Fortis case: FIR to be lodged over lapses, says Vij

A panel probing allegations of overcharging against a Gurgaon hospital regarding a case in which a 7-year-old girl died of dengue has found "several irregularities" following which the Haryana government is planning to lodge an FIR, state health minister Anil Vij said today.
"In simple words, it was not a death, it was a murder," Vij alleged at crowded press conference in his office here.
There were many irregularities, unethical practices and the protocol for diagnosis and medical duties was not followed, Vij, flanked by the committee members, alleged.
The Haryana health department will file an FIR against the private hospital while the license of its blood bank will also be cancelled, he said. Its land lease may also be looked into, he added.

The hospital made a hefty profit on medicines given, which works out to 108 per cent and for some consumables it is as high as 1,737 per cent, he claimed adding that costly medicines were used when cheaper substitutes were available.
Overcharging in giving platelets has also been found, he said. Platelets were given on 25 occasions, out of which Rs 400 per unit was charged on 17 occasions while eight times Rs 2,000 per unit was charged, Vij claimed.

A costly injection was administered on most occasions, which cost Rs 3,112, whereas a substitute costing Rs 499 was available, Vij said citing the inquiry report.

"The death of the girl happened due to not following the LAMA protocol, which is the Leave Against Medical Advice. The girl was on a ventilator, but she was put in an ordinary ambulance, ventilator was withdrawn and an ambu bag was not provided in that, which became the cause of her death, which is a very serious irregularity," the minister said.
He said that the IMA protocol says that if a patient is discharged against medical advice, then proper arrangements should be made to transfer him or her to another hospital.
This can be done by the hospital or it can advise the kin of the patient to do so, but the ambulance in which she was taken did not have the required facilities, he alleged releasing the contents of the inquiry report.

She should have gone in an Advanced Life Support ambulance, but was provided a basic ambulance, Vij said.
"Negligence, lapse, unethical, unlawful acts on the part of the team of doctors of Fortis hospital were found when the patient was shifted from the ICU to the ambulance," he added.
The minister said that his department will be writing to the Medical Council of India (MCI) demanding action against the hospital.
"When a child was on advanced life support system for so many days and when it is suddenly withdrawn, the patient does not know, her parents are not aware of what could be the consequences. But being doctors, they should have known that it will be a sudden death," Vij said.

The committee, which submitted its report today, was set up by the Haryana government on November 21 under the chairmanship of Dr Rajiv Wadhera, Additional DG, Health, Haryana and also comprised of chief medical officer, Gurgaon. Besides, the help of two paediatric surgeons from PGIMS Rohtak and Medical College, Nuh, and district attorney, Gurgaon, as legal expert was also taken, Vij said.
The case relates to the death in September of a 7-year- old girl who was admitted with dengue to the Fortis Memorial Research Institute (FMRI), Gurgaon, a multi super-speciality care hospital. The Centre had asked the Haryana government to initiate an urgent inquiry into the case.

Earlier, the hospital had refuted the charges, claiming the patient's family was informed about the bill on a daily basis and that there was no medical negligence.
Replying to a question, Vij said that girl's parents also put their views before the committee. He said the girl was diagnosed with dengue and was first admitted to Delhi's Rockland hospital in Dwarka.
"Later on the patient was diagnosed as suffering from Dengue Shock Syndrome. She was admitted to Fortis, Gurgaon on August 31," he said.
Asked why the girl's parents wanted her to be discharged from Fortis, Vij said, "they wanted to take her back to Rockland, may be due to cost which they were incurring in Fortis."

Asked about the sections under which an FIR would be lodged, Vij said that legal opinion would be sought. But we have decided that we will lodge an FIR against this Fortis hospital for medical negligence, he added.
He said dengue was a notifiable disease, "but it was not notified by the FMRI to the local authorities, which is a lapse. Our CMO has given them notice for this. Concealment of this fact can invite punishment ranging from one month to six months and fine from Rs 200 to Rs 1,000", he said.
The minister said that land was given to Fortis hospital under certain terms and conditions, which included 20 per cent of free OPD, ten per cent free beds and 70 per cent discounted treatment to 20 per cent IPD (In Patient Department), but prima facie these were violated.

"We are writing to HUDA in this regard because they have violated MoU agreements and if lease has to be cancelled, the HUDA committee will look into it," he said.
The girl's family have also alleged that their signatures are forged in some consent forms, Vij further alleged.