The Hindustan Times and the Hospitals in Delhi

The whole of the last week The Hindustan Times carried a series of stories highlighting incidents of 'negligence' in high profile private hospitals in Delhi. The hospitals featured included Fortis Escorts Hospital, Max Hospitals, Apollo Hospital, Sir Gangaram Hospital and Rajiv Gandhi Cancer Hospital. Now these hospitals in Delhi are the best that we have. While, Hindustan Times has a right to expose cases of negligence in hospitals I am still not sure what purpose was served by these reports.

Here are a couple of points I would like to make about these 'exposes'.

The cases reported highlighted horrific experiences consumers had in these hospitals. Most people featured in the story lost a loved one because the hospital failed to deliver adequate care and refused to take responsibility for what went wrong. These I am afraid were random cases picked up by intrepid journalists and made for riveting reading. However, the journalists doing these stories did not investigate the reason for these failures. The question why did these hospitals fail in their duty towards their patients remains unanswered. Was the failure a result of a doctor not discharging his duties properly, or was it a failure of the hospitals processes or both? Or was it negligence or an error of judgement on the part of a doctor? Did he deliberately mistreat a patient, was callous in discharging his duties, wilfully deviated from standard medical practices or just did not care enough?

The reports also did not establish a trend. By picking up five hospitals in the city and highlighting these horrific cases, I am not too sure the point that the newspaper has made. Are all these hospitals equally bad? Do we run a huge risk to life and limb if we trust these hospitals with our care? The stories were short on data. For example the story featuring the eminent cardiologist Dr. Ashok Seth, presently the Chairman of the cardiac program at Fortis did not establish how many times has he messed up an angioplasty. By highlighting a single botched up case amongst the thousands that Dr. Seth does every year, I believe the journalist has been less than fair to him. I would like to know Dr. Seth's success rate in deciding whether I trust him or not rather than go by a sensational story of an angioplasty and the subsequent care going haywire.

As consumers we must understand an ugly truth. There is no running away from the fact that cases of utter negligence and mind boggling errors are a part and parcel of life in a hospital. Even the best hospitals, will have some people who would take their work casually, be negligent in their duties and cause terrible suffering and yes loss of life because of their actions. At best a hospital can try to minimise these as best as it can. It can systematically identify such people and eliminate them, it can put in place systems and processes, which allow it to act before the damage is done. However, it is next to impossible to completely do away with error and negligence.

I just do not understand what point has been established by The Hindustan Times in doing these stories. Yes, it establishes the fact that some of our best hospitals in Delhi have been at times negligent in the discharge of their duties causing untold suffering to people, who trusted these hospitals.

But isn't it something that all of us know and isn't that true of all the hospitals in the world?

Wouldn't it make more sense if the newspaper clearly established a trend of deficient care  in one or all of these hospitals over a period of time and compare the hospital's record with that of other similar hospitals across the world. It would than stand to reason for citizens to avoid the hospital and for the management of the hospital to fix its people and systems.

Akkriti Bhatia and healthcare services in our schools

Here is the tragic case of Akkriti Bhatia, a 17 year old school girl, who died yesterday after collapsing in her school. The Hindustan Times reports that Akkriti complained of breathlessness to her classmates, who then called her mother to send a car to fetch her. Apparently when the car arrived, Akkriti requested her teacher’s permission to go home. The teacher realising that she was seriously ill sent her off to the nearby Holy Angels Hospital, where she was declared ‘brought dead’. Akkriti, it seems died on her way to the hospital.

This is a tragedy that could have been easily averted. Akkriti was an asthamatic child. This was known to the school authorities. Yet it seems there was no one in the school, who had the sense to realise that the girl was in acute respiratory distress and someone needed to call an ambulance. Apparently the school by way of medical support had a medical room and a nurse, and the young girl was administered oxygen in the medical room. Curiously enough when her mother’s car came to pick her up, she was taken off the oxygen cylinder and was sent to the hospital gasping for breath accompanied by the school nurse and another student!

How is it that no one realised how ill Akkriti really was? Why did no one summon an ambulance and trained paramedics? Why was she sent in a car, without oxygen to the hospital? Who should be held accountable for these lapses? Are our children safe in schools?

I believe that the school was just not equipped to take care of an emergency. There was no one including the nurse, who understood the gravity of the problem. I also suspect seeing the child’s condition deteriorating, the school authorities paniced and failed to act rationally. There was neither a person nor any system to deal with a situation like this and in the ensuing confusion, a patently wrong decision of not calling an ambulance and attempting to transfer Akkriti in her mother’s car without oxygen was taken, pretty much sealing her fate.

This is scary.

Particularly, when I know hospitals routinely approach schools requesting them to manage their medical rooms professionally with well trained staff (doctors and nurses), equipment and supplies and emergency hotlines being available all the time. While working for both Max Healthcare as well as Artemis Health Institute in Gurgaon I have myself in the past proposed such arrangements to various schools. I am afraid not a single school responded favourably. The school authorities usually fobbed us off by saying that they had a nurse and at times a doctor, who visited the school two hours a day and they believed that this was more than adequate for their needs. The hospital was always looked upon with suspicion of making money off the school. Many a times, I would request our paediatricians to accompany me to help convince the school head mistresses but all to no avail. They just could not look beyond their noses and my old fear of school authorities would make me beat a hasty retreat.

The blame for this tragedy must lie squarely with the school authorities. A child, while in school is their responsibility. In an emergency they must have set protocols and trained personnel to handle the situation in an orderly and efficient manner. That a well known school like the Modern School, reacted in a manner that cost one of their student’s her life is not only tragic but downright shameful.