In
my last post I had mentioned about my experience with
a doctor named Dr K. G Kallur, Consultant Nuclear Medicine at HCG Bangalore
Institute of Oncology during a nuclear scan. I had lodged an FIR against him with
the police who, in turn, had referred the case to the Karnataka Medical Council
(KMC) for investigation.
I
had in my written submission brought to the notice of the Hon’ble Council (KMC)
that according to Atomic Energy Regulatory Board (AERB) Safety Code, it
is mandatory for a specialist doctor/nuclear physician to supervise scans such
as mine and had annexed a copy of the relevant code.
The
Code inter alia spells out that the nuclear physician shall:
(a) have the
responsibility of dosage administration and maintenance of records providing
name of the patient, nature of procedure, radiopharmaceutical prescribed,
quantity prescribed, name of the nuclear medicine physician with signature and
date, and name of the person administering the radiopharmaceutical with
signature and date;
(b) prevent any
possibility of misadministration and promptly report to the licensee and the
competent authority in the event of any misadministration, adverse reaction or
death of a patient administered with radioactivity;
(c) consider
factors such as proper choice of radiopharmaceuticals, monitoring of procedure
and immobilisation of the patient in order to minimise absorbed dose to the
patient;
(d) inform
patient on safety measures to be observed to avoid radiation exposure to the
family members and others;
(e) instruct
nursing and ancillary staff on radiation safety and precautions in
nursing/management of therapy patients;
(f) obtain
an informed consent from the relatives of the patient, prior to administration
of therapeutic dose;
I had stated
that all the above mandatory prescriptions of AERB were flagrantly disregarded
by the specialist doctor, Dr Kallur, Consultant Nuclear Medicine, since neither he (who as per the money receipt was
mentioned as the doctor to oversee the scan) nor any nuclear physician
supervised the said scan. In fact, the doctor had not seen, leave alone
examined and discussed any issue with me, the patient.
I had further
brought to the notice of the Council that the HCG Bangalore Institute of
Oncology Speciality Centre claims to have accreditation from National
Accreditation Board for Hospitals & Healthcare Providers (NABH) Government
of India. According to chapter 2 (CPP) Control of
Imaging Processes and Procedures of National Accreditation Board for Hospitals
& Healthcare Providers (NABH) [Page 41]:
“The imaging
protocol shall address general population as well as provide for specific
modifications in patient with special needs, e.g. children, pregnant, females
etc. The quality of images shall be verified by the technician as well as by
the supervising radiologist/nuclear physician in terms of its technical nature
and the diagnostic content relevant to the patient’s condition.”
The above
stipulation enjoined as a “Shall” requirement in the NABH’s Standard for
Medical Imaging Services (MIS) was violated with impunity by Dr Kallur.
I had brought
out that my apprehension that the nuclear scan was done without the
specialist’s supervision was further vindicated upon receiving the report.
While the radiologist’s signature was affixed to the report, names of three
consultants in nuclear medicine were printed alongside, including Dr Kallur’s,
though no signature of any of the three consultants had been affixed. This
clearly shows that the nuclear scan was examined only by the radiologist, not
the nuclear medicine specialist, Dr K. G. Kallur.
I had concluded
that from the foregoing it was evident that Dr K. G. Kallur, Consultant Nuclear
Medicine has breached every conceivable norms and standards prescribed by AERB
Safety Code 2011, NABH, Society for Nuclear Medicine India, Code of Medical
Ethics prescribed by the Medical Council of India. Also that the behavior
of Dr K. G. Kallur, Consultant Nuclear Medicine, HCG has caused tremendous
mental agony and harassment to me and the damage caused is incalculable. Such
behavior – inexcusable from any denizen of a civilized society in normal times
– is entirely unacceptable coming as it does from a service provider (specialist
doctor) to whom the patient had gone seeking specialized service on payment of
requisite fees.
In light of
what has been mentioned above, I had prayed to the Hon'ble Council that it may
be pleased to investigate the matter and find out the following:
i. Can a Nuclear
Scan be done without the supervision of a specialist doctor in the concerned
medical speciality and if this is as per the universal medical protocol that
HCG Bangalore Institute of Oncology Speciality Centre espouses and is required
to follow? Does this not amount to criminal neglect in patient care?
ii. How could the
hospital, a service provider, flout its own stated commitment of a nuclear scan
under Dr K. G Kallur and not perform the task for which they have charged an
amount of Rs 17,000? Is there no accountability?
iii. Can a
doctor – because of being
stressed, busy and/or excess workload (taking about 60/70 nuclear scans a day) –
absent himself from a critical nuclear scan being taken? Is this as per the medical protocol
prescribed for nuclear scans as well as critical care illnesses like cancer?
iv. Was it fair and appropriate for the doctor to tell a patient –
“You can take your money back”? Was not the doctor breaching the code of ethics and
conduct by retorting to the patient in such a manner? It is well to remember
that (as I had told the doctor) while money can be returned, what about the
actual scan procedure experienced, the radioactive isotope injected into his
body and the ramifications therein? Isn’t Dr K. G. Kallur’s insensitive words and
behavior reprehensible/abominable and completely bereft of the moral and
ethical fibre expected of a doctor in his dealing with the patient? Is this as
per the MCI’s Code of Medical Ethics relating to
the PROFESSIONAL CONDUCT,
ETIQUETTE AND ETHICS for
registered medical practitioners?
v. Can a
nuclear scan be done and findings prepared by a doctor who is not a specialist
in that discipline when the specialist is available and whose name is mentioned
in the money receipt? Does this not amount to cheating and fraud? I’d stated that since the issue is of wider public
interest, as it affects the lives of vulnerable section of people (patients)
who often are voiceless – the illiterate, uneducated masses knowing nothing
what doctors they trust blindly do – and with wider ramifications, appropriate
punitive measures as deemed fit in the form of cancellation of his license be passed
against the errant doctor, Dr K. G. Kallur, in the interest of justice and in
the cause of upholding the Hippocratic Oath that all doctors are sworn to.
Among other
things, Dr K. G. Kallur in his written submission has given a new twist to his
not signing the report. To wit from para 8 of his written submission: “I submit
that Mr Mohanty’s PETCT report was dictated by me and left early on the day of
this episode i.e. on 24th May, 2012. However, next day the driver of
Mr Mohanty came to collect the report and he was in urgency to collect the
report and repeatedly pressurized Mrs Chandrakala (PETCT – Coordinator) to hand
over the report and that he has to leave urgently. Since I was not in station
on 25th May, 2012, the report was not signed by me. Mrs Chandrakala
had clearly informed the driver that I was not in station and that the report
has been signed by Dr Shiva Kumar Swamy. S (Consultant Radiologist). Since the
driver was in urgency, he informed that he would collect this report. Though
there is list of names of doctors in the report, it is not mandatory that all
should sign. PETCT report is a multidisciplinary approach. Radiologist is also
involved. He is also a responsible person reporting. It is customary in most of
the centers that at least one of the members signs the report if not all. In
view of the unpleasant scene created by Mr Mohanty the previous day and based
on the driver’s request, Mrs Chandrakala handed over the report. I submit that
as per the hospital protocol, original report will be issued after getting the
receiver’s signature in the outward register. In this case, since the original
report was not issued, signature was not obtained from the receiver. The
original report signed by all is still with us and the same has not been
collected by Mr Mohanty or his authorized representative.”
The Karnataka
Medical Council has passed the following ORDER on 19.07.2012:
‘Karnataka
Medical Council is of the unanimous Opinion that the Respondent Dr K. G. Kallur
has followed the Standard protocol while performing the PET Scan. The
Complainant has failed to establish “Negligence” on the part of the Respondent.
With the result the Case is dismissed.’
I desist from
giving my impressions here. I am merely putting the facts in public domain for
readers to judge for themselves. I need only remind readers to compare Dr
Kallur’s version conveyed in his letter dated 8.6.12 published in Moneylife
article titled Callousness and high-handedness of Bengaluru
cancer hospital HCG with the one he has given
now and quoted above [about my driver collecting the report (and even the CD of
the scan – that he forgets to mention] in his written submission to the KMC. On
8.6.12 he had said thus: “He (i.e. me) has abused front office people and
taken the report away from the front office of people even before I signed off
the report. Now he is alleging that that I have not seen his scan images and
not reported and this amounts to medical negligence.” Heavens! In my
reply dated 10.06.2012 posted in the Moneylife site, I had said: “You (Dr
Kallur) don’t have to give me an answer, nor to any one else, let you dialogue
with your conscience. How your petulance, which prompted you to refuse
signing the report because I had complained against you, has coiled you today
in so many knots? To tell one lie, you’ve to manufacture few more numbers; the
lies get squared and cubed, and on and on it goes gathering momentum and flight
– an infinite loop that you’ll find hard to keep pace with. It’s already
happened, and the more you try defending yourself through lies, more lies, and
still more lies, you’re likely to get ensnared more and more, inextricably, and
get caught in your very own self-created web of lies.” How gloriously Dr
Kallur has lived up to the expectations I had reposed in him! This is, what I
call, the cunning of healthcare in India
This has
become rather long and I apologize! But truth must prevail. I know it’s a long
haul. Well, I’m happily ready to travel the distance – seeking out every
available constitutional mean in quest of justice.
Satyamev
Jayate!
