Botched surgeries to fake papers: Despite 13 complaints and 4 adverse orders, South Delhi clinic got away lightly
Two of the four cases involved botched surgeries that resulted in the deaths of patients.
9 min read
Last week, Dr Agarwal, his wife Pooja, Dr Jaspreet Singh and lab technician Mahender Singh were arrested for allegedly performing and allowing surgeries without requisite medical degrees at the clinic. Much before police uncovered the fake clinic racket in south Delhi, at least 13 complaints had been lodged with the Delhi Medical Council (DMC) against Aggarwal Medical Centre. The council had indicted owner Dr Neeraj Aggarwal and doctors associated with his clinic in four of these cases. Two of the four cases involved botched surgeries that resulted in the deaths of patients.
Last week, Dr Aggarwal, his wife Pooja, Dr Jaspreet Singh and lab technician Mahender Singh were arrested for allegedly performing and allowing surgeries without requisite medical degrees at the Greater Kailash-I clinic. The police said while the doctors had MBBS degrees, only Dr Singh had a Master of Surgery (MS) degree. However, they said, he never performed any surgical procedures and would just create fake notes to validate the operations. The police said Dr Aggarwal had earlier worked at Safdarjung Hospital.
The earliest of the 13 complaints against the clinic dates back to 2011, raising serious questions about the oversight system. A scrutiny of DMC records by The Indian Express points to three significant loopholes — revealing how the clinic exploited them and continued to run its operations.
First, the Nursing Home Cell under the Delhi government’s Directorate General of Health Services — which grants licences to medical centres and hospitals, and can take action in case of complaints of medical negligence — did not suspend or cancel the clinic’s registration despite a November 2014 order by the DMC urging the Cell to take “stringent action” against the clinic for “illegalities and shortcomings”.
Second, laxity by the police in reporting complaints regarding loss of life due to alleged medical negligence. As per procedure, the police must seek DMC’s medical opinion before taking action in cases of medical negligence. According to the DMC, five complaints lodged between 2021 and 2023 that involved patients dying following a stone removal surgery or a C-section were forwarded by the police just last week.
“Five cases since 2021 were reported together by police to us right now (last week). Why were the complaints not forwarded earlier? All complaints of medical negligence should come to us. Police cannot take action in such cases on their own,” said DMC Registrar Dr Girish Tyagi.
Third, records show the clinic received mere slaps on the wrist by the DMC in multiple medical negligence complaints. Of the 13 complaints against the clinic so far, the DMC has passed orders in six. Of these, the clinic’s doctors were found negligent in four complaints. However, the DMC refused to term the fifth complaints as “negligence” due to shortage of medical care during the Covid pandemic.
As punishment in the four cases, the DMC, which includes prominent city doctors, struck off Dr Agarwal’s name from the medical register twice — for 90 days in 2018 and for 30 days in 2019. Doctors cannot practise medicine while their names are not on the medical register.
Earliest signs of malpractice
One of the first malpractice complaints against the clinic was filed in 2011. An MBBS doctor who claimed to be a gynaecologist had referred a patient of hers to the clinic in November 2011. At the time of the referral, the 26-year-old patient was bleeding profusely after an allegedly botched abortion performed after the legally permissible 20-week limit by the referring MBBS doctor. The abortion had led to a ruptured uterus, ruptured bladder and abdominal bleeding. While the treatment provided at the clinic thereafter was as per norms, the clinic failed to provide the DMC with the patient’s medical records, including her consent form.
In his statement to the DMC, Dr Aggarwal said all medical records in the November 2011 case were with the police and that the clinic did not maintain copies. His statement added that neither could he recall the names of the doctors who had treated the patient, nor could he provide records of the fee paid by the clinic to visiting doctors.
Dr. Neeraj Aggarwal, the owner of Aggarwal Medical Centre, who earlier worked as a general physician at the Safdarjung Hospital garnered patients by referring them to his clinic.
As punishment, the name of the referring doctor was removed from the medical register for six months. Though the disciplinary committee suggested the removal of Dr Aggarwal’s name from the medical register for 30 days for being “highly unprofessional” and “not following medical ethics”, the larger council let him off with just a warning.
One recent complaint against the clinic states that a “Dr Pooja” conducted medical procedures. The recent show-cause notice from the Nursing Home Cell states that there is no doctor or nurse named Pooja at the clinic. The only Pooja connected to the clinic is Dr Aggarwal’s wife.
Botched surgeries and the quantum of punishment
Besides this, there seems to be no consistency in the quantum of punishments awarded in six of the cases against the clinic.
A 35-year-old woman went to the clinic in 2016 for the removal of gallstones, with doctors suspecting that she was suffering from gall bladder cancer. The patient bled out and died after the surgery at the clinic. In its 2020 order, the DMC said excessive bleeding and the need for blood transfusions could have happened only due to an injury during the surgery. The committee, which included field experts, added that general anaesthesia should have been used instead of spinal anaesthesia. The committee also noted that the gall bladder was not sent to a laboratory to test for cancer. As punishment, the DMC removed the names of the surgeon, Dr Aneesh Lal, and the anaesthetist — Dr Aggarwal’s father — from the medical register for seven days.
Dr Aggarwal’s name was removed from the medical register for 30 days for issuing a fabricated medical certificate in 2018 to a person accused in a court case. Though the “medical certificate” advised a 26-day rest for back pain and spasm, it did not suggest any investigation or include a treatment plan. To support his claim before the DMC, Dr Aggarwal also provided fabricated prescriptions. His stamp on the certificate stated “MD Safdarjung Hospital”, even though he no longer worked there.
No punishment was awarded to the clinic’s doctors after a 27-year-old suffered from a ruptured uterus and infection following a complicated C-section in 2020. Although the baby was delivered safely, pieces of placenta left inside the mother caused an infection that rendered her sterile. The DMC noted that the patient had a history of the placenta adhering to the uterus wall, leading to complications like bleeding. It also noted that while the surgery was performed due to an emergency, the clinic was not equipped to handle such a complicated case and that a general surgeon lacking expertise in such cases operated on the patient instead of a gynaecologist. The patient’s inability to access medical services at other clinics due to the pandemic was the only reason why no punishment was awarded. “In Covid-19 pandemic, this life saving surgery can be justified,” the DMC noted in its order.
The highest quantum of punishment — 90 days — awarded to Dr Aggarwal was in connection with a 2018 case. The patient died due to uncontrolled bleeding in the stomach due to a tear in the uterus wall after a C-section. The DMC said such a tear is rare but possible so cannot blame the doctor. But, the bleeding should have been detected with close monitoring.
At present, seven cases against the clinic, mostly connected to stone removal and C-sections, are pending before the DMC. While the DMC has no power to take action against a medical institution, why did repeated complaints not set alarm bells ringing?
DMC Registrar Dr Tyagi said, “Most cases are spread over several years. If there are a few complaints against a centre over several years, we cannot say that it is a bad medical institution.”
Dr Arun Gupta, DMC president, added, “The DMC’s purview is to look into cases of professional misconduct and punish the doctors accordingly. We have done what is our mandate — we have punished the (owner) doctor thrice and another one from the clinic once. Only the Directorate General of Health Services can close a clinic.”
Repeated calls by The Indian Express to Dr Vandana Bagga, the Link Officer for the Director General of Health Services, did not receive any response.
To a query on the quantum of punishments, Dr Gupta said, “There is no maximum punishment mentioned as per the law. The quantum of punishment is decided on a case-to-case basis by the committee, depending on the facts.”
Sources said the maximum punishment for misconduct is permanent removal from the medical register. This punishment was exercised by the Medical Council of India and the DMC in case of Dr Narendra Gupta, accused of sexual assault in the United States. A Delhi-based doctor’s name was removed for five years for repeatedly issuing false medical certificates without having any medical facility to carry out tests or procedures, sources said.
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