Stent scandal

Some months after a massive scandal involving the use of substandard stents for heart patients undergoing angioplasty at both public and private-sector hospitals in Punjab, the Federal Health Ministry has issued a new set of guidelines aimed at tackling the problem. A key component of the guidelines is that cardiologists when performing surgery will video-tape the procedure and hand over one copy of the recording to the patient. Other copies will go to the path lab and to the Society of Interventional Cardiologists. The society is also to draft new regulations carding cardiac procedures particularly those using stents or balloons. The decision by the health ministry stems from the discovery by the FIA early this year that an entire mafia including doctors was involved in selling substandard stents to patients at exorbitant prices. Expired stents with a market price of around Rs6,000 were sold at rates closer to Rs200,000. According to the Drug Regulation Authority of Pakistan, 23 registered cardiac stents and 78 balloon catheters are available in the market. The federal ministry has now ordered that maximum retail price be printed on the label of the stent, publicised on the website of the manufacturer and a policy developed to maintain stable prices.

The horrifying scandal reveals a little more than just a question of how stents and possibly other devices are sold in the market place. The highly unethical activity of doctors at leading hospitals is disturbing and indicates a deeper malaise within our healthcare system. It is difficult to believe the practice could continue for so long and on so large a scale without the knowledge of senior doctors and supervisors. There have as yet been no names taken and no criminal action pursued. But the ripping off of desperate patients, some of whom were told they required intervention when this was not the case simply demonstrates the depths to which we have sunk in moral terms. If doctors are capable of such criminal practices what can be said about rest of society. It is also likely that other similar malpractices aimed at earning profit exist in other spheres of medicine. It is unlikely that cardiologists alone are involved in such businesses. The steps taken by the health ministry are in the right direction. We hope though that they will be implemented so we can protect patients who really have no choice but to follow the advice of medical specialists.