The West Bengal Clinical Establishment Regulatory Commission on Thursday asked a private hospital to pay compensation to an elderly woman who was billed ₹2.86 lakh for the treatment of a cut on her forehead.
A second hospital, too, was asked to pay compensation for billing for 58 litres of water in 22 days and physiotherapy for a patient who was in a coma.
Cut on forehead
A 80-year-old woman fell in her home and suffered a cut on her forehead that led to profuse bleeding, the chairman of the commission, retired judge Ashim Banerjee, said.
“The family took her to CMRI. The patient had a health insurance coverage of ₹1.5 lakh. The hospital gave an estimate of ₹2.1 lakh, to which the family agreed because they did not want to take her to another hospital, given her condition. Ultimately, they were billed ₹2,86,324, which included ₹1,18,000 for a surgical procedure. A plastic surgeon performed the procedure,” the chairman said.
The hospital said the patient was given renal anaesthesia, he said.
“The patient’s son said she was administered local anaesthesia to stitch the wound. There was no need to call a plastic surgeon. Doctors working for the commission told us she could have been taken to the Emergency ward of any hospital to get the wound stitched,” Banerjee said.
“Insurance covered only ₹76,154 and the rest had to be paid by the patient. We have asked the hospital to return ₹80,000 to the family,” he said.
Hospital reaction: When contacted by The Telegraph, a CMRI official said: “We are looking into it.”
Coma patient
A patient who was in a coma for 22 days at Manipal Hospitals, Mukundapur (formerly AMRI Hospitals, Mukundapur), was billed more than ₹9 lakh, the commission said. The hospital gave a discount of ₹44,000.
The family shifted the patient to a government hospital as his condition did not improve even after 22 days and they could no longer bear the expenses at the private hospital, the commission said.
The family lodged a complaint with the commission alleging billing discrepancies at Manipal Hospitals, Mukundapur.
“The patient, in a vegetative state (coma), was billed for 58 litres of mineral water. The hospital tried to justify that by saying medicines were often administered to the patient by dissolving them in water. But the hospital could provide no logic for the use of 58 litres of water in 22 days,” the commission chairman said.
“The patient was charged for treatment by an RMO (resident medical officer) for three days. If admitted to hospital, RMOs and nurses are the basic necessities and the patient can’t be billed for their service,” Banerjee said.
The chairman said the patient was billed for 13 visits by an anaesthetist. The fee for each visit was Rs 1,500.
The patient was also separately billed for the services of an anaesthetist who assisted the surgeon in the operating theatre.
The family was told that the services of the other anaesthetist (the one who visited the patient 13 times) were required as he has specialisation in neuro anaesthesia.
“Since the patient was in the ICU, his services were required. But we could not find any prescription of the anaesthetist, so we have disallowed that charge,” said Banerjee.
“The fourth charge which we have disallowed related to physiotherapy. There were 20 physiotherapy sessions and each cost ₹1,370. But the patient developed a bed sore. So, how did a patient in a coma require 20 physiotherapy sessions? We have asked the hospital to pay ₹48,840 to the patient,” said Banerjee.
Hospital reaction: Manipal Hospitals refused to comment.
Death after fall
A 76-year-old woman who was due for discharge from Manipal Hospitals, Broadway (formerly AMRI Hospitals, Salt Lake), allegedly fell while trying to use a commode chair, said the commission chairman. She later died in the hospital.
Banerjee said that although the order was not issued on Thursday, it was a case of negligence and the hospital would be asked to give monetary compensation. The order was pending as the hospital had asked for a day’s time, the chairman said.
“The 76-year-old woman was treated for comorbidities and the hospital decided to
discharge her. She had asked for a commode chair,” Banerjee said.
“The hospital said the woman sat down while trying to use the commode chair and the hospital denied any head injury. After two hours, she had excessive hypertension, haematoma and had surgery. She died on June 17,” said Banerjee. “The post-mortem report says the head injury was the cause of death.”
Banerjee said the hospital sent a CD to the commission where a female voice is heard telling the patient why she sat down.
“In response, the patient sounds apologetic. She said she fell on her own… her nature’s call was so strong that she did not want to soil the bed…. The record shows the haemorrhagic shock aggravated perhaps after two or three hours. This was a private space and there couldn’t have been any CCTV camera. The fact that a video on a mobile was recorded… it was done with a purpose,” Banerjee said.
“A commode chair is usually not there beside the bed. She had asked for it and the hospital staff should not have left while she was using it.... The bed has guard rails and a patient of that age couldn’t have removed the guard rails on her own to use the commode chair. So there was negligence,” said Banerjee.
“The hospital said it was a sad incident. We are not satisfied by their explanation and we have said this will require monetary compensation,” said Banerjee.
Hospital reaction: Manipal Hospitals refused to comment.
Commission’s advisory: Hospitals should give a patient’s health update to the family on the registered mobile number or through an email, said the commission chairman.
“This should be done every day for critical patients and alternate day for others. It will contain details of diagnosis, prognosis, medication and investigation results. It will reduce the number of complaints by patients’ families... and narrow down the scope of grievances,” Banerjee said.
