A doctor barred from practice by a US court in 2011 now sees patients in Gurgaon and Delhi, underlining how ill-equipped mechanisms governing medical practice in India are to detect such cases. Dr Narendra K Gupta, a specialist in diabetes, hypertension and nephrology, was charged in Georgia with aggravated sexual battery, a felony charge that carries a mandatory minimum 25 years in prison, for allegedly penetrating a patient with his finger during a pelvic exam at his clinic in Atlanta in 2009. He was also charged with two counts of sexual battery for unwarranted breast exams on two patients, one of them only 17.
An investigation by the Atlanta Journal-Constitution has found that at least 15 other women, including colleagues and patients, have complained that Dr Gupta made them uncomfortable, harassed them, touched them inappropriately or subjected them to unwarranted intimate exams. It was also found that he spent three months at a treatment programme for psychosexual disorders at the Timberlawn Institute in Dallas, part of disciplinary action taken by a hospital in Ohio.
Following his indictment by a superior court in Georgia in 2010, a plea bargain was negotiated. He pleaded guilty to three counts of sexual battery — the felony charge was reduced to a misdemeanour — and he was to surrender all US medical licences, leave the country, and “not practice medicine in any form within the United States or any other country”.
Dr Gupta now runs a clinic each in Kamla Nagar in Delhi and DLF Phase IV in Gurgaon, and practises at GNH Hospital, Gurgaon. Asked about his history of misconduct, Dr Gupta said at his Gurgaon clinic, “It’s a 10-year-old story; it’s been settled.” He dismissed the condition that he never practise medicine again, saying: “The court does not have jurisdiction that I would not practise anywhere.”
Dr Gupta claims he has registered with the Delhi Medical Council, though not with the Haryana State Medical Council. To practise in Delhi and Gurgaon, he is required to register with both. DMC president Dr Arun Gupta said registration with the council does not require the submission of any kind of job history. And while the registration form for the Haryana State Medical Council does ask the applicant to disclose “any matter or incident reflecting adversely upon the applicant’s previous character and conduct”; there is no stated requirement to submit records of disciplinary history from previous jobs.
For registration with either state council, a doctor needs a ‘permanent’ registration with the Medical Council of India, which is automatic once a candidate is registered with a state council after his or her MBBS and internship. Indian Medical Register online records show an entry for a Dr Narendra K Gupta registered with the Bihar Medical Council in 1977. The entry does not reflect any history of complaints or disciplinary action against him.
The procedures to vet doctors at GNH Hospital, where Dr Gupta is a consultant, also appear to be thin. Kuldeep Chaudhary, manager of administration, conceded the hospital did not check previous job records or licences in other countries. He declined to confirm if the hospital was aware of Dr Gupta’s history.
Dr K K Aggarwal, president of the Indian Medical Association, said, “NRIs who get convicted in the US or in any other country, or they get chargesheeted, they just resign, come back to India and start practising. We are aware of many such cases. Is that to be taken as a crime in India or not? Council point of view: unless there is a complaint, we don’t bother about what he has done in the US.” He added, however, that “if the council is made aware of a person who is likely to harm society, the MCI can take cognisance”.
Disciplinary action could take the form of a warning, a restriction on practice, or a suspension of registration, depending on the offence, and whether it is a first one, said Dr Aggarwal. The term of suspension, said DMC president Dr Gupta, could vary “from three months to maybe five years” at the discretion of the MCI disciplinary committee. Lifelong cancellation of a licence, he said, was very rare.
Though there are systems in place to handle a complaint, it is “not easy to make a complaint and to ensure justice happens”, said Dr Sunita Simon Kurpad, acting chairperson of an Indian Psychiatric Society task force that has drafted a set of guidelines for doctors on sexual boundaries, which the task force intends to present to the MCI, with the hope that it will incorporate them into its code of ethics. While the code of ethics does include ‘adultery and improper conduct’ in its definition of professional misconduct, Dr Kurpad says the line “doesn’t spell out details”.
Among the 15 guidelines, now on the IPS website, are that doctors should not enter into any romantic or sexual relationship with a patient, even when consensual, and should take a number of precautions when performing intimate exams.
“We felt that this issue [sexual misconduct], though it is rare, is of concern, because even if it’s only a few doctors across India, as in the world, they can be serial offenders,” said Dr Kurpad. “The problem is that unless the MCI changes the guidelines, we can’t hold all doctors accountable to it.”