Citizens' Issues
Our Beef with the Doctors
When doctors are sued for malpractice
 
Doctors are, often, at the receiving end of malpractice suits, and with disastrous results. The matter was getting so out-of-hand that many countries, especially litigation-prone ones, decided to cap damages. Otherwise, insurance companies would either refuse, or hike, insurance premiums. 
 
Normally, a malpractice suit would have a procedural or diagnostic failure as the cause of action. Yet, one case centred on defamation by a doctor, coupled with malpractice. The complainant was fast asleep, under sedation. It also involved a third factor, admissibility of evidence when the recording is not authorised and unknown to the accused.
 
Dr Shah is a specialist. He was carrying out a procedure along with an anaesthesiologist, a doctor who administers and controls the sedation on the patient. The patient was a lawyer! It became a potent combination, as unfolding events will show.
 
It is common practice, in an operation theatre, for doctors to banter. It may be the stress or boredom. But they talk. And joke and, often, the jokes veer towards the anatomy, because that is what they have before them. And, as doctors, they have been sensitised to jibes involving body parts. During an operation to mend a broken leg, in 1976, this author was subjected to some such light-hearted stupidity. Not aware that the pethidine had worn off, someone joked about asking me, when I got up, about her future. She had misheard ‘psychic’ for ‘cyclist’. Next problem; the drill had been misplaced. It was found in the adjoining operation theatre. Someone joked, “They must be wanting to make another hole.” That patient was in for piles. 
 
Back to our lawyer, unconscious on the table. The reports say that he was not a brave sort and had asked myriad questions prior to the sedation. He was also worried about some rash on his genitals. Not wanting to miss out on the post-procedure instructions, he had switched on his mobile phone to record them. Someone had picked up his trousers, phone in pocket and still recording, and placed them under his table. Evidence that was admitted and proved inconvenient.
 
Haemorrhoids are growths. Most people have them. But, when one has inflamed, or ulcerated haemorrhoids, he is said to ‘suffer from them’, the term being used as a disease. Suffering from ‘haemorrhoids’. What our lawyer went through is both funny and sad since he was in for nothing, definitely not for ‘haemorrhoids’. 
 
The doctors started with ridiculing him for his anxiety. They referred to his body parts, the private ones, and suggested that he may have sexually transmitted diseases. All this was small talk to keep the atmosphere alive, as it were. After all, the jokes were on the patient who was in deep sleep! Nary a word would reach his ears. Or so the doctors thought.
 
Next came the haemorrhoids. None was perceived as diseased. So, the doctors decided to ‘doctor’ the report. From jokes, it went to cheating—a crime.
 
On his way home, the patient switched on the phone and was subjected to his recorded ridiculing. The forged report was discussed while he lay comatose. He did what lawyers do. He sued. The asking sum was a cool US$1.7 million. Now you be the judge.
 
He got US$500,000. Not bad for an afternoon’s visit to a clinic. The doctors have since been shooed away. The clinic has expressed its regrets. This happens in India, too. An advocate friend complained to his client, a doctor, about stomach pains. The doctor quoted a fee. Our friend said he could not afford it. They settled for a lower amount, the maximum mediclaim allowed. Procedures were performed. Tablets were administered. The pain subsided. The lawyer had an uncle, a septuagenarian, who was a general medical practitioner, in the old mould, and he asked to see the reports. He asked one question: “Where is it indicated that you had stones?” What a few analgesic pills would have cured had cost many thousands of rupees… finally paid by all of us as higher premium. Where, and when, will it all stop?
 

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COMMENTS

Meenal Mamdani

1 year ago

Two types of malpractice are described in this article. The first kind where medical staff talk about the patient imagining him unconscious and then have to pay a hefty sum for causing mental anguish. In USA damages are awarded for non-quantifiable losses like pain and suffering while in most other countries damages are based on actual loss to the patient like say loss of use of an arm or a leg.
The second incident quoted is fraud, where a doctor treats deliberately for a nonexistent problem. This kind would be criminal offense, not just civil one.
As to author's last comment, where will it end, I guess that depends on the maturity of the insurance marketplace. There is no reason why a doctor should charge a patient 3 or 4 times as much as soon as he finds out that the patient has insurance. This should be investigated and the insurance company should beat down the doctor's charges or else patient told to go to another doctor whose charges are more reasonable.
Unless patients revolt, doctors will continue to charge higher fees to those who have insurance and insurance companies too lazy to haggle with the doctor, will pass the charges on to customers as higher premiums.
The bottom line is patients must stop treating doctors like gods, read up on their conditions on the Internet, ask pertinent questions and get a second opinion wherever feasible. I am a physician and I would much rather deal with a well informed patient than one who has "faith" and has unrealistic expectations.

Nifty, Sensex may rally - Wednesday closing report
If Nifty holds Wednesday’s lows, it may rally till 7,970
 
We had mentioned in Tuesday’s closing report that NSE’s CNX Nifty and S&P BSE Sensex may head higher however, there could be plenty of intraday volatility. On Wednesday, benchmarks in the Indian stock market were unable to sustain Tuesday’s recovery after the crash on Monday. The market fell again on Wednesday by over 1% and the bulls have beaten a retreat. 
 
 
Weakness in the Chinese market, despite an interest rate cut, weakness in the US markets on Tuesday and the upcoming derivatives expiry led to the 30-stock Sensex, shedding 318 points on Wednesday. Sensex opened at 26,063.27 points, closed at 25,714.66 points -- down 1.22% from its previous close at 26,032.38 points. The Sensex touched a high of 26,156.61 points and a low of 25,657.56 points during intra-day trade. The broader 50-scrip Nifty too closed lower at 7,791.85 points, with losses of 88.85 points, or 1.13%. 
 
What worried the market participants is the China’s interest rate cut administered by the People's Bank of China (PBOC) inter-policy decision on Tuesday. The move looked desperate. It might have propped-up the currency markets a bit, but its impact on yuan and thereafter the Indian rupee can be counter-productive.
 
The yuan has fallen by 4.6% till now since 11th August. 
 
The rate easing in China coupled-with a stalled domestic reforms process has greatly damaged the investors’ morale in the Indian markets.
 
Sector-wise, out of the 12 BSE sub-indices, only power and metal managed to remain in the green. 
 
The S&P BSE banking index plunged by 331.35 points, the healthcare index plummet by 198.20 points, capital goods index receded by 147.88 points, the automobile index declined by 124.04 points and the information technology (IT) index fell by 105.14 points.
 
On the other hand, the S&P BSE power index gained by 29.54 points and metal index was up 16.37 points.
 
Major Sensex gainers in Wednesday's trade were: BHEL, up 3.45% at Rs.240.20; Tata Motors, up 2.31% at Rs.336.80; Bajaj Auto, up 1.79% at Rs.2,244.15; Wipro, up 1.46% at Rs.549.75; and Coal India, up 1.22% at Rs.358.20.
 
The major Sensex losers were: HDFC, down 3.77% at Rs.1,102.45; Hero MotoCorp, down 3.45% at Rs.2,391.95; Mahindra and Mahindra, down 3.07% at Rs.1,215.30; State Bank of India (SBI), down 3% at Rs.245.80; and Bharti Airtel, down 2.57% at Rs.339.75.
 
The top gainers and top losers in the major indices are given in the table below:
 
 
Among the Asian markets, Japan's Nikkei gained by 3.20%. However, China's Shanghai Composite Index lost 1.30% and Hong Kong's Hang Seng dropped by 1.52%.
 
The closing values of the major Asian indices are given below:
 
 
European markets opened sharply lower but have managed to recover all their losses. 

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Beware! Incense smoke may be as bad as cigarette smoke
Burning incense at home may put your health at great risk including cancer as the pleasant smell from incense smoke contains certain particles that are more toxic than those found in cigarettes, warns a new study.
 
Incense burning is a traditional and common practice in many families and in most temples in India and other parts of Asia. 
 
It is not only used for religious purposes, but also because of its pleasant smell. During the burning process, particle matter is released into the air. 
 
"Clearly, there needs to be greater awareness and management of the health risks associated with burning incense in indoor environments," said lead researcher Rong Zhou from South China University of Technology in Guangzhou.
 
The researchers assessed the health hazards associated with using incense smoke in the home and compared the results for the first time with mainstream studies of cigarette smoke. 
 
They tested incense scented with agarwood and sandalwood, which are among the most common ingredients used to make this product. 
 
Tests on animals showed that incense smoke contains chemical properties that could potentially change genetic material such as DNA, and therefore cause mutations. 
 
It was also more cytotoxic and genotoxic than the cigarette used in the study. 
 
This means that incense smoke is potentially more toxic to a cell, and especially to its genetic contents, the researchers noted.
 
Mutagenics, genotoxins and cytotoxins have all been linked to the development of cancers.
 
Taken together, the incense smoke samples contained 64 compounds. While some of these are irritants or are only slightly harmful (hypotoxic), ingredients in two of the samples are known to be highly toxic.
 
The study was published in Springer's journal Environmental Chemistry Letters.

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