Two years after the death of a young 16 year old girl RavinaRodrigues, due to the sheer negligence of doctors who botched up a simpleappendicitis operation, the charge sheet has been filed against three of them.Two of them are government doctors at GMC, who brazenly defied the Goa MedicalPractioners Act of not allowing government doctors to practice privately. TheGoan looks back at the developments leading to Ravina’s utterly avoidabletragic death, but addresses where the problem really lies and what should bedone to prevent one more Ravina dying
In Edmund Burke’s words “For the triumph of evil it is onlynecessary for good men to do nothing.” In Ravina Rodrigues death by medicalnegligence case, a similar pattern may emerge even as chargesheet has beenfiled by Vasco Police in the matter.
16 year old Verna resident Ravina Rodrigues’s death due toan ordinary appendix operation going horribly wrong raises serious questionsabout the way the law protects the noble profession. Ravina was first operatedat Pai Hospital in Vasco. In the 34 page Inquiry Report of the Committee set upby Goa Government to investigate the horrible death, Dr Dilip Amonkar,Professor of Surgery, Goa Medical College says that first Dr. S R Pai, Chairmanof the Pai Hospital called him on July 2, 2010 to give his ‘valuable opinion’in the case of an acute appendicitis case and the very next morning, DrShantaram Surme made frantic calls to him that the patient’s situation hadworsened. Dr Amonkar, who operated upon Ravina assisted by Dr Surme, are bothGovernment doctors. Why then were they at a private nursing home?
The inquiry report formed the crux of the charge sheetagainst the doctors. This assumes significance since this is the first everdirect indictment, pending trial of government doctors, on two counts “Flouting laws to conduct private practice and sheer medical negligence.
Chargesheets filed against Drs Dilip Amonkar, ShantaramSurme, both working at GMC and Dr Sridhar Pai, running Pai Hospital at Vaddem, isturning more into a case of crime than just a mere flouting of government rulesthat prohibit government doctors from private practice, or doctors criminallyneglecting a minor’s well-being. Charges have been filed under Sections 304,468, 471,201 read with 34 IPC later as the case was put up in children’s courtsection 8 II of Goa Children’s act pointing out to a case more coldlycalculated and criminal than just accidental and routine.
The Inquiry Report was clear about the malpractice ofprivate practice. The report mentioned “In order to curb private practice bygovernment doctors, wider consultations with stake holders may be held tosuggest steps to be taken in this regard including stringent legal provisions”.But despite Ravina’s death, the State’s health machinery took no cognisance ofthe same. The Goan investigations reveal that Pai Hospital is the perfectexample of private-government collaboration of the unholy kind. While Dr Surme,a qualified obstetrician and gynaecologist is known to be having twoout-patient clinics in Vasco and Sada, his prescription proclaims that he is anexpert in Ear, Nose and Tongue. His clinic overflows with patients till 11 pmat night. While his battery of lawyers gear up to bail him out, Dr Surme canderive satisfaction from the fact that Pai Hospital has senior consultants fromover a dozen faculties in GMC including orthopaedics, gynaecology and surgery,operating at Pai Hospital.
The inquiry report mentions that “Dr Surme has admitted toprivate practice and charging fees for the same. Apart from disciplinaryproceedings, the Income Tax Department could be moved to look into if he haddisclosed this income”. Neither the Directorate of Health Services nor GoaMedical College has initiated any move to check Dr Surme or any othergovernment doctor’s source of extra income.
Shockingly, sources in Goa Medical Council revealed that allthe three doctors can still walk away unscathed. “The fault lies with thesystem. Dr Surme was just a general practitioner attending to the patient, DrPai’s Hospital just served as a place where Ravina was operated upon and DrAmonkar was doing a professional service by operating on an acutely sufferingpatient on humanitarian grounds. Mind you, Ravina did not die at that hospitalbut at GMC. Doctors at GMC are at fault and what the Inquiry Report did wassystematically absolve them of any wrongdoing” says the highly placed source.
That brings us to the big issue of why doctors get away andthe course correction the system needs. The Goa Medical Practitioners Act wasintroduced in 2004 to govern the practices of private doctors and lay down acode of ethics. It took five years for rules of this act to be framed whicheffectively rendered the it meaningless till then. Even after that, the Directorateof Health Services has not completed the process of registering private doctorsand establishments. Clearly doctors wanting to look at loopholes to indulge inmalpractices have no worries. The gaps are there on a platter.
The Goa Medical PractitionersAct 2004 makes it mandatory for all private nursing homes and hospitals toregister the names of doctors practicing at their institution. According toSection 3 of the Act no government doctors can be registered with a privateinstitution. How then were doctors like Surme and Amonkar operating in privatepractice? How many more Ravinas will it require to stem the rot in thesystem?
