The Future Frankenstein's monsterThe Mahajan Maamla being unraveled in bits and parts in the last three days over all television channels is not only intriguing but is becoming more complex by the day. Leaving aside the thousand of questions that come up in this case like - Is Rahul a drug addict, was he poisoned, why Mahajan’s other secretary admitted himself in the hospital etc etc, the key question and a serious issue is that of how ethical are hospitals today? An Apollo hospital’s is a trusted name in the health industry. Though they have an image of being costlier than other medical institutions, yet over the years its also come to be recognized as an hospital which is value for money, considering its league of Dr.’s and that of it being state of the art technology. The hospital is known to send its Dr.’s on international seminars and sessions to keep its Dr.’s abreast of the latest in medical science. Now if that is an image created only by its PR agency or if there are shades of truth in the media reports, can be argued. However Apollo hospitals has also always been in the midst of various controversies. The Mahajan Maamla seems to be just one more case that Apollo with its clout will again come over. But these indications do not ordain good for the common man. For many people in this country, who use their hard earned earnings to receive treatment at hospitals like Apollo, Escorts and the newly come up Max and Fortis, if these hospitals show lackadaisical attitude to patient care, and further demonstrate a lack of ethics then it’s a danger signal. Very obviously Apollo made a cover up for whom ? still remains a mystery, but that it was a cover up is beyond doubt. Goaded by someone ? Apollo showed over zealousness in calling a press conference to announce that neither poison nor any drug traces were found in the toxicology test of Rahul Mahajan. The immediate question that came to mind was that all the three boys and Sahil’s statement to police as to the flow of events of the night were all concocted – a cock and bull story. That one was a little too much to believe. But the next day was even better – As per AIIMS report Moitra’s body had traces of Thallium as well as Cocaine. Further the report from CFSL confirmed the AIIMS reports. But this did not seem to faze Apollo, who gave a statement announcing their adherence to their report. By this time Apollo had become the Big Joker and the laughing stock of the country. A lot of angry Indians were also voicing their indignation as to Apollo’s sell off for Money or under political pressure, resulting finally in Apollo taking a step back since their morning statement of adherence and suddenly hold another press conference and hand over the toxicology test reports both done by Apollo internally and also sent by Apollo to lal path labs. It was as if midway through the afternoon, Some senior Apollo Dr. Saw the mistake overlooked by some junior doc, and discovered that there was after all traces of drugs in Rahul’s body, and so the press conference. Beyond any doubt, here was Apollo – a medical institution, which is looked upon by millions, as messiah and life giver’s playing dirty. Weren’t Dr.’s supposed to be more ethical. Or has Apollo forgotten the Hippocratic Oath ? ? Now will we have hospitals also, which decide the results keeping in mind only the colour of money? So will even hospitals create different kind of treatments (even when it is paid for) depending upon your family background its money power and political clout ? This augurs a serious thought. The country very soon is going to have private health facilities outdoing all govt medical infrastructures. But are we expecting such facilities. Do we need new protective laws regulating hospitals like Apollo and laws that protect the interest of the patient more then anything else ? ? At the end hospitals are the thin line between a patients Life & Death.
We invite your comments on this issue. Till collective participatory initiative does not come into force, we don’t have any chance of improving our life and society.
Warm Regards,
Please find below an insightful account of all major events wherein Apollo’s role, ethics and professionalism have been questioned. The article is dated July 2003. Decide for yourself -
For a country placed 127th on the Human Development Index, issues like genetically engineering out disabilities would be far-out concerns. Nor would the debate sparked off by the failed surgery on the Iranian twin sisters, Ladan and Laleh Bijani, become more than news items here. But medical negligence and medical malpractices should move a heartless republic, as they don't, although they infect the poor and disconnected as the rich and mighty equally. Medical scandals also don't get play, even though they destroy individuals and families as much as Sangha shenanigans and AIMPLB hard line damage society.
If reports are true, one Subhash D. from Chennai was mysteriously cremated in Delhi after donating a part of his liver to MP and actress Jayaprada's husband, Srikant Nahata. Nahata has recovered and is doing well, but the donor has died. Donor deaths are extremely rare in liver transplant surgeries. Apollo Hospital where the transplant occurred on 25 June admits that only six donors have died all over the world after such surgery. The hospital says Subhash was related to Nahata, thoroughly investigated for surgery, but died from "pulmonary embolism" when blood clot enters the lungs. No autopsy was conducted. Apollo says it had no permission, but independent specialists say the hospital could have conducted a post-mortem if it thought it necessary.
Like before, Apollo will get out of this one. Three years ago, the power minister, Rangarajan Kumaramangalam, died after prolonged treatment in Apollo and the All-India Institute of Medical Sciences (AIIMS). He was first thought to have died of leukaemia. Then the Indian Medical Association claimed death as a result of septicaemia or "overwhelming infection of the blood". The health minister at the time, C.P.Thakur, said the cause of death was a collapse of Kumaramangalam's circulatory system.
Thakur made the claim on the basis of an inquiry report. The report dilly-dallied on assigning blame, but admitted that the treating doctor in Apollo had not carried out all the necessary investigations, including a so-called bone-marrow aspiration. "…if the investigation had been carried out, it may have helped to arrive at a definite diagnosis," the report said. It blamed the physician for not telling Kumaramangalam that his blood counts "were a bit unusual and should definitely be repeated in two to three weeks time, after discharge". Nor, it says, was there "evidence of follow-up by his treating physician after the discharge from Apollo Hospital". Despite the bad publicity, Apollo shrugged off the charges.
Last month, M.Karunanidhi accused Apollo and AIIMS of negligence in Murasoli Maran's case. The case is the reverse of Kumaramangalam's one, in that Maran shifted from AIIMS to Apollo in Chennai after a new valve grew fungus. Apollo replaced the mistral valve in an eight-hour, high-risk surgery – but left Maran with paralysed kidneys.
Karunanidhi directly blames Apollo for this. In his letter to prime minister A.B.Vajpayee seeking an inquiry, the DMK chief says the Methodist Hospital in Houston found him overdosed. Excess medicines had been given to "paralyse" Maran at Apollo, Karunanidhi alleged, so he would not remove tubes attached to his body. "After all the medicines, the treatment and the exercises there, Mr Maran could not overcome the paralysis." AIIMS he blames for lack of sanitation which caused the fungal infection. AIIMS did not rebut, while Apollo went into an overdrive of defence. The death of Nahata's liver donor suggests that nothing has changed.
One could be tempted to compare AIIMS and Apollo, but it would be unfair, because AIIMS is a cash-strapped, overcrowded, overworked government referral hospital, while Apollo is five-star, corporate entity. Apollo has made bad news since at least the table-tennis star, Chandrashekhar, was paralysed after a minor operation. It has a reputation of empanelling doctors who can compensate it highest as consultants – but who may not necessarily be the best in the business. Because of its star clients and money power, it can shrug off malpractices – and even ride through the controversial death of a minister, and the near-death of another. By that token, the death of the donor, Subhash D., would not create a ripple. But this is where the death of the Iranian twins and Subhash D. are intimately linked.
Western medical ethicists allege that Singapore's Raffles Hospital undertook to separate the conjoined twins because it would advertise Singapore's modern new medical facilities. "There are," Reuters quoted a Sydney University bioethics professor, Dr Ian Kerridge, "troubling aspects about this case…And one of them was the statement by one of the surgeons that they found it was more difficult than they had expected. To me that sets off a little bit of an alarm bell."
India is also showcasing its private hospital facilities as comparable to the West but a lot cheaper. The British National Health Service may fly some of its patients to India. How would it look for India if a NHS patient dies abnormally doing surgery in Apollo? A whole tonne of bricks would fall to make the attacks on Raffles look like pea shots. Subhash D.'s death should provoke a full investigation into Apollo and other private hospitals – and it should not matter that Jayaprada is an MP of the Telugu Desam, which holds a whip hand on the Vajpayee government.
