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Gujarat Patients' Death Over Unnecessary Surgeries: Why Ayushman Bharat Is to Blame

A newspaper has reported that an inquiry has found that the percentages of blockage in arteries shown in the medical reports of the hospital were higher than what the footage of the procedures revealed.
Representative image of doctors performing surgery. Photo: sswain_1999/Flickr, CC BY 2.0
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New Delhi: In what appears to be the latest in a series of incidents in which patients are taken in for unnecessary surgeries so that healthcare providers can pocket health insurance money, two Ahmedabad patients died this week due to botched angioplasty at a Gujarat hospital. Investigations have revealed that the surgeries had been planned when the blockage in their arteries was insufficient and did not warrant insertion of stents.

According to The Indian Express, the Gujarat police has lodged a first information report against two doctors of the hospital and its CEO, along with two others associated with it.

Khyati Multispeciality Hospital, where these surgeries were performed, will now be de-empaneled from the Pradhan Mantri Jan Arogya Yojana’s Ayushman Bharat Scheme. Under this scheme, the money for surgery is paid by a private health insurance company. The premium for health insurance is paid by the Union and state governments. Both patients had been beneficiaries of the Ayushman Bharat scheme.

The newspaper has reported that an inquiry has found that the percentages of blockage in arteries shown in the medical reports of the hospital were higher than what the footage of the procedures revealed.

For example, one of the deceased patients, was reported by the hospital as having had a 90% blockage while the footage revealed it was only 30-40%. Another artery had no blockage at all, as against the hospital report’s claims of 80% blockage.

In case of the other patient, the FIR states percentage of blockage differed in the different portions of left anterior descending artery (LAD). The LAD is the largest artery.

The hospital claimed that there was 90% blockage in the LAD, while the footage revealed it was 50-80% in two different segments. The right coronary artery had no blockage but the hospital report claimed it had 90% blockage.

An angioplasty (a procedure involving insertion of stents) is preceded by angiography (investigation performed to know how much blockage has happened). On request of patients, a hospital can provide a compact disc of the angiography as well. This footage is usually referred to in post-operative enquiry for medical or other purposes.

Also read: Treatment for the Dead, Discharge Before Surgery and the Many Problems of Ayushman Bharat

Apart from these two patients, five others belonging to the same village, according to the police, had undergone angioplasty. They have been shifted to another hospital of the city for post-op care. All of them had been identified by the hospital during a health check-up camp organised in their village.

The Gujarat police has recommended that the Gujarat State Medical Council suspend the licence of the doctors. It is only after the medical council’s action that the doctors concerned could be barred from treating patients.

A similar scam took place in Bihar in 2012 when 703 women lost their uterii to unnecessary surgeries done by hospitals which had been empanelled under the then Rashtriya Swasthya Bima Yojana, another health insurance scheme for which the premium was paid by the Union and state governments.

The FIRs were lodged by district magistrates of the concerned districts. However, even four years after the registration of FIRs, the Bihar State Medical Council has failed to take action even against one accused doctor.  

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