Wednesday, August 27, 2008

this-medical problem

---------- Forwarded message ----------From: <durai.gopal@wipro.com>Date: Mon, Aug 11, 2008 at 9:47 PMSubject: Real life (rather death) experience -- LIFELINE HOSPITALCHENNAITo: murug@googlegroups.comHi Friends,thanks for all the support extended from the murug family.I am still struggling to cope up with what had happened. Also stilltrying to find ways and means of pinning down the hospital. As as partof this, want to create a wider awareness on this issue. Can youcirculate this among your circles to increase awareness about thishospital and also in general.Any ideas of pulling this hospital, please do let me know. I fear Imay not succeed by going legal with the Indian legal system and don'tknow whether I can spend that much of energy (keeping priorities ofchildren in mind); please do give me ideas.I have come across few more affected people, included those links alsoin the mail.thanksdurai================================================================================================*LIFE AFTER DEATH – real life (rather death) experience **This is not a philosophical statement on one's life after death, thisis about how my wife, Padma died in a hospital in Chennai. Whatever Ihave seen only in movies so far, is experienced by me.*We were living in the UK for few years; our family includes me, mywife (Padma), and our 7 yr old son and 8months old daughter. My wifehad a symptom of ventral hernia (slightly bulged abdomen), we hadconsulted General Physician and Surgeon in the UK and advice was thatshe needed a surgery to have a mesh to fix the problem with a fewweeks rest. We were also told that this is not an emergency and it canbe done anytime though earlier is good. In fact the surgeon whom weconsulted in UK talked about an example of a lady having this done for30 years of the symptom. My wife did not have any specific pain orsomething except a small discomfort of bulgy abdomen (like a 2 monthspregnant lady) and she was in her normalroutine of taking care of our children, taking our son to school,household work, etc.We were planning for Christmas vacation in India in Dec 2007, wethought we will consult some 'good' doctors over in India and take adecision of when we will do the surgery if required and possibly feltdoing in India is good because of family support. We have got areference of Dr J S Rajkumar of Lifeline hospital and we booked anappointment to meet him.We landed in Chennai on 14th Dec 2007 for a three weeks vacation, metDr Rajkumar at his city hospital (Rigid hospital) in Chetput on 15thDec 2007 (Sat) at about 730pm. We have explained him the background,shown him all the comments of UK surgeon, medical reports related tomy wife pregnancy, deliveries, etc (she had delivered both ourchildren normally). After few minutes of assessment Dr Rajkumar toldus this hernia requires laproscopicsurgery and we can do this next day itself. We were little concernedinitially of getting this surgery done the very next day (particularlywe were still not out of jet lag and she was feeding our baby) and gotconvinced with the 'salesy' words given by the Doctors. To quote acomment from the Doctor *"she will run in two days time and can lifttwo suitcasesand you can return to UK as per your plan on 3rd Jan 2008"*). Also DrRajkumar told us that he will be on travel for 3 days from 17th Decand moreover he was teaching Post Graduates on 16th Dec aboutlaparoscopic surgery and let us get it done on 16th Dec.Then my wife was put into all sorts of equipments in the hospital (inthe name of assessment); blood, urine, ECG, MRI and so on and thetests were conducted till about 11pm on 15th Dec. In fact they haveopened the labs after closing hours and got the test done and handedover the testresultsto us. They had some problem in the ECG and we were told that ECG canbe done on the next day at Lifeline hospital.We were asked to report to Rigid hospital at 5am in the morning. Thinkof it, we went our residence around midnight and my wife had rush onsome food to keep compliance on the fasting 8 hrs prior to surgery.After preparing for the hospital visit that night and a couple ofhours sleep (3 hrs or so)we reached Rigid hospital on 16th morning at 5am or so and from therewe were transported by an 'ambulance' to Lifelife hospital inPerungudi (outskirts of Chennai).We reached the hospital at 630am, paid some initial advance for thesurgery and we were given a room. Padma went through some more basicchecks like height, weight, etc. Padma was taken to the operationtheatre at about 10am in the morning on 16th Dec. After thelaparoscopic procedure she wasmoved to post operative ward at about 12 noon and I have met her inthe afternoon to say a small hello when she gained consciousness. DrRajkumar met us on 16 th Dec afternoon and he in fact *congratulated*me for successful surgery and said he has used proceed mesh (costlyone) and advised his staff to move Padma to normal ward in the eveningas she had to feed her baby. But, Padmawas moved to normal ward only on 17th Dec morning, she was on IVfluids as per normal post operative procedure.Padma started to develop some fluids in her abdomen which duty doctors/ surgeons have 'rightly' observed. She was put in some series oftests on 17th, 18th, 19th and 20th – tests include multiple ultrasound, multiple CT scans, pricked her abdomen and taken fluids, shehad a long tube through her nose overnight to collect fluid for tests,etc. We were told the fluid is normal after surgery and it will bealright after she passes stool, etc.In the meanwhile Dr Rajkumar returned from his travel and seen Padmaon 19th, on 20th Dec evening along with other surgeons. He made anassessment and he told me that he might want to do one morelaparoscopic surgery to find out what is the fluid about. He wanted todo a surgery on 20th Dec evening itself, but he could not proceed asthe hospital has given solid food that afternoon– hence anaesthesia could not be given. (*lack of co-ordination amongdepartments, time lost here, may be she could have survived if theyhave did the surgery on 20th itself)*On 20th Dec night, fluid started oozing from Padma's abdomen stitches,after the duty Doctor's assessment she was shifted to ICU. We reallydid not know what complication she developed in the ICU.On 21st Dec (Friday) morning around 830am I was called in to the ICUto convey that they are going to perform a surgery and I had to sign"*high risk consent",* they were telling this in front of my wife*(just think of a patient hearing this before the surgery). *I wasjust shocked at that andhad no options to sign whatever they wanted. I said "all the best"*(my last conversation with my wife)* to my wife and she was taken toOperation Theatre.While I was discussing with the Doctors at ICU, the cashier in thehospital kept on calling me on my mobile. When I met the cashier heasked for Rs.60,000 to be paid immediately and I told him takeRs.40,000 and will give you the balance later in the day. Bang a replycame, "*you have to paythe money to for me to give clearance for surgery*". When I expressedmy unhappiness about the comment, he insisted for me to sign a pieceof paper saying that I will give the money later in the day. *(Whatmoney minded, in-human attitude!)*We had no news from the hospital on their own about the surgery, I hadenquired the staff nurse and visited my wife in the ICU and learntthat she had a diagnostic laparotomy (open surgery) and there was holein the intestine which was fixed.We have meet Dr Rajkumar at about 3:30pm on 21st Dec and understoodthat there was a *duodenum rupture* and he has fixed it, at the sametime he removed the mesh which was fixed on 16th Dec. She was alsoparalysed and put on ventilator as she was waking up. He explained itwas between lifethreatening and beauty so they addressed the duodenum rupture problem.What we were puzzled were, how did the rupture happen? for thatexplanation given were - it could be due to ulcer. My wife had noevidence of ulcer in the past.Explanation given was 40%+ cases of ulcer is silent and there will beno symptom *(I lack medical knowledge to appreciate this)* - it couldbe due to post operative stress (*so many test postoperation without any explanation of what we were doing could havecreated the stress on Padma is my argument)*On the same night (21st Dec) at about 930pm, I was called in to theICU and Doctors conveyed that my wife condition is critical – herpulse is high, BP is low and they were attending to her. I insisted ontalking to Dr Rajkumar immdediately, but they refused to connect me tohim at first and finallymanaged to speak to him. Dr Rajkumar came in around midnight andexplained that the lungs are getting affected (shown X-ray of whitepatches on the lower portion of lungs) and she was the most seriouspatient in the whole hospital that time and they were trying theirbest. He also said, it will need another 12-24 hours of observationbefore they can say anything.We were completely panicked and just waiting outside the ICU andpraying for Padma's recovery. We had to argue with the securityoutside the ICU to gain access to the Doctors to know her situation(*no courtesy from the security personnel, who just don't understandthe situation)*At about 4:30am in the morning, my friend gained access the Doctors inthe ICU and came out with the low face to tell me that Padma'scondition is worsened. Again I tried to reach Dr Rajkumar and thehospital says they don't have his contact number (*just can'tunderstand how they can behave like this). *Finally after some hue andcry Dr Rajkumar came on line to tell me that he is not God and don'tthink his visit can do any thing different. I cried, begged him tocome over to give some ideas to his team to recover Padma. He cameover at around 6am and said they are trying everythingpossible, etc; but her end came quickly. *The end came to our beloved Padma at 6:30am on 22nd Dec, throwing theentire family to rude shock and a life time sorrow. Our "LIVES AFTERDEATH" of Padma has changed for ever.*I can now think of so many questions retrospectively;1. Why did the surgeon perform the surgery the very next day ofconsultancy, that too for a non-emergency one like this? (Padma hadjust travelled many miles, she was not even out of jet lag.) Was itfor money? Was it for them to get one more sample for their post gradstraining?2. Did the Doctors made proper assessment on Padma's fitness forsurgery, frankly did they even had time to go through the reports,after the tests till 11pm on the previous night for next day 8amsurgery (particularly when the reports were with us till 730am on theday of surgery).3. Patient communication and counselling. Isn't it important tocommunicate to patient and their relatives on the development ofpatient condition (fluid collection started from the next day oflaparoscopic)4. Did the absence of Dr Rajkumar for three days post the firstsurgery is one of the reason for this disaster? Were the other Doctorsnot able to diagnose or take a decision? Were they waiting for DrRajkumar return?5. What is the real reason for duodenum perforation? My wife never hadany history of ulcer to the best of my knowledge. Why did the hospitaltake so much of time to react (5 days after surgery) when such acrucial thing like perforation has happened.6. Was there any issue in the initial laparoscopic procedure which hascaused the perforation?7. Careless attitude by hospital staff? – my wife sex was recorded as"Male" initially and corrected after I told them. The staff was noteven apologetic for this, he rather asked me "why didn't you inform".Can't he make out with the name Padma. *Think of it, if he has changedthe blood group from A + to B+; that is it!!*8. Will anyone with basic common sense ask for high risk signature infront of the patient? I was asked to sign just minutes before surgeryin front of my wife.9. Is the hospital money minded?: They were demanding money on gun point almost.a. Prior to the first surgery the cashier said please give Rs.30000/-more for him to give clearance for surgeryb. When my wife going for second surgery I was told by the cashieragain, please give Rs.60000/- for clearance for surgeryc. The hospital charged more than what was told for initiallaparoscopic, without even communicating to me increase in chargesd. The final "bill" was just on letter head, without mention ofcurrency, invoice number, etc. I had to insist on a proper invoicelater.e. I was given to understand that they even made arguments onambulance charges to send my wife dead body back home.!! *(makingmoney on the dead body also)*10. Why the hospital did not made me to talk to my wife when shegained consciousness after the second surgery? If not anything else, Icould have held her hand. Even a criminal gets an opportunity tocommunicate his/ her last wishes. Am I or my wife worse than?11. *FALSE reports* - After all these hospital sends me false reports(on Jan 11, 2008 – three weeks after my wife's death) :a. They had mentioned she had LSCS (caesarean section) and large scardue to LSCS. When my wife delivered both the babies normally, how doesone record as caesarean and *how there will be scar when there was nocaesarean?*b. The hernia was mentioned "incisional hernia" – when there was noincision on her body how the hernia is categorised as incisional? Itwas actually ventral hernia. Don't think one can replace any term withany term just like that!c. Most importantly, the surgery was performed on 16th Dec 2007, thereport said 17th dec 200712. *MISSING REPORTS - *From the hospital records Doctors notes weremissing for 16th and 17th Dec. The first report is available for 17thDec at 8:36pm. How come there are no Doctors' notes for *about 36hours after the surgery?*Isn't it fishy? Did something went wrong onthe first laparoscopic procedure?Our entire family is still mourning and trying to reconcile the factthat our Padma is no more. My 7 year old son is aware that is Mom isnot there, does he understand? My 1 year old daughter is too young toknow what has happened. What will her questions be in future?My sincere advice to all isa) Do not get carried away by advertisement / TV shows / big buildingsb) Please do not rushc) Do your own due diligence, particularly when things are not a emergencyd) Try and understand the medical terms, do research priore) Please ask questions, at every stage.f) Don't say "I can spend anything"g) Know patient rights *I am still not convinced that Padma has died after a 'simple'laparoscopic surgery? I am deeply upset of what has happened to Padmaand for what is happening to us. What I could have done (or not done)which would have prevented this. What is that we can do to preventthis in future forothers!!!Please join me in making awareness to others. While India is trying towoo many international Customers in the name of 'medical tourism';first let the authorities make regulation on the health care systemand take care of Indian people first.Read others experience as well* *http://birjupatel.blogspot.com/2007/10/unethical-practice-by-lifeline-hospital.html**http://www.hindu.com/2007/12/26/stories/2007122658760300.htmhttp://epaper.timesofindia.com/Repository/ml.asp?Ref=VE9JQ0gvMjAwOC8wNy8xMCNBcjAwNTAx&Mode=HTML&Locale=english-skin-customOur medical system must understand the differences between MEDICINE –TREATMENT and HEALTHCARE. What we get most of the time is medicine forthe symptom while we need healthcare. **From a big loser in life (** agdurai@hotmail.com **)

1 comment:

Durai said...

@Lakshi

I came across this post when I was searching something. This story is about me. You intro has caught my attention, you are wife, mother, daughter, sister - very true as a person one nee to play multiple personal roles. When I introduce in social circle, I first say I am father of two and then about my work, etc.

I invite to see some of my learning post my wife's death in http://agdurai.blogspot.com