June 20, 2009

Medical colleges offer PG degree with no hospital

The state of affairs pertaining to private medical and dental colleges is getting murkier.

Close on the heels of the capitation fee scam in medical colleges of Tamil Nadu, the Supreme Court on Friday stumbled upon another blatant violation of rules in permitting private dental colleges to be attached to government hospitals for practicals of PG students.

Counsel for Dental Council of India (DCI) Gaurav Sharma opposed grant of permission to Surendra Dental College and Research Institute to admit students for post-graduation courses on the ground that it had no valid tie-up with a hospital. Since PG courses were more practical-oriented than classroom based, non-attachment to a hospital would jeopardise the standard of education, he said.

To counter this, the college at Sri Ganganagar produced a letter dated May 26, 2009, from the health department of Rajasthan allowing it to be attached to the government hospital in the town "till 2012-13 academic session or till construction of its own hospital".

Sharma pointed out that another private college -- Maharaja Ganga Singh Dental College, Sri Ganganagar -- was permitted by the state government to be attached to the same government hospital. "In the larger public interest, it is not appropriate to attach two dental colleges for the purpose of clinical training with a government hospital as the same would definitely deteriorate the standards of dental education," DCI said.

The Bench, returning the letter to the college's counsel, senior advocate P S Narasimha, said, "Mr Narasimha, we won't pass any order. You see the worth of this letter. It appears as if it is just taken out of the minister's pocket."

The letter, in possession of TOI, was written by a deputy secretary to the Rajasthan government and starts with "I am directed to write..." and ends by forwarding a copy of it to the private secretary of the health minister.

The college, through counsel Bina Madhavan, pointed out to the court that the college satisfied the regulations by being attached to a hospital. It also assailed the decision of DCI not to grant permission to it to admit students for the academic year 2009-10, for which it had already appointed teaching staff.

The Bench refused to accede to the college's request for an immediate inspection of the institute by DCI for infrastructure facilities, including the strength of faculty, and give its report to the Centre for permission to start post-graduate courses.

The court issued notice to the Centre, which sought four weeks time to file a reply. It ordered the matter to be listed two weeks after the Centre has filed its reply so as to allow others to respond to the Union government's stand.

Link: Original Article

June 18, 2009

Supreme Court smells a rat in all-India quota medical admissions

The Supreme Court on Wednesday smelt a rat in the admissions under the 50% all-India quota PG courses in state government-run medical colleges and warned of a detailed probe if students successful in the second round of counselling were not accommodated in specified institutions.

It was the peculiar case of one Ruchika Arora that drew the court's attention to possible irregularities in the admissions to PG courses in the medical and dental colleges in various states under the all-India quota.

After being allotted a seat in the MDS course in Government Dental College in Amritsar in the first round of counselling held by the Directorate General of Health Services (DGHS), Arora participated in the second round of counselling and opted for Dental Sciences Chhatrapati Shahuji Maharaj Medical Univeristy, Lucknow.

On reaching Lucknow, she was informed by the university authorities that there was some communication gap between DGHS and the institution and that there was no seat for her. On returning to Amritsar, where she had deposited the fee, Arora realised that the seat vacated by her had already been filled up. For no fault of her, she is left in the lurch, senior advocate P S Narsimha informed the apex court.

A vacation Bench comprising Justices B Sudershan Reddy and Aftab Alam took strong exception to DGHS's excuse that there was a communication gap and asked it to ensure that she got admission in the Amritsar college.

When the DGHS official present in the court dithered and instructed counsel Naresh Kaushik to seek a direction in this regard to the concerned college, the Bench took exception and said: "It is a clear case for seeking damages. What do you mean by communication gap? Can the government take shelter behind such a plea?"

Then came the stringent warning: "If something happens and the child is deprived of admission, then drastic action will follow. We will reopen the entire admissions and order an inquiry."

As it transpired later, Arora's was not an isolated case regarding "communication gap". Counsel Prasanjit Keshwani told the court that his client Prashant Sadashiv Patil faced a similar fate and sought SC's intervention.

Keshwani said Patil was allotted a seat in MS (general surgery) at Gauhati Medical College after the first round of counselling. However, he decided to take the seat in the Institute of Post-Graduate Medical Education and Research (IPGMER) at Kolkata after the extended second round of counselling. Yet, on reaching Kolkata he was told that the all-India quota seats have been filled up because of a "communication gap". The SC decided to hear the case on Thursday.

Link: Original Article

China to Chennai is the new route for spurious medicines

Close on the heels of Nigerian authorities unearthing Chinese-made drugs with fake ‘Made in India’ labels, the Central Drugs Standard Control Organisation (CDSCO) here has stumbled upon a racket at Chennai port involving the use of fake labels and invoices to ship spurious Chinese drugs into Indian cities.

The central drug authority has so far traced three consignments of an antibiotic named roxithromycin, a female hormone called progesterone, and anti-ulcer drug cimetidine, which arrived from China in separate batches in the second, third and last week of May.

The tip-off for the interception came from licensed Chinese drug manufacturers, who informed CDSCO that spurious drugs bearing their labels were being smuggled into India. The assistant drug controller (ADC) at Chennai port, Shanthy Gunasekaran, then seized three consignments worth Rs 76 lakh.

The drugs, imported in bulk for use as raw material for formulations, weighed nearly three tonnes. They were intended for two traders in Mumbai and one drug manufacturer in Gujarat. It is not yet known whether the importers were involved in the fraud or whether they were duped by their Chinese suppliers. When TOI spoke to them, one of them admitted having received a notice from the authorities. Another denied knowledge of the incident, but blamed suppliers and middlemen for such incidents.

The first consignment was intercepted at Chennai port in the second week of May 2009. It had 500kg of roxithromycin, valued at Rs 21 lakh. It was sent by Sinobright Development Ltd, a major drug trader in China, to Envee Drugs Pvt Ltd in Kheda district in Gujarat. The consignment carried labels of Zhejiang Zheyuan Pharmaceutical Company Ltd, a licensed Chinese pharma company.

The manufacturer, however, while replying to a communication from the ADC, said the drug seized at Chennai was not produced at its facility. Also, it had not sold roxithromycin in bulk form to Sinobright, the manufacturer clarified. Inquiries revealed that Sinobright was a regular supplier of bulk drugs to Indian firms and had not come under adverse notice earlier.

The second contraband, 400kg of progesterone valued at Rs 40 lakh, reached Chennai port in the third week of May. It was sent by the Hong Kong-based Tiangao International Economic Development Corporation to J B Khokhani and Company, a Mumbai-based trader. A licensed Chinese manufacturer, Zhejiang Shenzhou Pharmaceutical Company Ltd, whose labels were used for it, disowned the drug and clarified that it had no links with the Hong Kong firm.

The third case — 2,000kg of cimetidine worth Rs 15 lakh — was reported in the last week of May. It was a batch imported by Sheetal Pharma of Mumbai from Zhejiang Chemicals Import and Export Corporation in China. Jiangxi Juermei Pharmaceuticals Company Ltd in China, which was supposed to have manufactured it, said that it was not their product.

Apparently, in all three cases, traders in China had sourced spurious drugs and sent them to India, said a senior official in CDSCO.

Drugs can be imported only through the Chennai, Kolkata, Mumbai, Nhava Sheva, Kochi and Kandla ports and six airports — Chennai, Kolkata, Mumbai, Delhi, Ahmedabad and Hyderabad.

Link: Original Article

Obama ask doctors to reform America's health care system

US President Barack Obama today asked the country's largest doctors' group to help him reform America's expensive health care system, making it affordable for millions of uninsured Americans, as he likened the escalating health care costs to a time bomb that may make the country go "broke".

"I need your help doctors. To most Americans, you are the health care system. Americans 'me included' just do what you recommend. That is why I will listen to you and work with you to pursue reform that works for you," Obama said here at the annual meeting of the influential American Medical Association (AMA), which represents a quarter of a million doctors.

He said if they work together, they will be able to bring spending down, quality up and save hundreds of billions of dollars on health care costs while making the nation's health care system work better for patients and doctors alike.

Obama's nearly hour-long speech to about 2,200 AMA members and guests received numerous standing ovations and was booed once. Terming the escalating cost of health care "a threat to our economy", Obama said the cost is a burden on US families and businesses.

"It is a ticking time-bomb for the federal budget. And it is unsustainable for the United States of America. If we do not fix our health care system, America may go the way of GM, paying more, getting less and going broke".

Link: Original Article

June 16, 2009

Indian-American doctors pledge to improve India's health care

Indian-American physicians pledged here to work to improve the health care system in India by entering into partnership with their counterparts in the country and its government, which they said would be their contribution to their motherland.

The Indian-American doctors, who participated the 27th annual convention of the American Association of Physicians of Indian Origin (AAPI) yesterday, said it is time that they make their collective efforts to ensure that basic health care facilities - the best of the world - is accessible and affordable to the poorest of the poor in the country.

Even as some of them shared some of their bitter experiences of trying to launch various projects in this regard in India, AAPI leaders said they were determined to work in this regard despite hurdles.

The leaders said they would vigorously pursue the annual Indo-US Health Care summit they had launched two years ago to channelise their efforts to this effect.

"India is a very difficult place to work, because it takes a long time," acknowledged Dr Navin Shah, a former AAPI president.

Sharing his own experience of trying to implement projects related to infectious diseases and trauma care, Shah asked his fellow Indian American physicians to have patience in their endeavour.

"Put the best of America there. Let us do major thing. It is not difficult. Persistence and of course, contacts, and dedication is important. Whether it is AAPI or individual, let's pull all together, and do something good for our motherland," Dr Shah said.

The incoming AAPI president, Dr Vinod Shah, who is running a few health care projects in Gujarat said there is desire among the Indian-American doctors to "give back" what they have achieved here.

"If we communicate, take steps and re-energise and take town after town, village after village, I think we can do very meaningful work back home," he said.

Observing that the back home Indian health care system or Indian doctors usually have negative approach to any foreign doctor or foreign health system, another physician urged AAPI to take the lead in reforming medical education in India, including residency program.

Link: Original Article

Options to pursue medicine

Don't be disheartened if you fail to get admission into a medical college. There are ample options of making a successful career in medicine-related and health science fields with degree and diploma courses in other pathies like ayurveda, homoeopathy, unani and siddha medicine, pharmacy, nursing, occupational and physiotherapy and of course the BDS degree (bachelor in dental surgery) besides a bunch of diploma and certificate courses in various health subjects like accupressure and acupuncture.

Admissions of most of these courses can be had through the Maharashtra State-Common Entrance Examination (MHT-CET) in government colleges. "The Maharashtra University of Health Sciences (MUHS), Nashik offers a host of degree and diploma courses in various pathies, nursing etc. Even some local universities also run a number of technical courses related to medicine. And mind you there is enough demand and job opportunities for technicians. In fact, there is shortage of such skilled professionals," says Dr Mridula Phadke, Vice-Chancellor, MUHS.

Dr Deepti Donganokar, dean, Government Medical College and Hospital (GMCH) describing the prospects of other courses in medicine said, "Very few students know the entire list of courses that are available to them after the HSSC examination in both government as well as private institutions. Even Nagpur University offers some courses like that of optician, lab technician, physicist (who decide the medicine dose for chemotherapy during cancer treatment) which few students are aware of".

After MBBS and BDS degrees, the most sought-after course is four- year degree course in nursing (B.Sc nursing) where admissions are available on merit basis in MHT-CET. Besides the degree course, students can opt for the general midwifery (GNM) and General Nursing courses. "Nursing has become a very specialised and demanding course. Nurses can now specialise in subjects like cardiothoracic, paediatrics, public health, cancer, neo-natology which have lot of job opportunities especially in private sector," said Sanjay Patil, senior teacher nursing in College of Nursing, GMCH. Although students from other streams can also seek admissions to GNM course, the seats get filled mainly by science students. Some other courses include courses in subjects like oral hygiene, nutrition, dietary and some entrepreneurship courses like artificial limb making, optometry, audiometry etc.

Link: Original Article

June 07, 2009

Medical bills underlie 60 percent of U.S. bankruptcies: study

Medical bills are behind more than 60 percent of U.S. personal bankruptcies, U.S. researchers reported on Thursday in a report they said demonstrates that healthcare reform is on the wrong track.

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy," Harvard's Dr. David Himmelstein, an advocate for a single-payer health insurance program for the United States, said in a statement.

"For middle-class Americans, health insurance offers little protection," he added.

The United States is embarking on an overhaul of its healthcare system, now a patchwork of public programs such as Medicare for the elderly and disabled and employer-sponsored health insurance that leaves 15 percent of the population with no coverage.

The researchers and some consumer advocates said the study showed the proposals under the most serious consideration are unlikely to help many Americans. They are pressing for a so-called single payer plan, in which one agency, usually the government, coordinates health coverage.

"Expanding private insurance and calling it health reform will fail to prevent financial catastrophe for hundreds of thousands of Americans every year," Dr. Sidney Wolfe of the Health Research Group at Public Citizen said in a statement.

About 170 million people get health insurance through an employer but President Barack Obama says soaring healthcare costs hurt the economy and force businesses to drop medical insurance for their workers.

"Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter do so within a year," the report reads.

Obama told Congress on Wednesday he was open to making mandatory health insurance part of the overhaul.

Neither Congress nor Obama are considering the kind of single-payer plan advocated by Public Citizen, Himmelstein and his colleague Dr. Steffie Woolhandler.

"We need to rethink health reform," Woolhandler said. "Covering the uninsured isn't enough.

"Only single-payer national health insurance can make universal, comprehensive coverage affordable by saving the hundreds of billions we now waste on insurance overhead and bureaucracy."

The researchers studied 2,134 random families who filed for bankruptcy between January and April in 2007, before the current recession began.

They used public bankruptcy court records and surveyed 1,032 people by telephone.

"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers

"Most medical debtors were well-educated, owned homes and had middle-class occupations."

The researchers, funded by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.

Patients with multiple sclerosis paid a mean of $34,167 out of pocket in 2007, diabetics paid $26,971, and those with injuries paid $25,096, the researchers found.

Link: Original Article

Want information on hospitals, doctors? Log in

With the aim of providing easy information on doctors, hospitals and health related issues in Delhi and Mumbai, a health portal - www.justhealth.in - was launched here on Thursday.

Prepared by Imarketing Advantage, an Internet-based marketing firm, the portal will have comprehensive health information and can provide free information about doctors with different specialisations, hospitals and other health related issues in their cities.

The main objective of this website is to allow users to make an "informed choice" by helping them to view details of the doctors and the hospitals before they visit them.

The health portal is linked to 100,000 doctors across India and has a database on hospitals and health service providers.

Nitin Dhawan, chief executive officer, iMarketing Advantage, said: "In the initial phase, www.justhealth.in services will be available for Delhi and Mumbai users only. However, over the next couple of months, the services will be activated for other cities also. We will be a national service over a period of one year."

According to Mr. Dhawan, with more and more people relying on the Internet, the portal will even provide services like online appointment scheduling and personal health record tracking.

Link: Original Article

Transfusion of wrong blood group is medical negligence

The Supreme Court has held that transfusion of wrong blood group to a patient amounted to medical negligence.

A Bench consisting of Justices D.K. Jain and R.M. Lodha said: “The law takes no cognisance of carelessness in the abstract. It concerns itself with carelessness only where there is a duty to take care and where failure in that duty has caused damage. In such circumstances carelessness assumes the legal quality of negligence and entails the consequences in law of negligence.”

The Bench upheld compensation of Rs. 2 lakh ordered by the State Consumer Disputes Redressal Commission and confirmed by the National Commission to the husband and children of a woman who died due to transfusion of wrong blood group at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh.

Writing the judgment, Justice Lodha said that “with regard to professional negligence, it is now well settled that a professional may be held liable for negligence if he was not possessed of the requisite skill which he professed to have possessed or, he did not exercise, with reasonable competence in the given case the skill which he did possess.”

The Bench said “it is equally well settled that the standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary person exercising skill in that profession. It is not necessary for every professional to possess the highest level of expertise in that branch which he practises.”

In the instant case Harjit Kaur was admitted to the PGIMER on April 19, 1996 for treatment of burn injuries. On May 15, she was transfused with A+ blood which was her blood group.

However during the second blood transfusion on May 20, she was transfused with B+ blood group, instead of A+. Her condition started deteriorating and it transpired that due to transfusion of mismatched blood, the kidney and liver got damaged. She died on July 1, 1996.

On a complaint from her husband Jaspal Singh, the State Commission held that the death was due to medical negligence and awarded Rs. 2 lakh compensation. On appeal by the PGIMER, the National Commission confirmed the award and the present appeal by the Institute was against that order.

The appellant contended that Harjit Kaur died of septicemia and not by mismatched blood transfusion and sought quashing of the National Commission’s order.

Appeal dismissed
Dismissing the appeal and upholding the award with Rs. 20,000 costs, the Bench said: “Although she [Mrs. Kaur] survived for about 40 days after mismatched blood transfusion it cannot be said that there was no causal link between the mismatched transfusion of blood and her death. Wrong blood transfusion is an error which no hospital/doctor exercising ordinary care would have made. Such an error is not an error of professional judgment but in the very nature of things a sure instance of medical negligence. The hospital’s breach of duty in mismatched blood transfusion contributed to her death, if not wholly, but surely materially. Mismatched blood transfusion to a patient having sustained 50 per cent burns by itself speaks of negligence.”

Link: Original Article

HRD Ministry, TN issue notice to 'Seat for Sale Scam' colleges

Two days after the TOI-Times Now expose on malpractices and misuse of autonomy by medical colleges in Tamil Nadu, the HRD ministry on Thursday issued notice to them asking why their deemed university status should not be withdrawn and action be taken under law.

Tamil Nadu's health department also issued notice to the two deemed universities asking why criminal action be not initiated against them for demanding capitiation fee — in the form of cash — from students seeking admissions for the MBBS course.

itimes: Share your experience on seat-for-sale scam

The HRD ministry and TN government notices were issued to Sri Ramachandra University and Bharath University of which Shree Balaji Medical College is a constituent unit.

Though the website of Bharath University names Union minister of state S Jagathrakshakan as the chancellor, the minister has denied any links to the college.

The HRD notice came after it went through the transcript and tapes of the sting operation. The ministry had written a detailed letter to the UGC asking if these two institutions had followed National Assessment and Accredition Council (NAAC) and National Board of Accredition (NBA) guidelines when the accreditation was given.

HRD ministry sources clarified that in case the deemed university status is withdrawn, the students will not suffer since the college will automatically become part of the university it was affiliated to earlier.

The TN notices, according to state health secretary V K Subburaj, asks the deans of the two institutions to send their replies immediately. "If we don't receive a reply within a week, we would give them a deadline of two or three days more and if they continue to remain silent, we would have to conclude that they have admitted that they are guilty of taking capitation fee," a senior health department official said.

Taking a holistic view of the malaise in the functioning of deemed universities, HRD minister Kapil Sibal used the opportunity to come down heavily on UGC and directed that all pending proposals should be held in abeyance till a thorough review of the functioning of the existing deemed universities is undertaken. UGC has been asked to review and report the deficiencies within three months with respect to academic standards, availability of qualified faculty, admission process and infrastructure.

Sources said Sibal might have to change his decision of letting UGC review the functioning of deemed universities, the reason being that it is the UGC that has in the past five years given such status to 120 private educational institutions. "How can UGC review its own decision," an official said. Many of them are mired in controversy with allegations of high level corruption.

In fact, Sibal's directive came as a shock to UGC which had invited him on Thursday to attend the full commission meeting. As UGC was gearing up to receive the minister — even getting a pashmina shawl for him — Sibal excused himself. In fact, the agenda of UGC meeting had a proposal for granting deemed university status to eight institutions. But in minister's absence UGC did not take up the matter on the ground that HRD ministry has instructed not to grant deemed university status.

Link: Original Article

June 01, 2009

Doctors booked under Pre Natal Diagnostic Techniques Act continue medical practice

Following a sting operation led by Chief District Health Officer (CDHO) Vaidya, the health department on Tuesday trapped Dr Kaushik Shah, a radiologist from Ahmedabad, and his two staffers under the Pre-Conception and Pre Natal Diagnostic Techniques (PNDT) Act.

Dr Shah is the fourth in the line with DN Prajapati in Palanpur, Harshad Thakkar in Ahmedabad and Bharat Bhope in Rajkot having been booked earlier under the Act.

An FIR was lodged on Wednesday and the two mediators in the case, Vijay Goswami and Paresh Shah, were arrested by the police on Thursday. Maninagar Police Inspector, PJ Trivedi, said, “We have arrested the duo on Thursday night. The doctor is presently absconding and could not be arrested as he got a day’s time as the FIR was lodged a day after the sting operation.”

Meanwhile, even as the government tasted some success by securing a Supreme Court stay in the case of Dr Harshad Thakkar against his application to allow him to sell off his sonography machine; in all the three previous cases though their machines have been sealed, the doctors have not been restricted from practising in the absence of any regulation.

Link: Original Article

Supreme Court ticks off doctors for medical negligent cases

The Supreme Court on Friday ticked off doctors for increasing number of medical negligence cases being reported in the country.

"Doctors can today do anything. They can leave behind a forcep or a scissor inside a patient's stomach and get away with it.

"Six months down the line when the patient develops pain and comes back, then you would discover the scissor left behind in the stomach and then remove it," a vacation bench of Justices Markandeya Katju and Deepak Verma remarked.

The bench made the remarks while issuing notice to Pintoo Kumar, a victim, on the petition filed by Dr Mahendra Prasad, a doctor who was slapped with a compensation of Rs 4 lakhs by the Bihar State Consumer Commission in a case of alleged medical negligence.

Mr. Kumar had alleged Prasad, a private medical practioner at the Neha Nursing Home, Buxar who had performed an operation on September 16, 2004, to set right a fracture in his right leg, left behind a screw in the operated portion. The alleged negligence resulted in the patient developing "callus formation" warranting another surgery at the Apollo hospital.

According to the victim, Dr. Prasad was not an orthopaedic surgeon but an MBBS with M.S (patho) and yet peformed the operation.

Link: Original Article



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