Wednesday, 30 October 2013

Read about famous case..........‘Anuradha’s death due to medical negligence must have a bigger purpose in life’ .........................110213

Dr Kunal Saha
Professor and Private Consultant in HIV/AIDS
President, People for Better Treatment (PBT)

Dr Kunal Saha, a US-based professor and private consultant in HIV/AIDS, is known for his struggle against a case in which his wife, Anuradha Saha, died at the age of 36 at Kolkata-based Advanced Medicare Research Institute (AMRI) of medical negligence on May 28, 1998.

Dr Kunal Saha
Since the incident, Dr Saha has travelled tirelessly between US and Kolkata, between the Supreme Court, Calcutta High Court and other lower courts in hope of bringing the culprits of medical negligence to justice.
His quest for justice was finally answered on October 24, when the Supreme Court, in a major ruling, awarded him Rs 6.08 crore for the death of his wife.
Dr Saha is also president of Kolkata-based NGO – People for Better Treatment, an initiative that was launched with an aim to eradicate medical negligence and promote corruption-free healthcare in India. He is also known for his open criticism against misadministration in medical governing bodies.
In an exclusive interview with India Medical Times, Dr Kunal Saha narrated his struggle to go against all odds and expressed his satisfaction on the Supreme Court verdict.
What exactly happened to your wife, Anuradha Saha?
Anuradha was afflicted with a disease, which in a layman’s term may be called as “drug allergy”. There are various types of drug allergies. The type she had is medically known as “toxic epidermal necrolysis” (TEN), which could happen as an allergic reaction to almost any drug or non-drug like vitamins and even gin and tonic. After her death, I have done extensive research on this area and even published a review article in the Indian Journal of Dermatology in 2000.
The people named in different cases in this relation (civil and criminal) are Dr Sukumar Mukherjee, a senior medicine specialist based in Kolkata who is presently the “chief adviser” of West Bengal Health Department; Dr Baidyanath Halder, a veteran dermatologist; late Dr Abani Roy Chowdhury, a medicine specialist who died two years ago; and Dr Balaram Prasad, a junior cardiologist who was also my classmate in medical school in Kolkata.
What difficulties did you come across in this struggle?
Of course, it was extremely difficult to fight this legal as well as public battle staying thousands of miles away in a country where at least at that point of time, i.e. 1998, doctors were literally “untouchable” and the term “medical negligence” was virtually non-existent in dictionary.
In a country (India) where pervasive corruption has plagued almost every sphere of public services, it was seemingly impossible to imagine that I could win this battle against the highly influential medical fraternity. So, I had all odds stacked against me right from the very beginning. But I never lost the faith because the incomprehensible death of my wife during a brief social visit to our homeland almost at the beginning of our family together must have a much bigger purpose in life.
Over the past almost 16 years, I’ve spent at least 1.5 million dollars to fight this legal battle in India. These expenses include not only the hefty fees for the lawyers in India but also numerous personal trips (as many as 4-5 each year), which also weighed heavily on my professional research career. In fact, despite making a decent income in USA as a tenure-track professor in one of the largest public universities (Ohio State University) as well as a private consultant on HIV/AIDS, I eventually had to file bankruptcy and foreclose my home in 2011.
Professionally, my tenure was eventually rejected by OSU solely because of my long absence in India where my attorneys categorically told me that there is no chance to win this legal battle with complex medical issues without my physical presence during the trial. Although I still have my research lab (since a lawsuit is still pending against my hospital), I’ve been working primarily as a private consultant (since denial of my tenure) but also work as an Adjunct Professor here in Columbus, Ohio.
How significant do you consider the verdict?
While I cannot say that I’m very pleased with the quantum of compensation awarded last week by the Supreme Court after spending so much money on my own only to fight this legal battle, but this fight was never for money. If it were, this battle with virtually no chance of winning back in 1998 would have never begun. In that way, I’m very happy with the Apex Court verdict because it has sent the right message to the hitherto untouchable medical community in India.
In the context of India, the verdict has undoubtedly raised the value of average human life in India. Until now, even on the rare occasions when a court held the doctor/hospital guilty for medical negligence causing death of a patient, the compensation generally awarded is in the vicinity of a paltry sum of few lakh rupees with which you perhaps won’t be able to purchase a second-hand car. Is the worth of a human life less than that of a junky second-hand car? This paltry compensation also failed to have any deterrent effect on the wealthy doctors/hospitals of India. In fact, the meagre compensation (after decade or more long litigation process) generally awarded by Indian consumer courts has encouraged more incidence of “medical negligence”.
This verdict is surely going to change the absolute travesty of justice and elevate the value of human lives in India. The verdict is also going to send some threatening signals to the doctors of India and as a result, I am confident that they would be more careful for treatment of their patients. And that is perhaps the biggest victory for this long 16-year-old fight.
What was the objective behind founding the People for Better Treatment?
As I said, I firmly believe that Anuradha’s death in 1998 in the most unfathomable fashion must have a bigger purpose in life. There is not one Anuradha in India. Many Anuradhas have kept on dying needlessly in India only because of the lack of a little more care and compassion on part of many doctors, not all, who are practicing there. In fact, Anuradhas are still dying today even though some awareness about medical negligence and patients’ rights has been generated in the course of my long legal fight for justice in India.
I established “People for Better Treatment” (PBT), a purely charitable organization in 2001 to promote a better healthcare delivery system, to eradicate the pervasive corruption in medicine and to help the hapless victims of medical negligence in India.
Thousands of alleged victims of malpractice have already come to PBT from all parts of India seeking help in their quest for justice. Over the past more than 11 years, PBT has brought major changes in the grossly flawed healthcare regulatory system in India. For example, our PIL (public interest litigation) in the Supreme Court has brought new laws that medical councils in India must investigate and dispose of complaints against doctors within a maximum period of six months. Until now, complaints against doctors were just collecting dust in the medical council office. We uncovered that a complaint filed in the 1960 was still undecided by the Kerala Medical Council.
The inherent problem and corruption in the health regulatory system have given rise to unscrupulous doctors like Dr Ketan Desai sitting at the helm of MCI (Medical Council of India) until 2010 when he was caught red-handed by the CBI in a sting operation while taking bribe from a private medical college in exchange to grant the MCI recognition.
Although my personal battle for justice for my departed wife might have ended last week with this historic verdict by the Supreme Court, PBT and I will continue this battle for justice for the humanity and to save innocent lives in India until the medical regulatory system is cleansed from all evils of corruption and start working to save the innocent patients from the wrath of the errant medicos and not shield their delinquent medical colleagues.
by Vidhi Rathee

New Delhi: The Supreme Court on Thursday awarded Rs 6,08,00,550 compensation to Dr Kunal Saha, an Indian-American doctor, ordering the Kolkata-based Advanced Medicare Research Institute (AMRI) to pay for medical negligence resulting in the death of his wife Anuradha Saha in 1988.

Anuradha Saha
A bench of Justice C K Prasad and Justice V Gopala Gowda passed the order in their judgment on an appeal by Dr Saha, challenging the compensation of Rs 1.72 crore awarded by the National Consumer Disputes Redressal Commission (NCDRC). Cross appeals were also filed by AMRI and three doctors against the Commission’s award.
Welcoming the verdict, Dr Saha said the “historic” judgement should rekindle hope for countless victims.
The US-based NRI said it should tell many honest and caring doctors it is time to step forward and cleanse the system.
“If you let a few corrupt and politically connected doctors to run the show, all doctors will continue to share the blame and will never be able to restore public trust that we had not so long ago,” he said in a statement.
The court directed that the hospital would pay compensation to Dr Saha, within eight weeks, along with yearly interest of 6 per cent from the date of the complaint. Allowing AMRI to deduct what it had already paid, the court also asked to file a compliance report.
The court has asked two doctors — Dr Balram Prasad and Dr Sukumar Mukherjee — to pay Rs 10 lakh each and asked another doctor, Baidyanath Haldar, to pay Rs 5 lakh to Dr Saha.
Since three doctors, after the NCDRC decision, had already made payment in excess of one fixed by the apex court, the court said that they are entitled for reimbursement from AMRI, which should do so within eight weeks.
The court took several factors into account in fixing the compensation, over the forum’s Rs 1,34,66,000.
Noting an increasing number of medical negligence cases coming before the consumer forums, the court said it hopes this verdict “acts as a deterrent and a reminder to those doctors, hospitals, the nursing homes and other connected establishments who do not take their responsibility seriously”.
Speaking for the bench, Justice Gowda asked the central and the state governments to consider enacting laws wherever needed for effective functioning of private hospitals and nursing homes.”
Citing an earlier apex court judgment holding the right to health a fundamental right guaranteed under the Constitution’s Article 21, the court said doctors and hospitals are to be dealt with strictly if found “negligent with the patients who come to them pawning all their money with the hope to live a better life with dignity”.
“The patients irrespective of their social, cultural and economic background are entitled to be treated with dignity which not only forms their fundamental right but also their human right,” Justice Gowda said.
Since the conduct of doctors is already regulated by the Medical Council of India (MCI), the court said: “We hope and trust for impartial and strict scrutiny from the body”.
It also expressed hope that medical professionals and institutions update themselves about any new developments and rare diseases so as to avoid tragedies such as this case where a life could have been saved with a little more awareness and wisdom on the part of doctors and the hospital.
The tragic story of Anuradha started a month after she reached Kolkata in March 1998 for her summer vacation, when in April, some rashes surfaced on her skin. She consulted Dr Mukherjee who advised her rest.
However, rashes resurfaced again in early May with far greater intensity. Dr Mukherjee prescribed her two doses of Depo-Medrol injection every day.
As her condition did not improve, she was admitted to AMRI and subsequently she was shifted to Mumbai’s Breach Candy Hospital where she was diagnosed to be suffering from life-threatening disease called toxic epidermal necrolysis (TEN). At AMRI, Anuradha was treated by Dr Mukherjee.
TEN, also known as Lyell’s syndrome, is generally caused by a reaction to drugs and leads to the top layer of skin detaching from the lower layer all over the body. It is a more severe form of Stevens-Johnson syndrome.
Anuradha succumbed to her ailment on May 28, 1998. [IANS]
The Supreme Court in 2009 had found AMRI and the doctors guilty of negligence and the case was referred to the NCDRC for the sole purpose of determining quantum of compensation. The NCDRC earlier found no negligence by doctors or AMRI and had dismissed the case in 2006, forcing Dr Saha to approach the apex court.
This is by far the highest compensation in a medical negligence case. Previously, the Supreme Court, in May 2009, had awarded the highest ever compensation of Rs 1 crore to a wheelchair-bound Infosys engineer Prashant S Dhananka for medical negligence in a surgery by Hyderabad’s Nizam Institute of Medical Sciences (NIMS), which damaged his spinal chord.
Dr Kunal Saha, who had claimed a compensation of more than Rs 78 crore for his wife’s “wrongful death”, has reportedly pledged to donate the entire amount to People for Better Treatment (PBT), a voluntary group set up by him in Kolkata to fight against medical negligence and corruption in medical field.
Read the full judgement of supreme court here............. 
Is it time for doctors to pack their bags... 



  2. Well My Friend...Dr Sukumar 1) IS NOT A it is QUACKERY if u knew it was TEN and u still treated it...for several days .......He is a Internist (MD medicine)..That makes him General Practitioner technically he is NOT a Specialist in any faculty...In simple terms a MBBS with a little more knowledge..
    2)He treated the Pt with DEPOMEDROL Inj which is a LONG ACTING STEROID...once. twice and several times during those 15 days period...SO He made a BAD CHOICE by administering Depomedrol...The action will appear after 1-2 weeks...and then if he wanted a QUICKER action he should have chosen a FASTER and QUICKER steroid like PREDNISOLONE, DEXAMETHASONE etc.....HE DID NOT KNOWN HIS PHARMA well....
    3)He called Dr B Haldar a Veteran Dermatologist LATE in the the time Dr Haldar came the Pt was in Septicemia...
    4)A Patient on High dose may GO into Septicemia UNTIL a Dermatologist is ALERT and experienced enough to Patient WILL be AFEBRILE, and ONLY TACHYCARDIA and leucocytosis will indicate Septicemia...which they clearly failed to detect...
    5)TEN is a autoimmune condition probably treated with STEROIDS BUT in such a Situation with WEALTHY or RICH Patients INTERFERON or IMMUNOGLOBULINS are administered, which were NOT advised so the treating doctors were NOT updated in their Knowledge.
    6)TEN is treated on the Line of BURNS and Fluids are to be replenished..WHICH were restricted in this case..
    7)SO The Patients died of a DRUG INDUCED T.E.N. Complicated with Steroid Induced Multi-organ failure and Dehydration in my opinion...Though I am several years Junior to Dr B Haldar and hold him in high ...The Law does not have such respect if u ARE not updated..
    8)Dr SAHA IS AS MUCH RESPONSIBLE for his wife's MURDER ...because HE is NOT A DOCTOR and has he was busy creating VIP scenario he should have taken his wife to a DERMATOLOGIST right from beginning....SO WHAT PEOPLE DO IN US...even a normal US citizen known which doctor to look for and NOT go to the person who has LONGEST Q art his house...
    9)Lastly IT IS SHEER BAD LUCK in case Dr HALDAR..because he DID NOT HIRE a Good Lawyer..If HE WAS ALREADY given a botched up Pt he had little to do..He should have made this clear to the Hon'ble Court...The Petitioner has showed ONLY Greed By asking for More money and wants to show generosity by setting up a charity....The court has NOT taken the case in its ENTIRETY,,,But that is LIFE...

    I am a Dermatologist and have dealt with Several TEN and SJ Syndromes and have Published papers in Various Journals and Am a Head of Deptt and EDITOR for Several International Journals...
    I hope Medics LEARN that KNOWLEDGE is UTMOST and keep urself UPDATED..Don't be ashamed in asking an expert's opinion even if he is JUNIOR to u...My Best wishes and Sympathies to Dr B Haldar and the Cardiologist in this case...

    1. now its 2013 sir , in1998 how and how early TEN could be diagnosed and what were the treatment guiedlines (if any) -obviously of america as we are having nothing of ours.

  3. Dear doctor Saha
    I want to congratulate to for getting handsome amount. I have some queries from you:
    1. During your fight to prevent negligence of valid degree holding doctor's, howmany of the lawyers given you receipt of whatever they charged?
    2.Did the doctors charged extra money from you considering that you are a rich person? I mean to say are the Indian doctors charging more from rich & less from poors?
    3. You fought against the doctors who had license from the council, what about the lakhs of the doctors who does not have any degree & treating crores of Indian people?
    4. It is a stressful profession & you want to discourage the people from joining this profession?
    At last I want to say that
    Apne hi apno par war kiya karte hai
    Gairon me kaha dum tha

    1. i m also agreed to u sir except the last emotional one. Because in India only allopathic medications have side effects others are like amrit ,if any one is giving even allopathy in 20 rupees without degree then pt will be thankful to him and no harm will be expected further deterioration will only be the natural course of disease or a will of GOD contrary to a degree holder who is suspected of harming from the very begining. This should should end and not the excuse for negligence or malpractice but how one can expect that any non medic can understand the complexities and situation of medical proffesion and can judge that what is right and what is wrong especially ,in our countrywhere we can not follow the guidelines of rich countries which are too costly and mostly unavailable.And on the other hand it is expected from a physician to diagnose a rash (i think necrosis at presentation would have been <10% SJS ,otherwise dr saha would have contacted to a dermatologist ) as TEN or to refer every rash at presentation to dermatologist. i m unable to understand the message from this case.Even if u are going for cbc, parachek and tests according to seasonal fevers u r suied as pt will not come to u again. But on the hand u are being taught to get biopsy of each rash in its earliest phase.I think we should take the advantage of American guidelines for treatment and betterment of patients and not their rules which will be decreasing the faith in science based tretments in India which is already lower than bhabhuts of babas and other ways of therapy.Negligence and malprctice should be discouraged and audit system should be started and punishments should also be given when necessary but medical narcissm should be kept in mind.I was very for becoming doctor but now i m afraid of telling me a doctor in public places and many of our seniors and superseniors too becoz of such verdicts ,perhaps public here is not understanding the messages as dr saha thinks .public just generalizes the thing to whole community and consults with decreased faith each time.Lastly I would like to say that neither drug trials nor rules should be imitated from america we should develop our own maintaining the quality as well as faith of patients.