Who robbed the blood bank?

Last month, at a private hospital in Hyderabad, a team of doctors told a six-month-old baby’s relatives that they required eight units of blood for her open heart surgery. The blood was arranged for and post surgery the baby went home with her joyous parents. But the happy ending didn’t quite add up. Why did a six month old baby require all of eight units of blood?

Blood money
Twenty three-year-old blood donor Amit Thanvi, whose blood group is O- (considered to be one of the rarer blood groups in medical circles), has been a donor ever since 2009 and has donated blood to almost six to seven people. In his three years of experience as a blood donor, Thanvi has seen many private hospitals make unreasonable demands that often left him startled and angry. The aforementioned instance in Hyderabad makes for a recent case in point.

“You can ask any doctor if a six-month-old baby would ever need eight units of blood — she won’t,” explains Thanvi. Moreover, the hospital — a reputed children’s heart hospital — insisted that the relatives draw the blood from a specific private blood bank. They were also asked, by the hospital, to replace the blood at the bank  by sending eight donors. Sensing something suspicious, a donor friend of Thanvi approached the management, asking for documents confirming that all eight units of blood were used for the baby. “They refused to give him the documents,” says Thanvi. “Probably they had some sort of a tie-up with the blood bank.” Though he has no proof to back his claim, Thanvi has a sense of what happened to the extra, unused units of blood. “They must have been used on another patient and he must have also been charged for it,” says Thanvi.

One needs to only look at the blood processing or testing fees that blood banks levy on patients, to understand the gravity of the issue. There is no single rate that regulates blood banks. While the processing fee has been fixed at Rs425 in the government sector, this amount can go upto Rs2,000 per unit in private blood banks. Last year, the state health department acknowledged the issue by agreeing to lay down a policy (which was to be framed by an ‘expert committee’) and bring parity in the prices of blood in all blood banks by 2012.

When contacted by DNA, Dr Girish Chaudhary, in-charge director, State Blood Transfusion Council (SBTC) denies knowledge of such a practice amongst hospitals. “There is a surgery schedule which specifies the units of blood for each surgery. Doctors rarely go above that,” explains Chaudhary. “But if they do, then they should not do it.” He also opines that asking both the first and second patients to pay a blood processing fee is valid. “Expenses will be incurred while cross checking the blood so the patient has to pay that. But the fee must be reasonable.”

Trapped in blood cells
Vinay Shetty of Think Foundation points out that certain hospitals do not discharge patients until their relatives replace the blood by bringing in donors. They also prefer patients to draw blood from their own blood banks as against standalone private banks, adds Shetty. “Their explanation is that they want to be sure of the blood quality, but the blood that is collected by a private blood bank during a blood donation drive is safer than that collected from a donor, during an emergency. This has been statistically proven the world over,” he explains.

It is the duty of the hospital and not the patients to arrange for blood, emphasises Shetty. “The Supreme Court bans the commercialisation of blood donation. But certain hospitals ask you to pay a huge deposit, which they will return to the patient only once they arrange for replacement blood. If you are unable to do so, that money too will reach hospitals’ hands. Is this not commercialisation?”

While Rekha Luke, a staff nurse at Hinduja Hospital, admits that such malpractices may occur in other hospitals, she argues that it is the patients’ relatives’ duty to clear any doubts that they may have regarding the treatment. “Before surgery, the doctor will explain everything related to the surgery — including the blood transfusion — to the relatives,” explains Luke. And SBTC’s Girish Chaudhary insists that he is yet to get a complaint about such unethical practices.

But as Khushroo Poacha, the founder of Indian Blood Donors, puts it, the fear of challenging big, powerful hospitals have stopped people from questioning hospital management. “Before a surgery, a harried man will be more concerned about arranging the blood on time,” explains Poacha. The adage of ‘there will be blood’ doesn’t unfortunately hold true in all cases.