MUMBAI: Can a general medical practitioner without specialized qualification practise as an anaesthetist? Would hands on training be a substitute for requisite qualification? This issue has been decided by the Maharashtra State Commission in a recent judgement delivered on September 26 by Narendra Kawde for the Bench along with Justice A P Bhangale.
Case Study: Hanumant and Jayshree Alkute had admitted their five-year-old daughter Shruti to Pune's prominent Ruby Hall Clinic run by the Grant Medical Foundation, a public trust. The child, who had a past history of renal calculi, was examined by a team of doctors which included a paediatrician, an endocrinologist and a urologist who concluded that she would require a surgery for removal of kidney stones.
The operation was performed by a qualified urologist, with Dr Rusi Nariman Marolia acting as the anaesthetist. Post surgery, the child's heart beats reduced and she became critical. Even though she was put on ventilator, she died due to cardiac arrest.
The parents later discovered that Dr. Rusi Nariman Marolia was not a qualified anaesthetist. They filed a complaint before the Maharashtra State Commission alleging negligence on the part of the hospital and its doctors. The complaint was contested. The hospital and its doctors stated that a medical committee from Sassoon Hospital had been constituted to report on the cause of the death. It was admitted that Dr Rusi Marolia did not have any degree or qualification in anaesthesia, but he had obtained knowledge and expertise in surgical anaesthesia while working as a Resident Doctor in Sassoon Hospital from August 1966 to January 1969. Subsequently, since 1975, he had been practising as an anaesthetist at Ruby Hall Clinic.
In view of this the Committee had opined Dr Rusi Marolia could had requisite training and experience to practice as an anaesthetist. It was also contended that there was no finding of medical negligence in the post mortem report. They sought a dismissal of the complaint.
The State Commission found that despite Dr Rusi Marolia having only an MBBS qualification, was appointed by the hospital as an anaesthetist. This was in breach of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, which prohibit an unqualified person from practising in a field in which he had not have the requisite qualification. It was also in contravention of the law as interpreted by the Supreme Court in the case of Poonam Verma v/s Dr Ashwini Patel where unqualified persons were held to be quacks and charlatans. The Medical Committee's observation that Dr Marolia could practice as an anaesthetist was trashed by the state commission as being contrary to law and its interpretation by the Supreme Court.
The state commission concluded that the administration of anaesthesia by Dr Rusi Marolia without having the requisite qualification was by itself sufficient to establish negligence. The Bench of Justice Bhangale and Kawde directed that their order be sent to the Indian Medical Council as well as the Maharashtra Medical Council for suitable action against Dr Rusi Marolia.
The state commission exonerated the other doctors, but held Dr Marolia and Ruby Hall Clinic jointly liable for negligence. It ordered them to pay a lumpsum compensation of Rs 10 lakhs to the parents of the deceased child, and an additional amount of Rs 80,000/ for expenses and litigation costs. It was directed that compliance of the order should be made within 45 days, else the amounts awarded would carry interest at 9% for the period of delay.
Conclusion: In spite of spending huge amounts on health care, hospitals compromise on patient safety by deliberately appointing quacks and letting them treat unsuspecting patients. This is a growing menace which requires to be curbed.