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Following the death of his daughter due to medical negligence in Delhi’s posh Max Hospital, the aggrieved father invoked 50 RTI applications in various departments to seek justice. Last week’s order by CIC Shailesh Gandhi provides some hope
Death due to medical negligence is common in our country but what is equally common is that doctors responsible for it are often shielded.
Delhi based SP Manchanda, an aggrieved father whose 30-year old daughter Nikita died two days after delivering a baby boy on 3 May 2009, has filed more than 50 RTI (Right to Information) applications in the health department, with police authorities, the Delhi Medical Council and the Medical Council of India (MCI) to strengthen his case of medical negligence that killed his daughter, and hoping for speedy justice.
His RTI application to the MCI revealed that the Ethics Committee in a meeting on June 2010 had found sufficient evidence to prove that four doctors of Max Hospital were proved guilty of medical negligence and the "quantum of punishment" would be decided in the next meeting. However, almost two years have passed, but there has been no word on whether any punishment was accorded to the four doctors even after Mr Manchanda invoked the RTI again. Mr Manchanda was thus forced to file a second appeal to the Central Information Commission (CIC).
On 9 May 2012, Central Information Commissioner Shailesh Gandhi ordered the Public Information Officer of the MCI to provide information on the quantum of punishment awarded to the four doctors of Max Hospital, Prithampura, Delhi and to put it up on the website.
Following are the sequence of events:
3 May 2009: Dr Nikita Manchanda gave birth to a bony baby boy through C-Section at the Max Hospital, Prithampura in Delhi.
She was perfectly fine until the evening of 4th May. She complained of severe abdominal pain from 7pm onwards, which was unbearable. She also vomited persistently. In desperation, she made a call from her mobile at 11pm to Dr Alka Gupta, her gynecologist who did not answer her call. Between these hours, she was given a series of pain-killers by the resident doctor after Dr Gupta prescribed this over the telephone and by the anesthetist who also telephonically recommended pain-killers. The doctors did not think it fit to examine her physically despite her pain which was aggravating.
After writhing in pain throughout the night, at 7.30am the next day, Dr Gupta realized that the patient had to be rushed to the Intensive Care Unit (ICU). Since Max Hospital has only two small lifts for a 10-floor hospital, it took one hour to rush Nikita to the ICU, located on an upper floor. Despite it being a full-fledged hospital, there is no blood bank and no proper co-ordination with other blood banks. It took the family a good two hours to arrange for blood by which time her battle for life was almost over. She was declared dead at 12.3 pm on 5th May.
7 June 2010 -A RTI reply to Mr Manchanda revealed that the Ethics Committee held the four doctors of Max Hospital guilty and recommended punishment: While the Delhi Medical Council gave a clean chit to all the doctors involved in treating Nikita stating there was no medical negligence, the Ethics Committee gave the following verdict: "…there is medical negligence since in a patient who has undergone Cesarean Section nearly 39 hours ago and has started complaining of severe pain in the abdomen and repetitive vomiting, no investigations including abdominal ultrasound were done and precious time was lost. In the morning when the patient went into irreversible shock, the team was energised to initiate the work-up but by that time the patient suffered a cardiac arrest and in spite of resuscitative measures, she died nearly 12 hours of the start of symptoms.
"`It is opined that the treating team was negligent in not picking up the gravity of the situation, did not act in a scientific manner of looking at alternatives but continued to attempt symptomatic relief hence the contention of the appellant is upheld and order of Delhi Medical Council is set aside.
"Dr Alka Gupta and Dr Pooja Bhatia were the immediate treating doctors and hence are held guilty of negligence in patient care… Dr Vikas Mangla advised medications without examining the patient, hence is guilty of his conduct… Dr Rajeev Kapoor was negligent in providing the wrong information. The quantum of punishment will be decided in the next meeting." What's being kept a secret is the 'quantum' of punishment and the suspicion that the four doctors continue to practice.
Mr Manchanda's use of RTI: "When Delhi Medical Council gave a clean chit to the doctors of Max Hospital in June 2010, I filed an appeal with Medical Council of India in August 2010. After several hearings, I procured the copies of minutes of meetings of March 2011. The Ethics Committee confirmed that doctors are guilty and extent of punishment was to be decided in the next meeting. Since then, the Medical Council of India has been postponing the judgment. To know the truth behind delay in awarding punishment, I again used RTI and went to Central Information Commission in second appeal. CIC has finally directed MCI to provide information to me in addition to compensation for the hardship. CIC also directed MCI to display names of doctors found guilty since Jan 2011 and quantum of punishment awarded on its website."
CIC Shailesh Gandhi's order: As per Mr Manchanda's request in the appeal to the PIO of Medical Council of India to disclose all correspondence/emails of the Medical Council of India had between Max Hospital and its doctors, the Ethics Committee and its members, Board of Governors of MCI and any other organisation/individual after 8 March 2011, including file notings. He also asked the MCI to compensate the appellant Rs3,000 as per the provisions of Section 19(8)(b) of the RTI Act for the loss and detriment suffered by him in pursing the appeal and getting the information late…
Mr Gandhi noted in the order that: "The complete collapse of mechanisms to punish people who have been found guilty is extremely damaging for society and denies victims a sense of justice being done."
Mr Gandhi further noted, "Harassment of a common man by public authorities is socially abhorring and legally impermissible. It may harm him personally but the injury to society is far more grievous. Nothing is more damaging than the feeling of helplessness. An ordinary citizen instead of complaining and fighting succumbs to the pressure of undesirable functioning in offices instead of standing against it. Therefore the award of compensation for harassment by public authorities not only compensates the individual, satisfies him personally but helps in curing social evil," the CIC said.
Information sought by Mr Manchanda from the PIO and subsequently in the second appeal to CIC:
1 What punishment was ordered against each of the four doctors?
2 When was the punishment ordered?
3 If the punishment has not been yet ordered, the reason thereof
4 Please let me know the present status in this case
5 Please inform me all correspondence/emails that the MCI had between Max Hospital and its doctors, Ethics Committee and its members, Board of Governors of the MCI and any other organization/individual in this regard after 8 March 2011. Please also provide file notings.
Reply by Davinder Kumar, Public Information Officer and joint secretary;
The appellant has sought information about four doctors who have been found guilty of medical negligence/misconduct by the Ethics Committee of MCI in a meeting held on 8 March 2011. The appellant has been informed about this in RTI by MCI. In the present case he had sought information about the punishment in this matter. According to the Ethics Committee meeting held on 8 March 2011, the quantum of punishment was to be decided in the next meeting. Thus, over 12 or 13 meetings have been held and the matter of punishment is claimed to have been still under consideration. Since the Ethics Committee is delaying giving the punishment, contrary to its own decision, information regarding the first four queries cannot be given.
However, the CIC stated that the PIO has given no explanation for denying information on query-5 which amounted to refusal of information.
(Vinita Deshmukh is the editor of Life 365 (www.life365.in). She is also the consulting editor of Moneylife, an RTI activist and convener of the Pune Metro Jagruti Abhiyaan. She is the recipient of prestigious awards like the Statesman Award for Rural Reporting which she won twice in 1998 and 2005 and the Chameli Devi Jain award for outstanding media person for her investigation series on Dow Chemicals. She co-authored the book "To The Last Bullet - The Inspiring Story of a Braveheart - Ashok Kamte" with Vinita Kamte. She can be reached at email@example.com)
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