Show-cause notice to Fortis for over-charging patient in Gurugram

NPPA has asked for invoices, copies of bills of Rs 18 lakh for drugs administered

After the Union health ministry, the National Pharmaceutical Pricing Authority (NPPA) has stepped in to investigate Fortis Hospital on the huge bill given for the treatment of a young girl, who eventually died. 

In a show cause notice to the hospital, the NPPA has asked for invoices and copies of bills of the drugs it had administered. The notice also states that if the hospital fails to provide the pharma pricing regulator the needed detail, the records will be collected under para 30 of the Drug Price Control Order (DPCO). The provision allows a gazetted officer to exercise power of entry, search and seizure to ensure compliance with the DPCO.

The girl was admitted to Fortis Hospital in Gurugram. The institute has denied the charges, saying the patient’s family was informed about the bill on a daily basis and there was no medical negligence. Her death has reignited a debate on the quality of health care provided by private hospitals.

The girl was admitted on August 31 with severe dengue, which progressed to dengue shock syndrome. There was progressive fall in platelet count. As her condition deteriorated, she was put on ventilator, within 48 hours of admission. Her relatives asked the hospital to first take a CT or MRI scan; the hospital reportedly refused. The relatives claimed the child, who was admitted in the pediatric ICU, was given 660 injections over 15 days. The family was billed Rs 18 lakh.

The hospital had claimed that the family was kept informed of the critical condition, the poor prognosis in these situations and also given daily counsel on the child. On September 14, her family decided to take her away from the hospital against medical advice and she died the same day. The family claimed they were forced to sign the LAMA (leave against medical advice) form.

The Union health secretary has written to the Haryana government to investigate. Union health secretary Preeti Sudan had asked for an action report within two weeks. “In case any overcharging, negligence or malfeasance is made out on the part of the hospital, exemplary action needs to be taken immediately to reassure the general public and to lend credence to the health care system,” she had written in her letter. Union health minister J P Nadda also sought a “detailed report” from the hospital.