A probe instituted by Haryana state government in the alleged case of overcharging and medical negligence of Adya by Fortis Memorial Research Institute in Gurugram has led to scathing revelations of misconduct by the private-run hospital.
A probe instituted by Haryana state government in the alleged case of overcharging and medical negligence of Adya by Fortis Memorial Research Institute in Gurugram has led to scathing revelations of misconduct by the private-run hospital.
A seven-member committee headed by Dr Rajiv Vadhera, Additional Director General of Health Services has submitted the report to Haryana state government. DNA accessed a copy of the report which criticizes FMRI at various levels.
It states that it is unethical to pull off life support from a patient who has sought Leave Against Medical Advice (LAMA) from the hospital. It also raises questions on forgery of parents, signatures on hospital documentation and overpricing of drugs and consumables.
The report notes that on September 14 there was a huge lapse in Adya’s treatment. Life support was pulled off from Adya in the ambulance by Fortis doctors while she was being shifted to another hospital. The report says that withdrawal of life support by the hospital staff in the ambulance amounts to negligence and is against the law of the land.
“Leave against medical advice does not mean that hospital disowns the patient completely. They must ensure all facilities for transfer/transport to home or other hospitals,” said the report.
Dr Jitendra Kumar Jakhar, forensic expert from Post Graduate Institute of Medical Sciences, Rohtak was a part of the investigation committee. Dr Jakhar observed, “It was unethical for doctor to stop assisted ventilation without handing over to another specialist or directing relative to ventilate the child by means of ambu-bag.”
The investigation committee has recommended that the case be sent to Medical Council of India for action under Professional Conduct, Etiquette and Ethics, Regulations 2002. “Under this all the senior doctors treating the case in PICU like Dr Krishna Chugh, Dr Vikas Taneja, Dr Vikas Verma and others should be held accountable,” the report states.
The report raises serious questions on how the deceased’s parents were not counselled. While Fortis maintains that the protocol of explaining seriousness to parent/attendant and putting the name and signature of both doctor and attendant to whom it was explained was seen in the case record of PICU, the report notes that except on September 12, none of these documentations have signatures of the parents.
“Further it was noticed that the entire patient record was being maintained on loose sheets and no proper files with page marking were maintained,” it states. “This protocol should not have been ignored in an NABH accredited hospital like FMRI.”
The hospital said that while it purchased drugs for Rs 3,33,044, it charged the patient Rs 6,70,126 and took a whopping 108% profit margin. The report noted, “Hospital management looks to be attempting to get maximum profit out of drugs and consumables in the garb of MRP.”
The investigation committee observed that the bill could have come down by one third of the cost charged (over Rs 15 lakhs) in absence of comprehensive package for billing. “There is need for regulatory authorities at national level to fix upper limit of cost of various medical procedures, investigations and raising protocols to ensure that the patients pay judicious or fair price,” it says.
On November 21, Principal Secretary Amit Jha had constituted a committee to investigate the matter. The committee examined medical, medico-legal, financial and regulatory aspects of baby Adya Singh’s death at private-run Fortis Memorial Research Institute (FMRI) in Gurugram.
Adya’s father Jayant Singh deposed to the committee that in the case file receives from Fortis, he had found that at many places signatures of his wife Deepti and himself were forged. Singh said that Jasbir Grewal from Fortis Management team had contacted him and offered him full refund as also another Rs 25 lakhs over and above the refund to do an out of court settlement.
“In subsequent conversations after I denied his offers, Grewal offered a cheque of over ten lakh rupees saying that the investigation committee had ordered the above compensation to be paid to me,” Jayant, the deceased’s father told DNA.
Close to 1300 pages worth records were analysed by the investigative committee over the past two weeks including Adya’s clinical reports, treatment records, old and new policies of Leave Against Medical Advice (LAMA) of Fortis Hospital, duty rosters of PICU resident doctors including others before submitting the report to Haryana state government.
Fortis billed Jayant close to 16 lakhs in fifteen days as his baby Adya succumbed to dengue shock syndrome, post which Union Health Minister JP Nadda asked for an inquiry to be instituted to investigate the case.
DNA had first reported the story of deceased baby Adya on November 20. The story can be read here.
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