A WEEK after Max Super Specialty Hospital in Delhi’s Shalimar Bagh erroneously declared a 22-week-old premature baby dead, the Delhi government Friday cancelled its registration. The hospital had come under the scanner on December 1 after it handed twins — one of them stillborn — to the parents in polythene packets, declaring that both were dead. On the way to the crematorium, though, the family found that one was alive. The child was rushed to a nursing home, where he died Wednesday.
The government had formed a three-member expert committee to probe the incident. After the panel found that “prima facie”, there was “gross medical negligence on part of the hospital authorities”, the Director General Health Services (DGHS) cancelled the hospital’s registration.
The decision was criticised by top specialists in the capital who said it was against existing medical protocols. Dr Alka Kriplani, head of obstetrics and gynecology, All India Institute of Medical Sciences (AIIMS), told the Indian Express that current protocols for a 22-week foetus, which weighs less than 500 grams, can “only be termed as an abortion and there is no requirement to resuscitate because the chances of survival are negligible”.
“With time, the protocol keeps changing. Initially, it was considered that we could save a child at 28 weeks. However, when in the US, there were cases were a baby weighing 500 grams could be saved at 22 weeks, we had to change the definition. But in a majority of cases, even at AIIMS, 26 weeks is the earliest at which we could save a baby. Even if it’s put on ventilator, a 22-week premature baby cannot be saved,” Dr Kriplani said.
Delhi Chief Minister Arvind Kejriwal said, “We do not want to interfere in the functioning of private hospitals. However, we won’t tolerate open loot and criminal negligence. In the field of education and health, we are very sensitive. And our government is upgrading government hospitals and setting up mohalla clinics and polyclinics.”
Officials said that the hospital, which was registered in September 2011 and caters to over a lakh patients per year with a 250-bed capacity, can no longer admit new patients in its in-patient and out-patient departments with immediate effect. The patients already admitted will continue to be treated or can be “transferred/shifted to another hospital of their choice”.
Apart from the findings on the death of the newborn, DGHS Dr Kirti Bhushan stated in the cancellation order that the hospital had violated norms for treatment of patients from economically weaker sections. Further, the DGHS said that during the dengue outbreak, beds meant for fever patients were used for non-fever patients.
“DGHS constituted a committee comprising senior doctors to inquire into the said incident (death of the newborn) and the said committee in its report concluded that the hospital has not kept any proper temperature and vital… record of the period of comfort care provided to the live male newborn,” the DGHS order stated.
The DGHS also said the nursing staff were “at fault” as they had “handed over the bodies of the newborns without any written direction from the paediatrician and had also missed signs of life in the male newborn while handing over the body to the attendants”.
The order stated: “The (three-member) committee also concluded that the hospital has entered the name of live male newborn baby in the still birth register… It also opined that the dead newborn and a live newborn should have been kept and managed separately… On the perusal of the report….a prima facie case of gross medical negligence is found on the part of hospital authorities.”
In a statement, Max Healthcare said: “We have received notice of cancellation of the license of Max Hospital, Shalimar Bagh. We strongly believe that this ruling is harsh and that we have not been given an adequate opportunity to be heard. We believe that even if there is an individual error of judgment, holding the hospital responsible is unfair and will severely limit the ability of patients to access treatment. This will compound the shortage of hospital facilities in the National Capital. We will explore all options available to us. We stand firmly behind our commitment to patient care, clinical and service excellence to the best of our capabilities.”
On November 22, the hospital was issued a showcause notice for its handling of EWS patients and the dengue outbreak. On November 27, the hospital replied to the notice, which, as per the order, was found to be “unsatisfactory”.
Delhi Health Minister Satyendar Jain said, “What has happened is not acceptable. We have earlier also issued notices to hospital for violating EWS norms. The Delhi government has decided to cancel the licence of Max Hospital, Shalimar Bagh. The hospital has been found guilty by the expert committee. As far as action against the doctors is concerned, the Delhi Medical Council is the competent authority to take any action against them.”