Every once in a while, a story comes along that reminds this Romantic Realist that journalism–and newspapers–can still be about comforting the afflicted and afflicting the comfortable. Here is one such story that ran on the front page of Mint on 12 November.
High-profile hospital death raises questions
By Shabana Hussain
New Delhi
A month after Jayant K. Bhuyan, a man widely credited with raising Brand India’s flag overseas, died suddenly following heart surgery, his wife is publicly pushing the hospital to take action against what she says are errant doctors.
Bhuyan, a well-regarded deputy director general of industry body Confederation of Indian Industry (CII), died following a triple bypass heart surgery at Max Devki Devi Heart and Vascular Institute on 6 October.
According to his wife, Ramola Bhuyan, the hospital has privately admitted to her that the 58-year-old Bhuyan died because of an “error” committed during the surgery.
“The hospital told me that a wrong tube was inserted into his heart, which released oxygen into his brain in a large dose,” she said. “He died because his brain shut down due to the oversupply of oxygen.” Another person familiar with the situation, a leading Indian industrialist with key ties to CII who didn’t want to be named, had described a similar sequence of events to Mint on 7 October.
Max Devki Devi institute is among the more prestigious- and expensive-hospitals in New Delhi.
Ramola Bhuyan, who works with the World Bank here, says she is speaking out because she wants to make sure those responsible for this medical negligence be punished either under the rules of the Medical Council of India or under Indian law. “I don’t want this to happen to anyone else,” she said in an interview.
The Max hospital, part of the health care division of Max India Ltd, for its part, had initiated an investigation into Bhuyan’s death. The investigation report is ready, but has not been shared with the family yet.
“I am obliged to tell the family about the report, not the media. We have been 100% honest and 100% transparent. This is between me and the family,” said Analjit Singh, chairman and managing director of Max India.
Singh, who according to the same industrialist who described the events of 6 October, was in the hospital the next morning, personally overseeing the situation after Bhuyan’s death, was combative in the brief telephone interview with Mint, saying: “If you misquote me, I will take you to court.”
Singh is a prominent member of CII and was the chairman of the lobby’s international committee last fiscal year.
“We know what exactly caused the death of Mr. Bhuyan,” said Pervez Ahmed, executive medical director, Max Healthcare. “The result of the investigation is with the press, it is their prerogative. If the family wants to share (it) We are making arrangements to meet the family.”
The cause of Bhuyan’s death, which had stunned many people in New Delhi, hasn’t received much attention despite his high-profile connections.
While Mint cannot independently confirm the sequence of events beyond what Ramola Bhuyan and the other person said, in general and not specifically referring to any Max hospital, medical errors are commonplace in India though there isn’t much of a mechanism in place to accurately report or track such instances.
Ramola Bhuyan says her husband was taken to a Max hospital in Gurgaon, a satellite town of New Delhi, on 29 September after he suffered his first ever heart attack. Later, Bhuyan was moved to the Max Devki Devi institute at Saket in south Delhi.
“The ECG did not show that a heart attack had happened,” said Ramola Bhuyan. “So, the hospital insisted on further investigation and I also wanted a refers to electrocardiograph, an equipment used to thorough check-up.” ECG monitor the heart’s rhythms.
An angiography was then performed on Bhuyan, after which it was found that three of his cardiac arteries were blocked. He was recommended an open heart surgery to remove the blockages and then given blood thinners for the next few days to prepare him for the operation, she recalled.
Bhuyan’s surgery on 4 October was scheduled for around 11am. Inderjit S. Virdi, a senior consultant and chief of cardiothoracic and vascular surgery at Max Devki Devi institute was heading the team performing the operation, Ramola Bhuyan said, which was confirmed by Dr Ahmed.
Around 6.30pm, the surgery was declared “successful” and Bhuyan was moved into the intensive care unit, Ramola Bhuyan said.
“The doctors told us that his liver and kidney were functioning well,” she said, describing the sequence of events. “He was put on a ventilator and they said that they will let us know about the functioning of the brain later as he was under heavy sedation.”
A relieved family-the Bhuyans have no children-went home. The next morning, when Ramola Bhuyan called the Max Devki Devi institute at around 8 to check in on her husband, she said she was told that he had suffered an extensive brain injury and was asked to rush to the hospital.
“I reached the hospital around 10.30am and a team comprising the cardiologist, surgeon and the hospital’s human resources (HR) person met me”. “The minute I saw the HR person, I knew something was wrong. They told me a terrible mistake had happened during the surgery and something went wrong with the procedure, which made him brain dead.”
According to Ramola Bhuyan, the hospital immediately accepted its mistake and did not try to shift the blame.
Dr Ahmed insists that at no point did the hospital tell the family that everything was fine. “The family was told after the surgery that there was a problem with the brain, which we can tell only after the effects of sedation wear off,” he told Mint.
On 5 October, at the insistence of Bhuyan’s family, the hospital called in two doctors from the All India Institute of Medical Sciences (AIIMS), a well-regarded government-run hospital in the Capital. Those doctors explained to the family that nothing could be done to revive Bhuyan. The family, through CII, also got in touch with the chief cardiologist of Sir Ganga Ram Hospital to also check on Bhuyan.
In the meantime, Bhuyan was put on various machines, including a dialysis support, because his organs were failing one by one, says Ramola Bhuyan.
On 6 October, around 11am, the hospital formally declared Bhuyan “dead”.
Having just returned home after spending some time with family in Hyderabad, Ramola Bhuyan says she wants Max Devki Devi institute to go after the guilty. “No leniency should be shown to the doctors,” she said. “The doctor should not be allowed to practise again. If the hospital wants more time, let them have it.”
Dr Ahmed says Dr Virdi was only heading the team that did the surgery and he was “not responsible” for the error. He declined to name any other doctors on the team.
Max Healthcare has a “four-page code of conduct under which we evaluate the mistake, understand, reason and take action on it”, said Dr Ahmed. “Based on the learnings from the case, we also put in checks and balances to ensure that such mistakes are not made again.”
Dr Virdi’s office told Mint he was travelling until 21 November and would not be available to respond to questions.
Dr Ahmed said he was meeting the Bhuyan family on Thursday. Meanwhile, Ramola Bhuyan says she is also waiting for two more parts of a post-mortem report from AIIMS. A complete post-mortem report is needed to file a police complaint.
Legal experts unrelated to the saga say that the recourse available to the Bhuyan family, if they choose to, is to file a lawsuit against the hospital in a consumer court.
Medical law is still developing in India when compared with countries such as the UK and the US where there is an established tradition of sorting out medical malpractice issues and law firms specialize in taking on hospitals and doctors.
These legal experts that Mint spoke to say there are three options available for Ramola Bhuyan: she can file a suit in the consumer court against the hospital for monetary compensation, file a suit against the hospital alleging criminal liability due to medical negligence in a trial court, or initiate a process to get the licence of the hospital cancelled by the state government of Haryana.
They also point to a 2005 Supreme Court decision that laid down guidelines for prosecuting medical professionals for negligence.
In the case of Jacob Matthew v. the state of Punjab, the court held that in a case of medical negligence, it is enough for a doctor to show that the standard of care was that of an “ordinary competent” medical practitioner “exercising ordinary skill” to escape criminal liability.
“The court felt that a Damocles sword must not hang over a doctor and he must be given a free hand,” Supreme Court lawyer K.V. Viswanathan said, explaining the court’s logic. “After the Jacob Matthew judgement, doctors are to be given a long rope. A doctor cannot be held liable for mere error of judgement or accident.”
If recklessness or rashness can be proved on the doctor’s part, then a case can be made, Viswanathan added.
According to Rahul Singh, assistant professor of law at the National Law School of India University in Bangalore, it is tough to estimate the exact number of cases on medical negligence as there is no pan-India database for trial courts across states where such suits are filed.
“Very few people file such cases as there is no incentive to do so,” he said. “This is because the probability of detection of negligence is very low, a stringent level of proof is required, the courts are not keen on awarding damages to consumers and legal literacy is low. Some cases also get settled outside court.”
Ramola Bhuyan says she will await the various reports as well as what Max plans to do about the doctors involved in the case before deciding what to do.
“Bhuyan was a very gentle soul…people loved him,” she said, speaking through visible distress. “The hospital should not shelter such people.”
Coming out of one Indian holiday season and headed into Christmas and New Year, Indian magazines and newspapers are full (well, not too full in these tough economic times) of editorial features clearly aimed at getting readers to buy stuff. But what really gets my goat is how many of these features have everything about a product–including very attractive product shots–except, that is, the price.
Ads like these from Hi! Blitz, the airline magazine of Kingfisher Airlines (I flew them four times in two days this weekend so there you go, but I could have picked up similar examples from most metro newspapers and magazines as well):
So apparently a Rs25,200 pair of Hugo Black shoes are ok to price but the other two shoes (and all the watches) require a reader to request the price. The same issue of Hi! Blitz had this ad for three Click and Clasp bags, with a Judith Leiber’s price (Rs145,000) as well as a Christian Dior (Rs144,000) mentioned, but not the Valentino (which is again price on request):
What annoys me is that most of these news features are clearly aimed at selling these products with most of photos being supplied by the retailers or the brand marketers. Yet most newspapers are willing to eagerly acquiesce to storekeepers and PR firms that try to make it seem like if a price is mentioned, somehow it will lower the exclusivity or devalue a product. And, on top of it, many newspapers don’t usually give a website or a store phone number to quickly get the price, assuming a reader is interested in finding out, without having to visit the store.
When Mint’s Saturday magazine Lounge did its Luxury Special, this is what Lounge Editor Priya Ramani had to say about what Mint thinks of Price on Request requests:
“How many times have you seen this phrase in Indian fashion and lifestyle magazines?
When we launched Lounge, we were clear that these three words would find no place in your favourite Saturday magazine. We saw no reason for you to request anyone for anything when we could provide you with that information. Readers have a right to know how much the products we feature cost, right?”
The column goes on to note how time consuming such a seemingly small task of giving all the prices of all the products Lounge features can be for reporters and editors. This Romantic Realist, for one, believes newspapers are here to serve readers, not to make them go through extra hoops to get basic information. So, it is a matter of pride at Mint that Lounge doesn’t take its readers down the Price on Request route. (
Read that column here.)
Wouldn’t it be nice if editors and journalists acted in the interests of readers and not retailers, PR agencies or brand marketers when it comes to such relatively simple matters? After all, if the ultimate goal for retailers and marketers is to sell that stuff, by writing about it (rather than asking the brands to run just ads), newspapers are the ones doing the brands a–free–favor.
Seems to me that this habit is a lazy and quick way to start losing readers to more one-stop information providers, especially on the web. I mean, if a price really needs to be requested, then how about the reporter or editor “requesting” it on behalf of the reader and providing that information?
If many bloggers are themselves refugees (either voluntary or involuntary) from the journalistic establishment, here is an idea worth blogging about.
Bloggers Unite is a global, volunteer group of bloggers, podcasters and videobloggers who use their space and voice to try and unite–for one day every month–for a common cause or issue that, hopefully, helps contribute to making the world a better place. The goal is very simple. Once a month, on a fixed day, the hope is to get as many bloggers to blog and debate about a single issue. And many are doing it.
For instance, on 15 October, at least 12,800 bloggers focused on a single issue–poverty–with 14,053 blog posts that were read by 13,498,280 readers with 17 such posts featuring in the Top 100 Blogs that day. (See more details of that Blog Action Day campaign here). The aim is not to try and solve what are chronic and complex problems but to raise awareness and create a discussion, a shift in the global web conversation, if you will. A lot of organizations with similar goals have supported this initiative (see list here)
Anyway, today (10 November) the focus for Bloggers Unite is on refugees. According to the 1951 Convention Relating to the Status of Refugees, a refugee is a person who:
“Owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of their nationality, and is unable to, or owing to such fear, is unwilling to avail him/herself of the protection of that country.”
Participation is simple and sometimes as easy as adding an action badge (as one above) to your blog. Of course raising awareness and offering some debate about this issue would go a long way beyond just posting a badge as well. For more details check out this site.
India, for its part, has a history of refugees (see more here) and from where I write this blog, New Delhi, has tens of thousands of refugees turned Delhites. But, since we are on the topic of movement–and since I have got you to read until now–let me use this day to take a small detour and tell you about Janarth, which provides education solutions for children of seasonal migrants. It reaches about 12,000 children in seven districts of Maharashtra who migrate every year to sugarcane factories with their parents. Launched by Pravin Mahajan and active in the Gangapur area of Aurangabad district of Maharashtra since 1986, Janarth’s signature innovation is Sakhar Shalas, or sugar schools, which run on the site of sugarcane factories for six months before marginal families return to their villages. Some 46% of the students at these Sakhar Shalas are girls. Since its founding, at least 40,000 children have take advantage of this initiative that has now started at least 102 Sakhar Shalas for children who often fall through the cracks each year. To know more about Janarth, go here.
To me, Janarth is a great example of organizations that quietly do a lot of good in a field–education–where the Indian government continues to spend enormous amounts of money with not much to show for.
