November 27, 2021 8:29:25 am
Days after the Supreme Court slammed the Gujarat government over awarding ex gratia compensation to kin of those who died of Covid-19, the two major government-run hospitals in Vadodara — the Gujarat Medical Education and Research Society (GMERS)-run Gotri Medical College and hospital and SSG hospital —have begun issuing Medical Certification of Cause of Death (MCCD) documents.
The apex court had directed the state government to include all those who died within 30 days of testing positive as Covid-19 deaths.
GMERS hospital in Gotri has issued 1500 certificates since the outbreak of the pandemic, 60 of which were distributed on Friday, for the death of patients who tested positive for Covid-19 and SSG has handed out 240 MCCD documents and proactively readied 500 certificates for handover, after checking its record books.
The MCCD documents, issued by hospitals so far, have overshot the Covid-19 deaths officially declared for Vadodara district and areas under the Vadodara Municipal Corporation — which was 623 till Friday, which is after an “audit process” introduced in July last year to classify those deaths as Covid-19 deaths in which the primary cause of death was Covid-19.
Preempting the crowds that the hospital is likely to witness, Vadodara’s SSG hospital has formed a committee of doctors and clerks from the hospital to attend to any disputes regarding the MCCD certificates, said Medical Superintendent of SSG, Dr Ranjan Aiyer.
The committee has Dr Jaya Pathak (Department of Medicine), Dr Sangeeta Patel (Preventive and Social Medicine), one officer from microbiology, one clerical staff from medical records department and two medical officers, including RMO Dr Sherabanu Pathan, another doctor, and two clerks.
Aiyer told The Indian Express, “The announcement of the ex gratia will prompt a lot of kin to turn up at the hospital, as not all have got the MCCDs”.
The MCCD is part of a hospital’s clinical record which is not shared directly with patients but, “becomes part of the civic body’s documentation of deaths and is shared with insurance companies to investigate claims raised by the patients”, says Dr Aiyer.
Dr Aiyer further said, “During the pandemic, deaths that were only due to Covid-19 were classified as Covid-19 deaths, as per instructions issued by the bureaucracy. Some were classified as Covid-19 deaths with comorbidities… now with everyone turning up to ask for the MCCD, we have to refer to case files and it is going to be a huge, exhaustive exercise”.
Aiyer added that the hospital will be issuing the certificates in two categories– Form 4 for institutional death of a hospitalised patient and Form 4-A for those, who died in a place outside the institution.
“We are anticipating many such people, who will come for a Form 4-A, whose relatives may have died within 30 days of testing positive but after they were discharged… For this, we have also appointed Professor of Medicine Dr Rupal Doshi to help in disputes,” he said.
Medical Superintendent of the GMERS hospital Dr Vishala Pandya told The Indian Express that the hospital has issued MCCDs for 1500 patients since the outbreak of the pandemic, of which, 60 MCCD certificates were handed out on Friday and 140 other certificates have been kept ready for handover.
At both GMERS Gotri and SSG hospital, the MCCD certificates will be issued for patients who were under Covid-19 treatment at the main hospital as well as for the extended facilities created for the hospitals to manage the inflow of patients, at Atladara Swaminarayan campus and Samras hostel, respectively.
According to Dr Pandya, patients were also asking for RT-PCR reports.
“During the pandemic, we did not conduct RTPCR on all patients. Those who tested positive on Rapid Antigen Tests were immediately put under treatment. We are having a hard time explaining to the relatives that they do not need RT-PCR reports as the MCCD Form 4 or 4A already mentions the same… I have spoken to the VMC to ask them to clarify the same to the officers and the citizens so that there is no ruckus in the hospital”, she said.
Private hospitals also stated that kin of patients, who succumbed during or immediately after Covid-19, are making inquiries for MCCD certificates. A senior doctor from a Covid-19 hospital in Vadodara said, “The whole situation could have been avoided if the rigidity for declaring only Covid-19 deaths without comorbidity had not been in place. This is a complete waste of time for the medical fraternity….”
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