ISLAMABAD: A complaint filed with the Islamabad Healthcare Regulatory Authority (IHRA) over the death of a patient on the operation table has put a question mark on the health system of Pakistan besides exposing the cruelty and non-professionalism of health professionals.

According to the decision of the IHRA on the complaint, the patient twice suffered a heart attack while undergoing an operation on his ankle at a private hospital in Islamabad, but the team of doctors continued with the operation. It may be mentioned here that the hospital had charged Rs250,000 from the family in advance.

The complaint said the doctor who gave the anaesthesia was not qualified to do so.

The IHRA has imposed the maximum penalty of Rs1 million on the hospital and Rs500,000 on the doctor who had administered anaesthesia to the patient. Moreover, cases of both the doctors have been referred to the Pakistan Medical and Dental Council (PMDC) for further action.

Cases against doctors referred to PMDC for further action,says IHRA chief

IHRA Chief Executive Officer (CEO) Dr Quaid Saeed while talking to Dawn said it was one of the most shocking cases that he witnessed in his life.

According to the IHRA decision, copy of which was available with Dawn, Mohammad Sajid, 54, was admitted to the hospital on July 11, 2023, for the treatment of a fracture and dislocated lower right leg.

“All we received was a prescription via WhatsApp that directed us to get the patient admitted as soon as possible. Out of all the pre-op requirements, tests included an echo and ECG which the hospital did not provide on their premises. We were advised to go to another private hospital to get the tests conducted. As per the report, it was probably an abnormal ECG, but despite that Mohammad Sajid was shifted to the operation theatre at 11:30am on July 12. My mother, uncles and a couple of my father’s friends waited patiently outside,” Hamza Sajid, 24, the son of the deceased, said in his statement to the IHRA.

He said the doctor’s personal assistant called him to the surgeon’s room and said his father had suffered a cardiac arrest. He alleged that there was no cardiologist in the hospital but doctors shifted the patient to the Intensive Care Unit (ICU) and later a cardiologist was called in, but the patient could not survive.

The IHRA chief said: “I personally heard the case of Mohammad Sajid who visited Baku (Azerbaijan) on family vacations and had a small fracture in his ankle. Doctors applied plaster and suggested the family to get the fracture operated in Pakistan. It was unfortunate that the doctor did not bother to meet the patient and examine him. They directly called the patient for the operation and their first interaction was at the operation table.”

He said the patient was suffering from deep vein thrombosis (DVT) as plaster was applied on his foot for almost a week and in such cases blood stops flowing.

“The patient should have been treated for DVT before conducting the surgery and giving him anaesthesia. However, as doctors had received Rs250,000, they decided to operate upon the patient. The doctor who gave anaesthesias had just an MBBS degree and was not qualified to give anaesthesia,” he said.

“During the hearing, I was shocked to know that the patient had a heart attack twice but the doctors got him recovered and started the procedure and then the patient had a third heart attack. Finally he was shifted to the ICU. Though they claimed that the patient was put on a ventilator, I doubt it,” he said.

“The IHRA has imposed the maximum penalty of Rs1 million on the hospital and Rs500,000 on the anaesthetist. We have also referred the case to the PMDC to take action against the doctors,” Dr Saeed said.

The son of the deceased told Dawn: “My mother and nine-year-old sister are still in shock and we don’t believe what has happened to us. I will also contact the PMDC to cancel the licences of the doctors because of negligence. I wanted to shift my father to some other hospital but they did not allow me,” he said.

However, according to the decision, the surgeon replied to IHRA that Mr Sajid was suffering from bimalleolar fracture of the ankle and was admitted through his family friend, who was also a doctor.

“I did not examine the patient in the initial go because the patient was referred by the doctor and had shared his radiograph via WhatsApp with my assistant. They said the patient was in pain and difficult to get mobilised for consultation at my clinic. History and fracture were straight forward; all pre-work up was done. The pre-operative assessment was done by a doctor in the recovery room. His pre-operative tests were carried out along with cardiac evaluation,” he said.

The surgeon said the patient had a history of chronic hypertension along with obesity. He said the patient was stable in the early phase of surgery but during the procedure he collapsed suddenly and there was no pulse. He said later the patient was revived and the procedure was started again, but the patient collapsed again.

PMDC Registrar Dr Azhar Ali Shah said the council had not received a complaint from the IHRA. “Once it is received, it will be sent to the legal branch for comments before the start of formal proceedings,” he said.

Published in Dawn, October 4th, 2023