Medical negligence at its heights: Hospital throws patient into coma, serves Rs 3 crore bill

By Syed Akbar
Hyderabad: “The dedicated team of doctors, nurses and philanthropists serve people with uncompromising dedication. It seeks to build a bridge between needy patients and the fast moving medical technology of the third millennium. In a country where thousands die each day due to their inability to access an expensive health care system, (we seek) to advance the frontiers of specialised medical care…” boasts the Mumbai-based Lilavati Hospital in its introduction to prospective patients.
Going by the hospital’s tall promise of philanthropy, how much do you think the authorities would charge from a patient, who slipped into coma due to negligence of its medical staff? Rs 10 lakh, Rs 50 lakh or Rs 1 crore? Hold your breath, Lilavati believes Rs 3 crore is not a huge bill to be served on the family of the coma patient, who has been undergoing treatment for the last two years for no fault of hers.
The hospital has slapped a bill for Rs 3 crore on the family of Nazma Alam Khan of Hyderabad. Nazma slipped into coma minutes after she was administered anaesthesia for hysterectomy at Lilavati hospital in September 2008. Ever since she has been in what doctors call vegetative state. It was a clear cut case of medical negligence but the hospital has been issuing bills at frequent intervals much to the chagrin of her family. 
The last time the hospital served a bill was for Rs 1.5 crore. The latest bill is reportedly for Rs 3 crore. Nazma’s family including son and daughter have been put to a lot of mental agony in the last two years and the now the bill for Rs 3 crore has only further compounded their suffering.
Nazma’s family members are not willing to talk about the case. But it is learnt that they are fighting a legal battle against the hospital authorities for medical negligence. Thanks to the legal battle, the hospital has been providing treatment to the patient, though it has been serving exorbitant bills occasionally. The family has reportedly refused to pay the bill as the hospital is at fault.
Efforts by this correspondent to contact the authorities at Lilavati hospital failed. The telephone operator, after keeping on hold for 10 minutes, said the superintendent was busy and could not be contacted.
Nazma Alam Khan’s unfortunate episode has triggered medical debate not only on the need for safe anaesthesia practices but also the need for strong legislation on medical ethics and patient’s rights. Strangely enough the government has double yardsticks for hospitals run by it and by private individuals or corporate bodies. One can bring pressure on the government and seek disciplinary and penal action against doctors and other medical staff involved in medical negligence, besides seeking monetary compensation, if something goes 
wrong in government hospitals. But in the case of private hospitals, one has to go through the long process of fighting it out legally in a consumer court. Unless medical negligence is proved by the complainant, consumer courts cannot deliver justice to the victim.
“This is a complete case of medical negligence on the part of the treating doctors, especially the anaesthesia team of the hospital,” argues Dr Ramesh Reddy, chairman of Andhra Pradesh Medical Council. The Council is empowered to derecognise doctors under its jurisdiction in cases of proved medical negligence.
Stating that a healthy woman goes for a routine hysterectomy and slips into coma after anaesthesia, Dr Ramesh Reddy said had she developed post operative complications and been a diabetic, things would be different.
“The hospital authorities have absolutely no right to charge Rs 3 crore as medical bill. Her family can either approach consumer forum and file a petition, or approach Maharashtra Medical Council and based on prima facie negligence on part of the treating doctors, a petition can be filed for violation of code of medical ethics. Post enquiry by a team of experts from the MC, if negligence is proved, a criminal case can be filed 
under Section 304 of the IPC,” he adds.
The Indian Medical Association too found fault with Lilavati hospital for charging exorbitant fee. Says Dr E Sai Prasad, honorary secretary-general, Indian Medical Association, AP chapter, on humanitarian grounds in such cases, hospital should not have charged such an exorbitant amount.
“There is no justification in keeping a family in mental agony for such a long time and give them daily hope when there has been no improvement in the condition of the woman. Instead of the hospital, the patient could be shifted to home and kept under the care of nurses,” Dr Prasad observes.
The Consumer Protection Act defines medical negligence as a failure to exercise reasonable skill and care in diagnosis and treatment as per the prevalent standards as that particular point of time.
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Rights of Patients
===============The World Health Organisation has recognized patient’s rights as part and parcel of human rights. Supreme Court has declared that medical treatment is a service and hence falls under the purview of the Consumer Protection Act, 1986. As consumers, patients or their relatives have every right to demand information from the doctor/hospital concerned.
1. Patient has the right to information. He must be told about all the facts regarding the illness, the procedure to be undertaken and the risk involved, if any
2. Patient has the right to access his or her medical records, investigative reports etc.
3. Patients enjoy the right to know about the doctor or doctors attending him or her, like doctor’s qualification, whether any case of medical negligence is pending, doctor’s expertise in the given field and the number of successful and failed cases. In USA hospitals make it a point to include medical negligence cases, if any, in the profile of their panel doctors.
4. Patients enjoy their right to confidentiality about their treatment and the medical problem.
5. Patients have right to compensation in case of medical negligence.
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What was the case
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Nazma Alam Khan was admitted to Lilavati Hospital for hysterectomy in September, 2008.
She slipped into coma after she was given anaesthesia. The doctor who gave her anaesthesia reportedly committed suicide two months later.
Nazma’s family filed complaint with the Mumbai police, following which the hospital reportedly agreed to provide free medical treatment till she recovers.
The hospital failed to keep up its promise of free treatment. Much to the shock of Nazma’s family, the hospital served a bill for Rs 1.5 crore within six months of the anaesthesia going wrong. The family decided to fight it out legally and contested the bill.
Last week the family got bill for Rs 3 crore.