No guidelines on glove and syringe usage: panel on Fortis

A 7-year-old girl had died on September 15, following which her family had raised allegations of overcharging by the hospital, which had billed them almost Rs 16 lakh. (Express Photo: Manoj Kumar)

On the allegation against Fortis Hospital, Gurgaon that the 750 pairs of gloves and 600 syringes used during a seven-year-old’s 15-day stay were more than what was required, an expert committee constituted by the Haryana government has said “there are no guidelines on how many consumables are to be used” every day in a paediatric ICU.

The girl had died on September 15, following which her family had raised allegations of overcharging by the hospital, which had billed them almost Rs 16 lakh.

However, the committee, headed by the Haryana health secretary, said there is a “need for regulatory authorities” at the national level to fix the “upper limit of cost of various medical procedures and investigations”.

“There are no guidelines on how many consumables are to be used for a PICU patient. However, general guidelines state that a liberal use of consumables — for example syringes, gloves, etc — must be made to decrease risk of hospital-acquired infections,” the paediatrics specialists opined in the report.

The report further states: “Hospital management looks to be attempting to get maximum profit out of drugs and consumables in the garb of MRP… In the absence of any comprehensive package, this billing pattern generates a very high cost, as is evident in this patient’s bills.”

On allegations of “exorbitant charges” on drugs and consumables, the report states that “all the drugs issued… were found charged as per maximum retail price printed theron. Further, no violation of drug price control order was observed.”

However, it was observed that the girl was issued Meropenem injection 1 gm of two different brands with different MRPs with a “huge gap in price”. “Similarly, it was observed that she was issued Human albumin of two different brands with different MRPs with a huge gap pricing,” the report states.

“Though MRPs of the above mentioned drugs are not notified by NPPA, but due to a huge gap between the MRPs of two brands of the same drugs, the basis of selection of the particular drug to be used is neither understandable nor a satisfactory explanation has been given in this regard by authorised signatory of the firm. However, the drug prescribed by the treating doctor is supplied to the patient,” the report states.

A Fortis Hospital spokesperson said, “The inquiry team observed that there are no guidelines on how many consumables are to be used per day in a PICU patient. General guidelines state that liberal use of consumables must be made to decrease the risk of hospital-acquired infections in these patients. The committee deputed a team from the Office of Civil Surgeon, Gurgaon to monitor the use of syringes and gloves in their physical presence for 24 hours on patients in ‘near similar’ setting in ICU as the seven-year-old. The team reiterated that there has been no injudicious use of these consumables in her case. Investigation by the inquiry team confirmed that all the drugs issued to treat her were found charged as per their MRP. It has been confirmed by the panel that no violation of drug price control order was observed.”

What the Haryana govt report says

* There is a violation of National Accreditation Board for Hospitals & Healthcare Providers guidelines for documentation
* No helper was provided by the outsourced ambulance services
* Patient was suffering from dengue shock syndrome, not mere dengue fever
* Unlikely that conducting an MRI earlier would have affected treatment
* No injudicious use of consumables