Three years after seven-year-old Harleen Kaur died after her stem cell (bone marrow) donor backed out at the last minute before a scheduled transplant, the State Consumer Disputes Redressal Commission of Punjab held the Christian Medical College and Hospital (CMCH), Ludhiana guilty of MEDICAL negligence in handling the case and ordered it to pay Rs 40 lakh compensation to the family.
“In the present case, the minor daughter aged 7 years of the complainant had died due to medical negligence on the part of hospital to some extent, and the complainant has been deprived of all the love and affection towards his daughter,” the commission said in its order.
However, the complaint against Dr Joseph John, professor and head of department of Clinical Haematology, Haemato-Oncology & Bone Marrow (Stem Cell) Transplantation, CMCH, Ludhiana and Raghu Rajagopal, CEO, DATRI — a Chennai based stem cell donors registry service, was dismissed noting that the doctor and DATRI had “no control” over donor backing out at last minute, adding that stem cell donation is completely voluntary in India under existing laws.
The order was passed on November 14 last year, but the copy of it reached the complainant on April 2 due to shortage of postage stamps. The shortage of postal stamps in Punjab has been been an for the last nine months. Even as 2,500 cases were disposed off by the commission in these months, the copy of orders were unavailable as there were no postal stamps with the commission.
Harleen Kaur (7), a thalassemia major patient since birth, had died on November 4, 2014 at CMCH after her stem cell donor, arranged by DATRI, had backed out from the procedure at the last minute. Harleen’s father, Inderpreet Singh from Mandi Gobindgarh of Fatehgarh Sahib, had then dragged CMCH, the doctor and DATRI to court questioning that who is responsible for her daughter’s death.
The father had alleged that the CMCH doctors, despite having a bone marrow stem cell preservation unit, had failed to preserve his daughter’s cell as back-up (in case transplanted cells were rejected by the body) and that chemotherapy was started when the donors’ cells had not even arrived at the hospital and her own cells were destroyed which led to her death.
The commission in its orders stated that “DATRI cannot force any donor under the law to donate his stem cells”.
Dismissing the complaint against DATRI, orders said, “They tried their best to persuade the donor but they failed. As goodwill gesture, they also paid entire hospital bill amounting Rs 22.15 lakh and also returned Rs 36,000 to the complainant. DATRI is not responsible if the donor refused to donate stem cells at the last moment. Bone marrow transplant is at initial stage in India and voluntary organisations like DATRI are acting as non-profit organisations for welfare of humanity.’ The commission dismissing complaint against DATRI said that it does not want to “hamper or discourage the work being done by such organisations”.
Further dismissing the complaint against Dr John, the commission added, “Merely because the donor did not reach in time and refused at the nick of time, the doctor cannot be burdened as he had no control over the donor…”
However, the commission held CMCH guilty of not preserving Harleen’s own cells. It said:
“The issue arises that hospital authorities had not preserved the bone marrow stem cells of the patient itself, which were preserved in case of one Nishant Madaan. The opposition parties 1 and 2 (hospital and doctor) were required to do so. As stated by them, they have cyro preservation system for extracting cells and preserving the same for use in case of emergency. No reason has been assigned why the cells were not preserved.”
The commission further held CMCH guilty for not having proper ‘HEPA air-filtered bone marrow transplant unit’. “The patient was kept where other patients were also there. Since the immunity level of patient was zero, there would have been proper HEPA air filtered unit for the same. Even no well informed consent has been obtained from complainant’s family and they were not informed about complications, risks etc. Accordingly, we hold there is some negligence on the part of hospital in handling the case,” said the order. Ordering CMCH to pay Rs 40 lakh to the father, it added: “Although no amount of money would be sufficient to compensate the loss of a child, yet we assess the lump sum amount of compensation for loss of love, affection and mental tension, harassment and agony to tune of Rs 40,00,000 along with interest at 9 per cent per annum from date of filing of complaint till actual payment…along with Rs 33,000 as litigation expenses….’
Inderpreet Singh, father of Harleen, “We will be moving to National Consumer Commission now as doctor has been given clean chit without considering the fact that he is the head of department. Who would have saved Harleen’s own cells if not Dr John? We are not satisfied with clean chit given to him.”
A similar case filed by Inderpreet Singh is pending for hearing in a local court of Amloh at Fatehgarh Sahib. The CMCH and DATRI appealed for its stay in Punjab and Haryana High Court for which arguments will be held on May 24.
Meanwhile, Dr Joseph John said the verdict against CMCH is ‘unfortunate’. “It was a rare and first such incident in entire world when donor backed out at last minute. It is not a standard procedure to preserve patient’s own cells. Had I performed the procedure to preserve her own cells and something would have happened to her, then also who would have been responsible? The orders have been passed without any physical verification of our hospital even as we have a proper air-filtered HEPA bone marrow transplant unit,”he said.