Fortis Healthcare — Unethical Practices & Careless in treatment

Chief Medical Superintendent,
Fortis Hospital, Sector-62
Noida (Uttar Pradesh)

Dear Sir/Madam

Sub: Unethical Practices and carelessness in treatment at Fortis Hospital, Noida Sector 62

I am a retired Additional General Manager of Bharat Heavy Electricals Ltd., which has empanelled Fortis Hospital for IPD & OPD treatment of its serving and retired employees.

My wife, Asha Sinha, aged 67 years, Fortis UHID No. 363056, who was operated for Ca-breast in December 2019 at Apollo Hospital, is undergoing treatment of Oncologist at Apollo Hospital. A cyst had grown on her right cheek and treating Oncologist advised her to consult a Skin Specialist. Accordingly, we consulted Skin Specialist who advised to get it removed by Surgeon/Plastic Surgeon and biopsy to be carried out to rule out any malignancy. We were advised to contact Dr. Kapil Kochhar of Fortis Hospital for further treatment.

We contacted appointment desk through phone on 30.08.2021 and granted an appointment of Dr. Kochhar for 02.09.2021 at 03.00 PM. We reached hospital at 2.30 PM on 02.09.2021, to be told that the empanelment of BHEL had not been renewed till that day. We contacted our Doctor in BHEL who in turn talked to Mr. Parag of Fortis Hospital. It was informed to us by Mr. Parag that though Fortis had received approval from BHEL, the data was not yet uploaded in its system and therefore billing could not be done. However, he arranged consultation with Dr. Kapil as per the original appointment given to us telephonically for 02.09.2021 on 30.08.2021, even though he did not have the OPD day on 02.09.2021.

After examination by Dr. Kapil, we were told that cyst had to be removed under General Anaesthesia (GA) instead of Local Anaesthesia (LA) and for that Pre Anaesthesia Check-up (PAC) to be done at their Operation Theatre. To our query that could the procedure be done in LA, the doctor advised that it would be better to do the procedure in GA. We were referred to OT where an Anaesthetist recommended Blood Tests, X-Ray and also referred to Cardiologist for his opinion. We got the Blood Tests and X-ray done and consulted Cardiologist on 04.09.2021 who advised to get Stress Echo done for which an appointment was given for 07.09.2021. Stress Echo was done on 07.09.2021 at 12.00 noon and consulted Cardiologist same day at around 3.00 PM with report. After going through the report, the Cardiologist cleared the patient for surgery. Thereafter, we went to Anaesthetist who after going through the Blood Reports, X-ray and Stress Echo accepted the patient for surgery. Dr Kapil, on PAC clearance, fixed 10.09.2021 for surgery in Day Care and advised us to report on 10.09.2021 at 10.00 AM. He further informed that surgery would take place at around 1.30-200 PM and advised not to take any solid food after 6.00 AM on 10.09.2021. He also advised to get RT-PCR test done on 08.09.2021 which was done and report was negative.

Meanwhile patient developed some problem in her ear for which we consulted ENT Surgeon, (whom we have been consulting for years, at Kailash Hospital) on 06.09.2021 who advised Audiogram. We consulted the ENT Specialist again on 08.09.2021 along with Audiogram. He prescribed Steroid along with other medicines. We informed him about the surgery which was scheduled for 10.09.2021. At this, he advised to start Steroid immediately after the surgery but advised to continue taking other medicines.

On 10.09.2021, we reported at Fortis at around 09.30 AM and admission formalities were completed by around 10.00 AM. While submitting all reports in Day Care ward to the Sister present, we also submitted photocopy of the Prescription of ENT Surgeon and told her about the ear issue. She informed that the ENT Surgeon at Fortis would be consulted for further clearance. At around 12.30 PM, we reminded her about ENT clearance. Then she sent the patient to ENT OPD. ENT Surgeon checked all the papers and patient. He confirmed the diagnosis of ENT Surgeon of Kailash Hospital and advised us to take Steroid which is utmost necessary after the surgery. On specifically asking the date by which we should start Steroid as advised by ENT Surgeon of Kailash (the treating doctor for ear) to start immediately after surgery, he informed that Surgeon performing Surgery would tell us.

There was a chaos in OT and the patient was not taken from Day Care for Surgery inspite of our repeated follow up with all concerned right from 01.00 PM in the afternoon onwards. It was informed that the OT is not available and perhaps the surgery could not be performed on that day. It was a total failure of co-ordination between Surgeon and Anaesthetist of OT on one hand and of administration on other hand while the senior citizen patient remained without food and water throughout the day.

Finally, the patient was wheeled in OT at around 6.00 PM. However, she was kept waiting outside till 7.00 PM when supposedly the surgery started as informed by the guard outside. Before, the surgery started, the patient asked to meet Dr. Kapil to inform him about the ear issue. She was informed that Dr. Kapil had left and now Dr. Pawan Kumar Gambhir would perform the surgery. The patient informed Dr. Gambhir about her ear issue – damage to nerve and sought his advice when to start Steroid as suggested by ENT doctor of Fortis. On this Dr. Ganbhir told her to start only after one week of surgery.

At 08.00 PM, we were informed to see the patient in OT. While meeting the patient, Dr. Gambhir was present and when I personally asked him about date of starting Steroid, he told that this had been informed to patient and should be started after a week. Sister at OT told us that the patient had been allotted Room no. 1513 and we should wait there.

At around 09.00 PM the patient was brought in Room No. 1513. The sister in the ward told us not to give anything orally to patient till 12.00 PM in night. She further informed me that the patient would be discharged at 11.00 PM. On asking why the patient was not being kept in hospital till she started accepting water orally, she rang up someone. She finally informed that she would discharge the patient at 11.00 PM but the patient would remain in room till 00.30 AM (11.09.2021) so that she would be under observation for half an hour after giving some water and food at 12.00 midnight. We were told to leave at 00.30 AM thereafter. I informed this to Mr. Parag who also was not in agreement with his staff and informed me that he would speak to them. However, there was no message from him after that.

At around 11.00 PM I was called by sister to clear the bill (20% of total Bill to be deposited by employee before discharge). I went and cleared the Bill. At that time, I was informed by the person who was in Billing Section that we could remain in Room till morning. However, by that time, I had already arranged conveyance & help etc to take us home. The patient was given coconut water, Khichdi and curd at around 12.00 midnight and when she did not have any problem, we left at 00.30 AM, 11.09.2021. We were given discharge summary and were called for follow-up on 13.09.2021 at 03.00 PM at Room No. 2015, the Room of Dr. Kapil OPD.

We reached Dr. Kapil’s OPD on 13.09.2021 at 2.45 PM to be told by Mr. Parminder Singh to go to Room no. 2033. There Dr. Gambhir, who checked the wound and changed the dressing. To our horror, there was no Band-Aid in the Procedure Room and the attendant of patient was asked to bring it. Somehow on 13.09.2021, one small tape was available which was used by Dr. Gambhir. He advised the patient to bring Band Aid on her next visit on 15.09.2021 on which he would remove one and the only stitch. I asked Dr. Gambhir once again about starting of Steroid for ear treatment to which he got annoyed and said once “I told you not to start before Saturday, why are you asking me again and again. It is irritating.” The patient, therefore did not start Steroid. Again on 15.09.2021, when we went, Dr Gambhir did not turn up and informed sister to remove the stitch and ask the patient to come on 18.09.2021.

On 18.09.2021, we went to ENT Surgeon at Kailash Hospital who was very unhappy that patient did not start Steroid and said that due to this lapse, there could be irreversible damage. When we told him that Surgeon did not allow to start Steroid, he further said that the surgery was so small that could have been done in LA and not starting Steroid would affect the ear, probably the damage could be irreversible. We told him that ENT Surgeon of Fortis had also checked. On this, he further said that why the Surgeon and ENT could not discuss among themselves to decide the priority. Though, he gave the treatment yet he is not very optimistic about the result. This has caused anxiety in our mind about the patient’s ear due to careless approach by the Doctors at Fortis.

At the end, I would like to ask the following questions.

1. Why was the appointment for Dr. Kapil fixed for 02.09.2021 when he did not have the OPD on that day?
2. Why was the procedure conducted in GA which could have been easily, and with much less hassles, performed in LA? This would have avoided the complications of not starting Steroid in time. We being non medical professionals, do not understand the implications and go as per the advice of treating doctor. This should have been taken care by the doctors at Fortis. Is the cost of conducting surgery in GA not more than LA besides the cost of tests? Also due to this unethical practice, we have not only incurred extra money but also lot of inconvenience to patient as well as her attendant, both of whom are senior citizens.
3. Why was the date of surgery given for 10.09.2021 when the OT was not available on the date? That shows the lack of co-ordination.
4. We came to Fortis Hospital for expertise of Dr. Kapil. However, he left the hospital as OT was not made available to him and did not perform the surgery. Why was this situation and why did hospital not inform us before hand?
5. Why was the patient initially planned to be relieved by 11.00 PM on 10.09.2021 without observing whether patient had accepted water?
6. Why was the patient asked to leave hospital at 00.30 AM on 11.09.2021 i.e. at dead of night?
7. Why did Dr. Kapil not attend the patient even after surgery on 13.09.2021 when patient visited on follow-up? She was asked to report to him only.
8. Is patient required to carry necessary bandage items when goes for dressing change? It depicts ugly side of Fortis who charges hefty bills for a small surgery.
9. Why was there no co-ordination between Surgeon and ENT specialist of Fortis to decide about starting Steroid? Who will be responsible for damage to ear, if there is any?

I expect you to investigate the entire incident and take necessary action under intimation to undersigned.

Warm regards

ALOK SINHA
D-2/802, Plot-11, Golf City
Sector-75, Noida
Moblie: [protected]
Email: asinha.[protected]@gmail.com