Encouraging Carelesness: India does not have adequate regulations to guard against medical malpractices (Pic By Bivash Banerjee)

Bhuyan passed away on 6 October due to a medical error during a bypass surgery — an operation that today has a success rate of about 99 per cent. CII, which is providing support to Bhuyan’s wife, Ramola Bhuyan, has already initiated a post-mortem examination and could, depending on its results, take legal action against the hospital.

“Tissue samples have been sent to two institutions and we are still awaiting the results,” says Ramola, a financial management consultant with World Bank. “The system is such in India that you cannot touch doctors. It is high time doctors be made responsible for their mistakes. And when something like this happens, the punishment should be exemplary.” The incident reflects the poor state of India’s private healthcare sector and the lack of transparency at hospitals (see ‘Who Cares...’, BW, 20 October 2008).

While Max Hospital has admitted that “some error” was committed, what exactly happened during the operation still remains unclear. “The internal investigation is almost complete and we will share the results with the family in a couple of days,” insists Dr Pervez Ali Ahmed, the hospital’s executive medical director.

Bhuyan, 58, was admitted after a minor heart attack at the Max hospital on 29 September morning. While he recovered quickly, tests showed extensive blockage in three arteries and Bhuyan was advised to go for a bypass surgery. The following Saturday Bhuyan was operated upon by Dr I.S. Virdi. In the evening, his family and friends were informed that the operation had gone well.
“The doctor informed us that the liver and kidney were functioning well and that when sedatives wear off, we will know whether the brain was functioning properly,” says Ramola. While Dr Ahmed admits that the family was not immediately informed that a mistake had been committed during the operation, “we shared some concern about the brain”, he says.

It is only the following morning that Dr Virdi informed that her husband’s brain had suffered extensive damage. “Dr Virdi told me that during the operation he gave my husband a wrong tube that was later removed, but that oxygen was pumped in causing a massive insult to the brain,” explains Ramola. Dr Ahmed denies this version. “This is not correct; some event happened,” he says, but does not elaborate.

Dr Virdi performed an on-pump surgery wherein the surgeon sutures cannulae (small tubes) into the heart to take over the functions of the heart and lungs. Alternative methods of coronary artery bypass surgery have been developed such as off-pump surgery. At Wockhardt and Apollo Hospitals, 90 per cent of bypass surgeries are off-pump — as they are less invasive and the patient’s recovery is faster. When asked whether the family had been informed that an alternative to on-pump surgery existed, Dr Ahmed said: “I believe so. An informed consent detailing the procedure has to be signed before every operation.”

Bhuyan was pronounced dead the next day at 11.30 a.m. “I would like to put my faith in the system,” says Ramola. “One good thing is that the hospital did not deny guilt. But it is not enough.”

noemie(dot)bisserbe(at)abp(dot)in

(Businessworld issue 04-10 Nov 2008)