Holding Gurugram-based Fortis Hospital responsible for the death of seven-year old Adya Singh in September, the Haryana Government has decided to get an FIR registered against the hospital for grave negligence, lapse, unethical and unlawful act.
The committee constituted by the State Government to investigate the case of death of Adya Singh, who was suffering from dengue, has indicted Fortis Hospital, Gurugram for grave negligence and unethical act in handling the case.
“A case will be registered against the hospital and notice has been issued to cancel the license of blood bank of the hospital. A letter has been written to Medical Council of India (MCI) for taking appropriate action against the hospital,” said Health Minister Anil Vij while talking to the mediapersons here on Wednesday.
He said, “In addition, Haryana Urban Development Authority will also be requested to explore the possibilities for cancellation of lease of land given to the hospital,”
The Minister said that the Fortis Hospital has not only violated the norms of IMA and MCI, but also ignored the protocol of medical treatment.
“In simple words, it is a murder and not a death… The girl died due to the negligence of the hospital authorities. In this direction, a letter has also been written to Medical Council of India (MCI) for taking appropriate action,” he added.
Vij said that the matter has been sent to legal remembrance (LR) for recommending the registration of FIR under appropriate sections.
Fortis Hospital had charged a Dwarka resident Jayant Singh nearly Rs 16 lakh for 15 days when they had admitted their daughter to the hospital for treatment of dengue. Adya was declared dead on September 15.
The issue had snowballed into a national debate on unethical practices followed by private hospitals and healthcare system of the country.
A committee constituted by Haryana Government under the chairmanship of Additional Director General, Dr Rajiv Wadhera to probe the matter, has found many irregularities in functioning of the hospital administration.
The parents of the girl have also registered their statements before the Committee.
The committee has alleged several irregularities, including refusal of appropriate ambulance service to the patient, not following leave against medical advice (LAMA) protocol, and overcharging.
The committee has also recommended review of NABM accreditation given to Fortis Hospital.
Sharing details of the report, Vij said, “Keeping in view of no improvement in health condition of the girl and overcharging of bill, the parents wanted to shift her to another hospital. Serious irregularities in this regard have come to the fore.”
The girl was on ventilator in the hospital, but she was provided with an ordinary ambulance while being shifted to another hospital. The ventilator system was withdrawn. This eventually led to the girl’s death, said he.
As per guidelines issued by IMA, advance life support ambulance should have been provided to the patient.
“The ambulance in which the girl was being transported had no such facilities. An Advanced Life Support (ALS) ambulance should have been used. But Basic Life Support (BLS) ambulance was provided which had no such facilities,” he added.
Giving more details, the Health Minister said that as per the report of the committee, the girl was admitted in Paediatrics ICU from August 31 to September 14. During this period, the hospital not only violated the diagnosis protocol, but also ignored the rules and regulations of Indian Medical Association (IMA).
On overcharging of bill, Vij said that the total bill was charged at profit margin of 108 per cent to Adya’s family by the Fortis hospital.
The committee has found out that the hospital administration deliberately used expensive medicines rather generic and affordable medicines in treatment of the girl by violating the IMA norms.
Apart from this, the hospital has carried out platelets transfusion for 25 times and bill has been overcharged in this practice.
Taking cognisance of the same, the orders have been issued to cancel the hospital’s blood bank license, said the Minister.
As per the rules, hospital also has to provide information related to dengue patient to the local civil hospital, but the Fortis Hospital has ignored this fact.
Pointing out another violation by Fortis, he said that land was given to Fortis hospital under certain terms and conditions on concessional rates, which included 20 per cent of free OPD, ten per cent free beds and other provisions, but prima facie these were violated.
are writing to HUDA in this regard because they have violated MoU agreements and if lease has to be cancelled, the HUDA committee will look into it,” said Vij.
The parents of the girl has also apprised the committee that hospital administration had forged their signature on the consent letter, he added.
The parents of the seven-year old girl, who died in September of Dengue Shock Syndrome (DSS), had alleged the Fortis Hospital for charging Rs 16 lakh for the 15-day treatment.
The hospital, however, had denied the allegations.
Observations in the report:Overcharging
The total bill was charged at profit margin of 108 per cent. It shows profit margin as low as 5 percent to as high as 173 per cent. All drugs and consumables used on Adya was purchased by the hospital at Rs 3,22,044 but the MRP paid by patient was Rs 6,70,126. Apart from this, the hospital overcharged for 8 units of platelets inspite of knowing the guidelines that they have to charge at Rs 400 per unit only. Out of 25 units of platelets given to Adya, 17 units of platelets were charged at Rs 400 per unit and 8 were charged at Rs 2,000 per unit resulting in Rs 12,800 of overcharging.
Consent forms—alleged forgery
The father of Adya alleged that Fortis had forged signatures on the consent form. On checking the documents, it was verified that inspite of all documents having original signatures of the patent on the last page of each form, in space of for initial of parents at the bottom of all preceding page, the hospital staff had filled in the name of the parent.
Report named senior doctors
On the day of LAMA (leave against medical advice), the father wanted to shift the patient to another hospital, he was not well informed about the advanced life support ambulance with ventilator support to transport the child. The committee has recommended the case to be sent to MCI for action under the professional conduct, etiquette and ethics, regulations 2012. All senior doctors treating the case in PICU should be held accountable, stated the report naming these doctors.