Decision on Delhi’s Max Hospital is sentiment over science, anti-doctor, say specialists

At the hospital after the decision was announced. (Express photo by Amit Mehra)

The Delhi government’s decision to cancel the registration of Max Hospital, Shalimar Bagh, was met with shock by healthcare specialists, who raised doubts over the assertion that the death of a 22-week-old premature baby was the result of “gross medical negligence”. They also said that the Delhi government’s action amounted to “destroying the empirical medical protocols”.

India’s top gynecologist and head of obstetrics and gynecology at AIIMS, Dr Alka Kriplani, told The Indian Express that according to the current protocol, a 22-week foetus which weighs less than 500 grams can “only be termed as an abortus, and there is no requirement to resuscitate because the chances of survival are negligible”.

“With time, the protocol keeps changing. Initially, it was considered that at 28 weeks, we could save a child. However, when in America, there were cases where a baby could be saved at 22 weeks and if it weighed over 500 grams, we had to change the definition. But in a majority of cases, even at AIIMS, a 26-week foetus is the earliest we could save till date. Even if the abortus is put on ventilator, only the cost will run into lakhs, but the 22-week premature baby cannot be saved. This can only be termed as an abortus and there is no requirement to resuscitate because the chances of survival are negligible” Dr Kriplani said.

Read | Delhi govt cancels Max licence after it declared newborn survivor dead

On Friday, Chief Minister Arvind Kejriwal said, “We do not want to interfere in the functioning of private hospitals. However, we won’t tolerate open loot and criminal negligence.”

Dr Kriplani, however, said, “We are just destroying the empirical medical protocols. We are heading towards a place, where we do not prefer science but go for sentiment. The decision is only a populist one. The decision is anti-doctor. And the society will suffer at large.”

Asked about expert committee findings, which state that the hospital staff missed “signs of life” in the newborn while handing him over to the parents, Dr Kriplani said that “suspended animation”, which shows signs of life in premature babies, has been reported in the past as well. “However, never can a 22-week abortus with this weight be saved,” Dr Kriplani said. “

Indian Medical Association president K K Aggarwal said, “The step taken is harsh. Action should be initiated against those who are at fault after proper inquiry by the Delhi Medical Council. We are not backing the mistake committed by Max super specialty hospital. But mistakes have occurred in government hospitals. If government starts cancelling the licences of hospitals in such a manner, then all healthcare facilities will have to be shut down.”

Also Read | Newborn at centre of Max row dead, parents refuse to collect his body

Dr Vijay Kumar Malhotra, president of the Delhi Medical Association, said “there is no set protocol and guidelines for such extremely pre-term deliveries”.

“Indian law permits medical termination of pregnancy up to 20 weeks and, in extreme cases, court has permitted 24 weeks of pregnancy. It means Indian law considers a foetus up to 24 weeks as non-survivable and non-viable… Many a times, due to hypothermia, the heartbeat in such cases may be absent and reverts time to time. Such rare cases have occurred in the past across many parts of the world, including a recent one in Safdarjung Hospital,” Dr Malhotra said.