JOIN USHospitals prefer profit over patients
Shamashad Begum’s voice breaks at the memory of her brother, Mohammed Shakeel, a towering, gentle giant of a man known within clubbing circles in Hubballi as “DJ Shakeel,” who had perished after being taken to a hospital for a check-up late last year.
On November 6, at the onset of Deepavali, Shakeel, 41, had come home, following a visit of several farms where he hoped to start a business, to find a numbness creeping over his legs. Although he had gone out to visit friends, he had soon discovered that he was unable to walk.
Alarmed, his family decided to have him seen by a doctor. The onset of the holiday season, however, meant that a large number of medical professionals were on leave, throwing the family into a quandary.
Eventually, they were referred to Dr Ullas Bisleri at the Tatwadarsha Hospital in Hubballi, who, Shamashad, alleges, determined that extensive blood clotting in the legs was responsible for his condition and pressed for immediate surgery without carrying out preliminary testing to determine the precise nature of the problem.
Much of Dr Bisleri’s energies at this early stage of admittance were allegedly spent trying to force the family into signing a consent form for surgery and to make cash payment so that the procedure could be carried out. We felt besieged, Shamashad told DH.
Dr Venkatesh Muger, a nephrologist at the hospital who was brought in later on when Shakeel’s kidney’s began to fail, insisted that the patient was given a Doppler ultrasound test, which determines blood flow through the body. “Because of this, my colleague Dr Bisleri, knew the problem was due to clotting,” he said.
Within a few days of the procedure, however, Shakeel’s feet had swollen and the tips of his toes had turned black as if he had frostbite. Shamashad offered DH medical documents which showed that the cause was muscle damage inflicted during the course of the surgery. By November 14, Shakeel’s condition was critical. Alarmed by his deterioration, Shamashad, who is a lawyer in Bengaluru, rushed to have her brother moved to a hospital in the city.
Patient pays the price
By November 15, Shakeel was at the Bhagwan Mahaveer Jain Hospital in Bengaluru, where the chief of the vascular surgery department and his team expressed surprise at the condition of the legs and suggested an immediate amputation to save the patient’s life.
“Can you imagine how difficult it was for us to take this decision?” Shamashad said. “Because we wanted to save him, we convinced him to agree to the amputation.” Despite the amputation, Shakeel died on December 7, 2018. The staff of Bhagwan Mahaveer Jain Hospital would later tell the family that Shakeel could have been saved had he been brought to their hospital at least two days earlier.
This prognosis is all the more hard for the family to swallow considering Shamashad’s insistence that Tatwadarsha Hospital had failed to carry out preliminary tests or take into account that Shakeel was diabetic and that his sugar level was nearly 357 at the time of his admittance, which compounded the risks of surgery.
Dr Muger of Tatwadarsha disagreed that medical staff were reckless with the surgery, saying that everything that could be done for Shakeel had been done. “I know that people will say that we all doctors stick together, but in this case, I can say that Dr Bisleri really took pains to help the patient,” he said.
Shamashad, however, presents a different picture of Dr Bisleri who she says assured the family that the hospital had all testing and scanning equipment on hand to diagnose the patient, only to have the family discover that the technical staff had gone home and that there was no one to operate the machines.
Dr Ramaswamy Balasubramaniam of Swami Vivekananda Youth Movement, which has worked extensively in the health sector, said this type of promised services are often endemic to healthcare in the private sector today, where even though clinics and hospitals do not have the infrastructure support, they will pretend to have them.
“Surveys show that in Karnataka, more than 80% of the health infrastructure is in the public sector while only 34% of patients use them,” Dr Balasubramaniam said. “While we need to worry about this poor utilisation of government facilities, we also need to ask ourselves how can private hospitals with a mere 20% of the total health infrastructure in the state cater to 66% of the state’s population?”
Dr Balasubramaniam was careful to point out that government-run institutions hire and appoint only qualified personnel unlike the private sector where personnel need not be appropriately qualified. There are several nursing homes that are staffed with nursing and laboratory personnel not having the required qualifications. “Merely wearing an apron does not necessarily make that person a nurse,” he said.
Lack of experience
This sense of white-clad medical personnel not being proficient in their jobs was brought home to Jayalakshmi, a septuagenarian patient, who, despite informing the medical anaesthesiologist handling a respirator that she was wearing dentures, had a respirator pipe forced into her mouth, slamming her dentures down into her throat.
Jayalakhsmi’s son, E Gangadhar, said that the incident occurred when his mother was taken to G M Hospital in Bengaluru for a kidney ailment. Her entreaties to hospital staff that she was in discomfort allegedly fell on deaf ears until finally, after 30 days of hospitalisation, she was moved to another hospital where an Ear-Nose-Throat doctor removed the dentures using a pair of basic clippers.
“The doctors did not tell us the true reason for her discomfort,” Gangadhar said. “We had to pay a heavy price for this. They took a month to tell that they would be unable to treat her and that we had to take her elsewhere.”
The incident, which took place three years ago has come to haunt G M Siddeshwara, the sitting member of parliament (MP) from Davanagere just weeks before the polls, in whose hospital the negligence had been committed. On March 20, Jayalakshmi and her son approached the Election Commission in Bengaluru, to demand that the Commission reject Siddeshwara’s candidacy on the grounds that a case of medical negligence had been filed against him.
Bolstering the family’s case is a report from the district health officer (Bengaluru), announcing that doctors at G M Hospital had committed gross negligence.
Vijayakumar Seetappa, a member of the Bengaluru-based NGO, Karnataka Janaarogya Chaluvali, explained why they were seeking to disbar Siddeshwara from elections. “These people are supposed to be the lawmakers. They are supposed to abide by the rules that they themselves have set up to protect the people,” he said. “This is why we feel the incumbent MP should not be allowed to contest the upcoming elections.”
Siddeshwara could not be reached for comment. In another instance, relatives and friends of Nagaraj, an auto driver, had protested in front of CG Hospital, Davanagere in 2018, alleging that doctors’ negligence had caused his death.
Malpractice in govt hospitals
Although, many reported cases of negligence re-emerge from private hospitals, incidents of malpractice can also be found in government institutions. One such case involved a three-year-old child, Mariam Kouser, who was taken to the State-run Sanjay Gandhi Institute of Trauma and Orthopaedics, Bengaluru for an injury to her elbow.
Although the exact sequence of events are still unknown, Mariam was subject to an overdose of anaesthesia. Medical staff later said that her brain had been damaged due to hypoxia, a condition triggered by deficiency in the oxygen supply. Mariam is now in a vegetative state.
The incident, which triggered outrage, prompted the state to move quickly, suspending two of the attending doctors and suspending two others. This, in many ways, stands in contrast to doctors in private hospitals who are rarely subject to anything more than a rap on the knuckles.
According to Akhila Vasan of Karnataka Janaarogya Chaluvali, part of the problem is that Indian Medical Association does not do enough to punish doctors at fault. “Often, the maximum punishment is six months that I have seen,” she said, adding that a series of laws in the regulation of healthcare is at fault, including fragmented laws, lax enforcement, doctors with class-caste biases who engage in preferential treatment of patients and the arrogance of medical professionals who refuse opinions or questions from patients. “All of these reasons make the medical profession immune from legal redressal. Doctors are seen as Gods,” Vasan said.
This is the sort of trust, that Shamashad now regrets having. “Tell us what mistake did we do?” she asked. “We trusted the doctors as Gods and because of that I lost my only brother. But we have all the medical documentary evidence. They cannot just play with people’s lives. I will fight this all the way to the Supreme Court if I have to.”
(With additional reporting from Reshma Ravishanker)