Dr R Gupta also at 6:00 pm stated that the condition of the patient is very serious, shifting at this stage to any other hospital will be catastrophic and will unstabilize the patient. He further wrote that we all join together to pray to God by offering prayer to god and by giving medicines so that recovery should happen in the patient who is pretty young. Thereupon, at last, having lost all hope, and after his signatures referred the case to Dr Jaideep Bansal, a neurologist, who finally arrived at 10 pm after four long hours. Dr Jaideep Bansal suffers a blemished and tarnished service record. He was once suspended for one week by Medical Council of India on the charges of negligence causing death of a young 16 year old boy and is accused of murder for which a criminal case is registered against him in District court of Delhi (courtesy: internet). He took his time and arrived at 10.00 pm and recorded urgent night visit.

It is not apprehensible as to how/why the CT scan report taken at 11.19 am calls for a neurologist’s urgent night visit at 10.00 am whence the patient had gone into coma at 5 pm. After observing the CT Scan and giving details of the ailment he referred the matter to Dr Anil Kumar Kansal, a neurosurgeon, recommending neurosurgery. Incidentally Dr Jaideep Bansal is a full time senior doctor/consultant with the hospital whose name and photograph is prominently displayed on the official web site of the hospital. Dr Anil Kumar Kansal, despite taking consent of the father of the subject to perform immediate neuro surgery, did not perform any surgery whatsoever. Nor does he inform the relatives of the patient as to why he didn’t bother to perform the referred surgery. Thereafter the patient was kept on ventilators for 36 hrs. On July 14, 2009 at 8.41 am Dr Gupta informed the relatives of the patient that the patient had expired. Dr Rakesh Gupta/Dr Diwakar Jha have committed professional negligence by not referring the matter to neurologist/neurosurgeon from 11.19 am to 6.00 pm when the CT scan report called for neurology test. Their negligence is aggravated by not performing surgery to release the pressure gradually enlarged in the brain of the patient. Their negligence caused a premature death of a young promising boy who had just completed B.Tech and was on the verge of a professional bliss.

Dr Jaideep Bansal negligence was in not attending the patient between 6.00 pm and 10.00 pm when the matter was referred to him.

GS Sachdeva

My father was under treatment of Bakson's Homeopathy Clinic, A-51, South Extn, New Delhi wef 2004. During his stay in the clinic, my father was treated by several doctors of the said clinic including its Chairman (senior most doctor). However, instead of getting any relief from the treatment, the condition of my father kept on deteriorating, which was initiated to the doctors from time to time. However, they informed us that the condition of the patient is improving and there is no need to worry. In November 2007, the condition of my father worsened so much that he started developing signs of memory loss and also suffered acute breathing problem among other symptoms such as weight loss etc.

Hence, we approached the Chairman of the clinic about the same but was shocked to hear him saying that “you are now too late and the disease is at last stage”. We requested a complete case history and also to inform us about the disease being suffered by the patient and treatment given for the same and why there was no improvement despite continuous treatment for the past 3 years. Instead of giving any reply, the doctors got annoyed and stated that they do not want such kind of patients and also the treatment was stopped immediately, although payment for the treatment was taken well in advance.

On approaching another hospital in the same month of November, 2007, it was informed to us by the doctors that one lung of the patient was almost finished and that the patient was surviving only on one lung. We were not informed about this by Bakson’s Homeopathy Clinic. In fact, the doctors never informed us about any of the diseases the patient was suffering from and kept us in dark from the very beginning stating that the patient was alright.

Moreover, no case details/history was provided. After a long and painful suffering, my father expired in December 2007. Ever since the treatment (when my father was alive) and until now, I have been requesting Bakson’s Homeopathy Clinic to provide me the case details/records of my father but it is of no avail. Several RTI applications have also been made to different government agencies (including Deptt of AYUSH (Ministry of Health & Family Welfare); Medical Council of India; Board of Homeopathic System of Medicine; Directorate of Indian System of Medicine and Homeopathy etc) but Bakson’s Homeopathy Clinic has misguided these agencies stating that the case details and records have already been provided to me during my visit to the clinic, which is not true.

As per order of the Hon’ble National Consumer Disputes Redressal Commission and also the rules framed by the Medical Council of India, medical records are to be provided within 72 hours of making the request. However, I am still waiting for the case records to be provided to me even after a lapse of around 4 years. I have every right to know as to what treatment was being given to my father by the clinic. The Hon’ble National Consumer Disputes Redressal Commission in one of its order has also pointed out that “in case of non supply of the relevant documents, adverse inference could possibly be drawn with regard to deficiency in service”.

Mohit Jhangiani

I truly appreciate the efforts of Hindustan Times towards for the series on private hospitals and their deliberate negligence that have been undercover till now.

I would like to bring to your attention another critical case of negligence for Max Hospital, Pitampura where my sister delivered a baby girl on February 8, 2009.

Prior to the delivery, my sister was consulting a visiting faculty doctor of Max hospital at Pitampura. It was told to her by the hospital authorities and by the doctor herself, that she can deliver the baby in Max Pitampura. But the hospital refused to register on board even after repeated requests. She was told that the hospital will entertain her only when the labor pain will start.

Secondly, on the day of delivery, there was NO specialized doctor to attend her, in the hospital. Even the general doctor was not available. The doctor who was on emergency duty, as told by hospital, was himself admitted in the hospital at that point of time. A hospital without doctors? My sister gave birth to the baby WITHOUT any doctor (I believe you can understand the seriousness of the matter). The doctor, whom she was consulting reached the hospital an hour later. This was the situation when my sister informed the hospital much earlier when she started from home. This was a sheer case of negligence on the hospital's part. This could have endangered both mother and the baby. The hospital is inefficient in the 'taking care' part, post delivery. Breakfast, lunch and dinner -- were provided to the patient after repeated follow-ups. No routine was followed

Even after my sister provided a bad feedback and a complained to the hospital through a feedback form till now there has been no response/action from the authorities. With so much to complain against the hospital - Max Hospital, Pitampura in particular, I really wonder, how they are operating/playing with people's life withouth any fear from the government and the concerned autorities.

Vertika Saxena

Dear Rhythma,

I am S Manchanda, Nikita Manchanda's father (victim of Max Healthcare). I appreciate your initiative to expose mis-treatment by private money minting hospitals, business houses like Max.

In an attempt to take my fight further against Max Hospital, a dedicated site has been created

It is to start a force against these institutions that do not care about people’s lives in their quest to mint money. None of their efforts can bring back a life and undo the loss suffered; however, together we can help save many more precious lives.

Site details out the case history, talks about all the media mentions so far and includes status updates. I have also started a Signature Campaign to raise voices to condemn the state of medical care in India. 211 people till date have promised me their support in this campaign.

SP Manchanda

Sir/ Ma'am

This may not be a sensational case, but does demand attention. I congratulate HT for covering their feature on hospitals and doctors so well. I hope it is successful in stirring up the dormant conscience of most of the doctors.

Such is not the case with only Private hospitals. Govt hospitals do not fare very well either. I lost my father-in-law, Mr AK Singhal, to the doctor's negligence in RML Hospital, in 1993. My father-in-law was in the Health Ministry at one time and had retired as the Additional Director General, CPWD. He was also the Member Staff Selection Commission and was revered for his poise and honesty.

My father went through Angiography at the National Heart Institute under a senior Cardiologist, Dr Vinod Sharma. Fortunately, for my father, the doctor exclaimed, “the blockage is a negligible 10-15 per cent. All is well. Mr. Pratap, you need not worry.”

We heaved a sigh of relief. Yet, there was somebody in that recovery room, who was not at all pleased by the doctor’s declaration. There sat, an ungainly person whose appearance was that of a business man. By the girth of his waist, one would assume, his own heart could have an arterial blockage of at least 80 per cent. This gentleman, with the abundance of adipose tissue, lamented, “Good for the patient but not at all good for the doctor.” Only because the patient was well and the hospital would not be able to make a killing on him! The constant repetition of this statement was infuriating. Since my father was still admitted in the hospital, I kept my calm.

This gentleman happened to be Dr Prem Aggarwal, owner of Sanjeevan Hospital at Ansari Road, Daryaganj. God forbid, if anything happens to him, how much of the patient’s money can he carry with him to his heavenly abode? Can conducting bypass surgeries on patients, get Dr Aggarwal, a healthy life and assure him immortality?

‘As you think, so you become’, is apt for him. His thought process is like that of a businessman with no morals and to top it all – has an appearance of one too. It is people like him, who have made a business out of this noble profession. It has become a matter of utter ridicule. I am sorry to say, being ethical and keeping your moral values upright, can not be preached. It is inborn. God save the doctors!

Thanks for reading,
Ruchi Singhal

This mail goes to congratulate your commendable effort to get the readers to write about their personal experiences with the pvt hospitals. Everyone at some point or other have been harassed by them.

Yesterday's story about Rajeev Gandhi Hospital brought back memories of 12 yrs back when this hospital had newly started. My father had been diagnosed with cancer and the doctors there congratulated him for getting it diagnosed at level 0 so that he can be fully cured in a matter of couple of few months.

But unfortunately due to the negligence of the doctors during biopsy and subsequent chemotheraphy sessions we lost him in just less than 1 month of the diagnosis and treatment due to the apathy of the doctors.

Today on his 65th birthday I pray to God to rest his soul in peace.

Nidhi Chanana

Dear Sir/Ma'am

Greetings! I have been reading your section Private-Mistreatment regulary. It is unique attempt to unveil pvt hospitals' cruel nature towards patient. No one has the right to play with anyone's life. Everyone's life is important to their family.

Pradeep was young man with a dependant family. With his death I dread to know how his family must feel. I pray that no one's parents have to go through the same.

When I read this story I could not stop myself from writing to you. I hope you understand my feelings.

Warm regards,
Santosh Kumar

Sanjeev Sethi had related how his son, visiting a Vasant Kunj hospital for a severe stomach-ache, was whisked away to the emergency ward, where the staff started his heart monitoring and other tests. Unfortunately, getting patients to agree to quite unnecessary hospital admissions, often under false pretexts, is a very common malpractice with most private hospitals in Delhi. The authorities need to do something about it. Besides, too often, the specialists at surgical OPD’s of many private hospitals tell uninformed patients that a major surgery is the "only option" even where conservative, non-surgical treatment would be more appropriate. All this helps to keep the hospitals in business as hepless patients are milked to the maximum.

Jyoti Rani

According to your report in HT (Aug 18, 2009) Lilawati Mehta, 83, who was suffering from many ailments including high blood pressure, “bled to death after operation”. I am nobody to question your judgement as I am neither a doctor nor the eye witness to this specific case and it is not my intention to hurt the sentiments of the members of the family she has left behind. However, I would like to tell you my own experience with the hospital. My father, aged 78 years, whose femur got broken, was operated in Ganga Ram Hospital by the same doctor Dr SP Mandal about 3 months back. Junior doctors regularly visited my father along with Dr Mandal. Nurses were very co-operative. I was told that bleeding does take place in such an operation. However, bandage was tied very carefully for 2-3 days and every thing went very well.

In your report, you have mentioned that according to the death certificate, she died of a cardiac arrest. Do you doubt this certificate? Do you have enough proof that it was due to bleeding and not due to cardiac arrest, that Ms Lilawati died? Before the operation in my father’s case, we were asked to arrange two units of blood. I hope Lilawati’s family must have done so. In such an operation, loss of blood is very common, and I think a doctor of Dr Mandal’s stature needs nobody’s advice how to handle it.

Because of rapid commercialization in our society, many doctors, like in other professions, fall prey to it. They are treating patients like clients, without any human touch. But there are exceptions and as far as my experience goes, Dr Mandal is one such exception.

Your column is doing a great job in exposing inefficiency, incompetence and negligence in private hospitals. This will be in your newspaper’s interest that the credibility of what you give in your column, is never questioned. Dr SP Mandal is undoubtedly the most sought-after orthopaedic consultant at Sir Gangaram Hospital. I am not saying that he has never made a mistake or will never make one in future. All I am saying is that his reputation can make any professional, leave alone doctors, feel envious. Before giving catchy headlines, you must verify facts and then publish.

Ajay Kumar

Dear Rhythma Kaul,

Kindly accept our compliments for highlighting the prevailing conditions in the Health Sector. I am just forwarding a case sent to Delhi Medical Association, but still awaiting their response.

In the evening of April 23, 2004, I got admitted in Sukhda Hospital, Local Shopping Centre, near ‘R’ Block (opposite Pamposh Enclave), Greater Kailash-I, New Delhi-110048, due to acute, urological problems under emergency conditions.

Instead of immediate Ultrasound and inserting cathedral to release the collected urine in the urinary bladder, they put me on D/saline drips along with other medicines. As a result, I continued to suffer till the morning of 24th when they took ultrasound and inserted cathedral.

I feel, as a result of D/saline drips, on one hand and delay in inserting cathedral, my PSA became 22.1 and glucose (random) 287. Anyhow, I got rid of the hospital in the morning of April 28, after paying Rs.28,000/-.

Thereafter, I got my PSA tested from the same Dr Lal Path Lab on May 27. It was only 2.97. Similarly, True Glucose was 146 on Nov 27 and March 5, 2005.

Hope, Delhi Medical Council could do something in this matter to repose the confidence of the common man in our medical fraternity.

S K Agarwal

Congratulations to your 'Private-Mistreatment Campaign' for further dehumanising city of Delhi by adding more mistrust between doctor and patient. Right now, we Indians don't care about human values and your endeavour will further enhance it.

Dr Atul Kumar Gupta

The views I’m presenting are probably the views of a majority of doctors (barring a few black sheep). We are the same ones who studied with you in school and probably topped in our classes, played cricket and football in the same fields, shared the same occasional samosa and Coke, saw movies together etc etc. We’re not from a different planet, nor from a different society. We’re only the one’s who somehow managed to fulfill our parents’ and probably, our own ambitions and were entrusted the job to take care of the society’s Physical and Mental health so that you could pursue your Social and Spiritual health goals, freely.

To provide optimal health care I decide to use the following ethical strategies:

(1) Listen attentively to your patients symptoms and empathize with his grief and fears.

(2) Health care should be patient-centric: the patient is a human being and not merely an outer wrapping of a disease.

(3) Maintain good computerized records.

(4) Patients should be offered choice and alternatives and allowed to participate in decision-making. Yet, do not underestimate the amount of information patients wants nor overestimate how much we actually give. However, if I feel my patient trusts Google more than me, I do tell him it's time to switch doctors.

(5) Treat the patients as you would treat yourself! Additionally, maintain the patient’s confidentiality, never to be breached except in a court of law. While discharging your professional duties respect your patient’s privacy and uphold his dignity. Patients also have expectations during physical examinations, expecting proper draping, provision of chaperones for sensitive examinations (eg pelvic or breast examinations) and other accommodations to convey an environment of personal comfort and respect for the patient.

(6) Follow the five as of patient counseling: Assess, Advise, Agree, Assist, and Arrange. And, if something goes wrong, immediately take the patient into confidence.

(7) The patient has every right to terminate a relationship with his doctor at any time and seek the help of another. A reciprocal right rests with us. However, we are duty bound to help the patient until he contacts another doctor. In the best interests of the patient we could refer him to a colleague or specialist, if required. A referral should be made in writing with all relevant medical details being provided. The consultant, in turn, is duty- bound to return the patient to the referring doctor with a note bearing details of the diagnosis made and treatment advised.

(8) While taking the consent for any procedure, explain all the facts to the patient fully and in his own language.

(9) We should not be judgmental about a patient’s personal habits or attitudes. Scolding, too, may rapidly close down communication.

(10) Whilst having sexual relationships with current patients is clearly unethical, the ethics of such a relationship between a doctor and former patient is another debate, altogether. Simultaneously, I decided to steer clear of unethical practices, like fee splitting and the payments of commissions (cuts) to attract, referrals of patients; getting influenced by pharmaceutical company inducements, including gifts, travels and food; selling of body parts etc for personal monitory gains.

Yet, there still remained some dilemmas…

(A) I realized that not all treatment modalities are risk-free. In some circumstances, e.g. in life-threatening situations, one would sometimes have to administer risky treatments that stand a high chance of harming the patient because the risk of not treating is also very likely to do harm.

(B) “Medical futility”: with patients having less than a one percent chance of surviving but the family members insisting on advanced care.

(C) A disabled child's right to life, ensuring that this right is protected even over the wishes of parents or guardians in cases where. they want to withhold treatment.

Over and above, I needed to be careful about MEDICAL MALPRACTICE: professional negligence by act or omission in which care provided by a 'health care provider' deviates from accepted standards of practice in the medical community and causes injury or death to the patient. Thus, Medical Negligence (opposite of Medical Diligence) is when a doctor does not do what a doctor of average knowledge experience and capability would do or he does what a large body of Doctors would not, do.

Here, a 'health care provider' could be a physician, dentist, nurse and therapist. “Following orders" may not protect nurses and other non-physicians. Claims may also be brought against hospitals, clinics, or medical corporations for the mistakes of their employees.

A plaintiff must establish all four elements of the tort of negligence for a successful medical malpractice claim:

1. A duty was owed - a legal duty exists whenever a hospital or health care provider undertakes care or treatment of a patient.

2. A duty was breached – the provider failed to conform to the relevant standard of care. The standard of care could be proved by expert testimony or by obvious errors (the doctrine of res ipsa loquitur or the thing speaks for itself).

3. The breach caused an injury – The breach of duty was a proximate cause of the injury.