MBBS with IGNOU PGDCC performing Echo: Hospital fined Rs 20 lakh

West Bengal:  BM Birla Heart Research Centre (BMBHRC)  has been directed by the West Bengal Clinical Establishment Regulatory Commission to pay Rs 20 lakh compensation to the family of a patient who died during treatment after concluding that two employees including one doctor at BM Birla Heart Research Centre in Alipore were not qualified to conduct and report echocardiography.

The case pertains to a female patient, known hypertensive who had come to the hospital with complaints of chest pain and shortness of breath. After 4 days of treatment she was shifted to Calcutta Medical Research Institute, where she died. Following her death, her family filed a complaint of negligence against the hospital with the commission.

After going through all the submissions made by the complainant and the hospitals as well as the case files of the patient, the commission observed a number of discrepancies in the submissions made by the hospital to the commission and the case file and discharge summary of the patient.

Besides this, the complainant had alleged that no echo screening report was given to them, whereas the hospital submitted an echo report dated 3rd May, 2017, whereby an echo was done by one Dr Giri who noted his findings and recorded his opinion and impression thereon. His authentication stated him as the " Head of Non-invasive department.  Another echo screening report, dated 7th May 2017, was given, where the commission found that the screening was done on a portable machine and the findings were recorded and interpreted with impression by one Ms Chaitali, who was the Echocardiography Technician at the hospital.

On going through their degrees, the commission found that Dr Giri had done his MD from Russia, which is equivalent to MBBS in India. He had received his registration from MCI after clearing the FMGE exam. Post this he was awarded a Post Graduate Degree in Clinical Cardiology ( PGDCC) from IGNOU, New Delhi. The commission sought clarification from the Medical Council of India as well as the West Bengal Medical council, where the MCI response stated

" It is to inform you that Postgraduate Medcial qualifications ( Indian/foreign) which are included in the Schedules to the IMC Act, can only be considered deemed to be recognised medical qualification(s) for the purposes of registration of additional qualification and entitlement of its holder(s) to practice in the speciality concerned.

Further, as per clause 7(2) of the Indian Medical Council ( Professional conduct, Etiquette and Ethics) Regulations, 2002, a physician shall not claim to be specialist unless he/she has special qualifications in that branch.

As per the available records, the postgraduate diploma in Clinical Cardiology awarded by Indira Gandhi National Open University is not included in the Schedules to the IMC Act.

In view of above, you are requested to take further appropriate action in the matter at your end please."

The response from the WB Medical council stated

" With reference to this mail, I am to inform you that the medical qualifications, which are included in the Schedule of the Medical Council of India are only the recognised qualifications for grant of registration by any state Medical Council. The qualification awarded by the Indira Gandhi National Open University do not appear in the Schedule of Medical Council of India. Hence, registration to such qualification holders cannot be granted for practicing modern scientific medicine (allopathic)."

The commission then opined that the

In view of the above communications, the employment of the doctor as consultant in charge, NI department and engaging him for conducting non-invasive procedure and echocardiogram and to give study report interpreting the data available from such a procedure and on the basis decide the course of the treatment is not only detrimental to patient care service but also completely unauthorised and illegal. The practice on the part of the Clinical establishment, BM Birla comes within the ambit of deficiency in patient care service and amounts to irrational and unethical trade practice.

Similar observations were made by the commission on the employment and engagement of the technician in Echocardiography, whose qualifications revealed that she pursued and ElectroCardiography Technique Course from Society for School of Medical technology, whereby neither the course nor the institute was recognised by the State Medical Faculty. The commission also observed that the echo screening dated 7th May, 2017, was done by the technician but not authenticated by any doctor.There were also a lot of differences in the LVEF reported at BM Birla and that reported at CMRI.

The commission stated

It goes without saying that a qualified and trained technician can always carry out and perform a Non-invasive procedure like Echocardiography, monitor the same and record the findings obtained from the system. But it is not permissible for such technician to interpret the findings and give an impression about the medical condition of the patient. It is for a qualified cardiologist to interpret those findings and to give the impression out of that. However, in the present case, the Clinical Establishment, BM Biral entrusted Dr Ashok Giri with the independent charge of Non-invasive Department inclusive of conducting vital procedure like Echo cardiogram, Colour Doppler Studies, etc as also an unqualified person as technician for conducting such procedure.

Holding deficiency on the part of the establishment ,the Commission slapped a Rs 20 lakh compensation on the hospital to be paid of the complainant.