Medical malpractices: A student’s struggle exposes sickness of system

ISLAMABAD: In April 2018, he went to an elite hospital of the federal capital for taking second opinion on his low platelets count. The hospital admitted him instead. By the time of discharge, he was sicker than before. A non-qualified physician treated him there; he was charged for medicines and lab tests over and above the market price.

When decided to sue the hospital for malpractices,he found another rude shock awaiting: the system was sicker than him. It was unable to offer any help. A journalism student, Wajahat Ahmed Ghous, knocked at every door to get justice for himself and for the other affected patients who have resigned to their fate. He approached the Islamabad administration, adjudicators, regulators as well as concerned ministries but in vain. None said his case is invalid but none helped either.

Wajahat, 22, was suffering from low platelets. A physician he went for consultation prescribed medicine hoping he would recover through medication but advised him to get second opinion. A resident of Sector F-10, Wajahat went to an elite hospital located nearby and asked for medical specialist. He was referred to one doctor whose nameplate carried his qualification: MBBS, FCPS, FCCM, MCCM. (It later turned out he was only MBBS.) The doctor advised his admission in emergency. The patient was informed that he was in immediate need of transfusion of platelets as he had 11,000 platelets at that time, a condition that may lead to internal bleeding, unconsciousness and even death. Initially, he was told that the hospital would arrange platelets but after admission, the patient was asked to arrange on their own. Meanwhile, the doctor disappeared from hospital only to return after 24 hours.

Wajahat was then at the mercy of medical staff on duty who, on the doctor’s advice, had his lab test unrelated to the problem like of malaria, typhoid, c-reactive protein and brucella antibodies. He was administered the medicines which are not done in this situation. Not only he was medicated beyond prescribed limit, they were same medicines of different brands. He was given four doses of same medicine of two different brands of Ceftriaxone each; another same medicine of two different brands of Amikacin and three different antibiotics. Other than overcharging for the medicine, lab tests were also extra-charged as the patient came to know about this after checking prices at medical stores and labs. A blood count test, for example, charged at Excel Lab in Rs750 was done at the hospital in Rs1,400.

His diagnosis was written on unsigned letter pad of the doctor; all this exercise was carried out in the doctor’s absence which is violation of basic SOPs and code of ethics of Pakistan Medical and Dental Council’s Code of Ethics. At the end, he was also prescribed Revolade; its four tablets at the hospital’s store would cost Rs1.5 lac.

After getting discharged unrecovered, Wajahat sought treatment from another place and his crisis resolved.. Later, he decided to challenge the overpricing of medicines and treatment at the hand of unqualified doctors at a hospital frequented by the elite of Islamabad. He approached the chief commissioner of that time. Initially, he promised to help but later reprimanded for being too rigid in the follow-up. “If you can’t afford treatment at expensive hospital, go to a government hospital,” he said though the case was related to over-pricing and bad treatment. What he said in the next line revealed the reason behind his inaction: “I myself go for treatment there,” the chief commissioner said with reference to that hospital.

At the same time, Wajahat had submitted application to District Health Officer (DHO) narrating his personal experience backed with evidence and demanded action against the doctor and the hospital for overpricing, negligence and fake qualification. Initially, he didn’t respond. When pressed through other forums, the DHO submitted the following response that the (1) medical malpractices and fake qualifications don’t come under his domain and for overpricing, the complainant must seek relief from the consumer court. (According to rules, the DHO is authorised to act against overpricing.)

Then Wajahat opted for litigation. He went to the consumer court; his case was then moved to district court. In the meanwhile, he sought help from Member Inspection Team of Islamabad High Court. While his case remained shuttling from one forum to another, the lawyers engaged by the accused hospital would harass him and the hospital administration approached him for out-of-court compensation that he refused to accept.

He then wrote to the Ministry of Health. While the doctor’s fake qualification case was referred to the PMDC, the ministry remained non-committal on the issue of over-pricing. Disappointed, Wajahat, decided to file a separate complaint to the PMDC which initially didn’t take any action. He then went to Federal Ombudsman for seeking directions for the PMDC of early disposal. The ombudsman ordered the PMDC to dispose of the case within 10 working days. It was August 2018. Since the ombudsman doesn’t have any judicial authority to proceed against the non-compliance, the matter remained pending with the PMDC until May this year.

After hearing both sides, the PMDC though admitted Wajahat’s point that the doctor who treated him at the hospital was simply an MBBS and the remaining qualification he had claimed was fake. Such an offence could lead to 10-year imprisonment but that was not awarded to the doctor who had now fled abroad.

The PMDC, however, sought an explanation from the hospital for having unqualified doctors whereas the issue of overpricing, it says, is beyond the PMDC’s jurisdiction. To-date, the hospital has not submitted any reply. When Wajahat inquired as to why the regulator, the PMDC, can’t press on for the reply, a PMDC official told him: “We can only ask them to submit; nothing beyond it.”