Over the short period of less than a month, two shocking incidences took place in Indian medical jurisprudence that may or may not be linked with each other but that will certainly have major implications in spread of medical education and healthcare delivery system across the nation. In the first incidence which surprisingly remained unreported by the media, the long-lasting criminal case against Dr. Ketan Desai, ex-MCI president and most well known corrupt medical leader who was caught red-handed by CBI in 2010 allegedly for taking a huge bribe from a private medical college, was freed by the Patiala House Court, New Delhi after CBI submitted that Gujarat government declined “sanction” to prosecute Dr. Desai. “Sanction” (under CrPC Section 197) is a purely technical and routine legal process that may be obtained from the authority before prosecution of a allegedly corrupt public servant. Supreme Court of India has repeatedly held that “sanction” may not be even necessary before prosecution of a public servant involved with corruption. It is also a puzzle why CBI went to Gujarat government, instead of the central health ministry, seeking “sanction” when Dr. Desai was apprehended for taking bribe as MCI president. PBT president, Dr. Kunal Saha, had West Bengal Medical Council president and several members indicted for “criminal conspiracy” (under IPC section 120b) in 2001 and Calcutta High Court categorically dismissed the same plea of “sanction” adopted by the accused doctors.

The second major incidence took place last month, which was also widely reported by the media, involves BJP government’s abrupt move to dissolve entire MCI and replace it by seven hand-picked doctors (“Board of Governors”) by passing an “Ordinance”. The government has made a bogus plea that since the proposed National Medical Commission (NMC) Bill is likely to be approved soon and since the 5-year term of the elected members of the present MCI would expire soon, MCI is no longer needed. But what would happen if the proposed NMC Bill fail to be passed in the parliament soon? Also, government was well aware for a very long time that the regular term of the present MCI members would expire in late 2018. Why the health ministry did not make any plan in a democratic manner to hold election in time to replace the present MCI members? Instead, they now make this untenable claim that since the present MCI members’ term would end soon, entire MCI must be replaced with a few doctors chosen by the government. The MCI website has been down since this shocking disbandment of MCI. PBT is also deeply concerned about what is going to happen with the victims of medical negligence whose complaints are currently pending before the MCI Ethics Committee. But PBT and ordinary people of India are mostly concerned to imagine whether the two strange and major incidences last month are orchestrated by the one and same corrupt doctors and unscrupulous political leaders in India.

A Judge in the “Special Court” in Barasat, West Bengal created for delivery of expedited justice for criminal complaints pending against corrupt and unscrupulous MLAs and MPs issued charge-sheet under Indian Penal Code (IPC) Section 120b (criminal conspiracy) and Section 500/501 (criminal defamation) against Dr. Nirmal Maji, sitting West Bengal Medical Council (WBMC) president and a powerful MLA of the ruling Trinomul-Congress (TMC) party in West Bengal, and fixed December 1, 2018 for further proceedings of the trial (see news below). This unprecedented criminal case started last December after PBT president, Dr. Kunal Saha, lodged allegations against Dr. Maji for making untrue and slanderous attacks against him following publication of reports regarding Dr. Saha’s complaint to the Medical Council of India (MCI) against Dr. Maji for his role in planning to perform dialysis of his pet dog at the SSKM Hospital, a premier tertiary-care government hospital in Kolkata putting the lives of countless innocent patients at serious risk of contracting new “zoonotic” diseases. Ironically, everybody from the medical community including the Indian Medical Association (IMA) and Mamata Banerjee-led state government in West Bengal remained absolutely silent against the brazen and potentially harmful activity by Dr. Maji until PBT lodged a formal complaint with the medical council demanding cancellation of medical registration of Dr. Maji for his unethical action. A separate criminal complaint against Dr. Maji alleging extortion of funds from the state medical council will be heard by the same court in Barasat next week.

Sanmarg (Sept. 16, 2018)

In a remarkable demonstration of delivery of medical justice, Medical Practitioners Tribunal Service (MPTS), highest legal tribunal to adjudicate complaints of medical and ethical violations against doctors practicing in United Kingdom (UK), has held Dr. Pantula Sastry, an Indian cancer specialist, guilty for professional misconduct and permanently canceled his practicing license in UK for causing death of a 55-year old patient who was suffering from blood cancer. The most striking aspect of this unprecedented decision by the tribunal in UK is that the victim was wrongly treated by Dr. Sastry resulting in her death in a hospital in Mumbai, and not in England (see attached judgment below).

The victim, Sushma Agarwal, was admitted at Kokilaben Dhirubhai Ambani Hospital in Mumbai in 2014 under care of Dr. Sastry for Non-Hodgkins Lymphoma when she was treated with bone marrow transplantation without taking minimal precaution leading to death as held by the judges at MPTS. Although victim’s family lodged a complaint against Dr. Sastry with the Maharashtra Medical Council, Dr. Sastry relocated to UK in 2015 and started practicing there. As victim’s son also lodged a complaint against Dr. Sastry with the medical council in UK (GMC), the complaint was referred to MPTS which after a thorough investigation and taking opinions from medical experts came to the conclusion that Dr. Sastry was grossly negligent in his treatment of Mrs. Agarwal in the Mumbai hospital. The Tribunal also casted serious doubt on doctor’s credibility and permanently removed Dr. Sastry’s medical registration by holding that his “conduct was so unacceptable, that it is fundamentally incompatible with continued registration“. Ironically, the complaint against Dr. Sastry that was lodged with Maharashtra Medical Council has still remained undecided even after 4 years. Do we still have to wonder why public has lost complete trust on doctors and medical councils in India?

UK-Tribunal-GMC Order (cancellation for negligence in India) Aug, 2018

West Bengal State Consumer Disputes Redressal Commission (WBSCDRC) in Kolkata passed a major judgment this week holding a general surgeon and local nursing home in West Midnapore, about 150 km from Kolkata, guilty for medical negligence and slapped a compensation of Rs. 20 lakh against the doctor and hospital. Banamali Samanta, a 62-year old poor agriculture-worker, eventually died from sepsis following a botched gallbladder stone surgery by surgeon Dr. T.K. Biswas and absolute lack of post-operative care at Roy Nursing Home in Kotwali, West Midnapore. The consumer court has also held that the surgery was performed without a valid “informed consent” and directed that Dr. Biswas must pay Rs. 15 lakh and Roy Nursing Home would pay another Rs. 5 lakh compensation to the Samanta family within 45 days.

PBT played a central role in bringing medical justice in this case. With no hope to fight for justice against the influential doctor/hospital, victim’s son came to PBT seeking justice for the wrongful death of his father as PBT guided the family to the legal battle starting with obtaining the medical records from Roy Nursing Home. Over the past almost 4 years, PBT also provided support in the court completely free of cost as we do for many victims of “medical negligence” across India. In fact, PBT president, Dr. Kunal Saha, personally appeared on behalf of the Samanta family and argued before the consumer court last month during his trip to India. Dr. Saha’s compelling argument won the case and brought some solace to the unfortunate Samanta family. A formal complaint seeking disciplinary action against Dr. Biswas was also lodged with the West Bengal Medical Council but even after holding a hearing more than one year ago, the state medical council has still remained silent (see the news below).

Statesman (Sept. 2, 2018)

Additional Chief Judicial Magistrate (ACJM) at Bidhannagar Court, Kolkata admitted as a “pre-cognizance” stage, a new criminal complaint lodged by PBT president, Dr. Kunal Saha, against West Bengal Medical Council (WBMC) president and sitting MLA of the ruling Trinomul-Congress (TMC) party, Dr. Nirmal Maji, with serious allegations for embezzlement of public money from the state medical council for payment in his personal legal defense. After going through the complaint (C.C. No. 4055/2018; Dr. Kunal Saha vs. Dr. Nirmal Maji) and examining the complainant (Dr. Saha) along with another witness under section 200 CrPC, Ld. ACJM has transmitted the case to the Special Court (under Prevention of Corruption Act) for taking full cognizance and issuance of summons/warrants considering the nature of the allegations, i.e. alleged corruption by a “public servant”. The “Special Court” will hear this unprecedented case on 17th September, 2018.

This case emerged from a separate, pending case for “criminal defamation” (IPC Section 500/501) against Dr. Maji last December following slanderous and untruthful personal attacks by Dr. Maji after Dr. Saha lodged a complaint with MCI seeking cancellation of Dr. Maji’s medical registration as Dr. Maji and two other doctors were involved in planning dialysis of a pet dog at the premier government medical center in Kolkata (SSKM Hospital) putting the lives of countless innocent patients at serious peril. Dr. Maji has already surrendered in that case and was released on bail with the next hearing fixed on 15th September, 2018. During the course of several hearings in this personal defamation case against Dr. Maji between December, 2017 and April, 2018, it was observed that the same attorneys who generally represent the medical council in other cases, were also appearing to defend Dr. Maji even though WBMC is not a respondent or involved in any way with this personal defamation case against the council president. Recently, in response to an RTI application, WBMC has informed that the medical council, and not Dr. Maji, has been paying legal costs to the tune of tens of thousands of rupees to defend Dr. Maji in his personal lawsuit. The criminal complaint lodged against Dr. Maji includes Indian Penal Code (IPC) Section 409 (“criminal breach of trust by public servant”) which is a cognizable, non-bailable warrant case carrying maximum of 10 years imprisonment, if convicted.

In a unparalleled move in the annals of medical council history in India, Maharashtra Medical Council (MMC) has suspended medical registration of 7 medical specialists for an unprecedented 5-year period while another 50 doctors’ registrations were suspended for 1 year each – all for using fake certificates with post-graduate diplomas from the College of Physicians & Surgeons (CPS). The lesser sentence of 1 year suspension was given to 50 doctors for committing the same offense because these doctors pleaded guilty for being involved with the fraud and also submitted written apologies to the medical council, according to published report. It is also reported that some of these doctors have confessed that they paid several lakhs of rupees to obtain the fake CPS certificates even after failing the medical examination. Many doctors across India have been using fake certificates and degrees to entice the unsuspecting patients. Some of these unscrupulous medicos also use bogus degrees after their names allegedly obtained from top Western Countries like USA and UK. Government has remained largely blind to such broad daylight criminal activities by otherwise registered medical practitioners. State medical councils and MCI also remained absolutely silent to these medical atrocities until today when MMC has taken this truly remarkable disciplinary measures against medical corruption. We salute the courageous doctor-members of MMC for their bold and honest stance and hope other medical councils will soon follow their footsteps for the sake of the vulnerable patients and to improve the sagging doctor-patient relationship in India.

On Monday (July 23), West Bengal Medical Council (WBMC) received a major blow as Calcutta High Court Justice Mr. Tapabrata Chakraborty quashed the order passed by the medical council rejecting the nomination of PBT president, Dr. Kunal Saha, to participate in the ongoing council election. Although Dr. Saha’s PIL in 2012 was instrumental to hold council the last election in 2013 where Dr. Saha was also ran as a candidate, his nomination to participate this year’s election was rejected by WBMC on the ground that he wrote his name as “Kunal Saha” and not as “Saha Kunal” as it appeared in his registration certificate and also because he sent the nomination form electronically via email. The HC lambasted WBMC advocate in the court and questioned him whether the council believed that he was a different person because he wrote his first name first. WBMC advocate also raised objection against Dr. Saha’s nomination on the ground that he was only an Overseas Citizen of India (OCI) which was also rejected by the court. The court directed WBMC to include Dr. Saha (and another doctor, Dr. Tripti Das, who came before the court with similar allegation) name in the ballot to allow him contest the council election.

Serious allegations of election manipulation were raised by different medical groups in West Bengal against WBMC headed by Dr. Nirmal Maji who is also sitting MLA of the ruling Trinomul-Congress party. In his writ petition, Dr. Saha also raised allegation of deliberate retaliation by Dr. Maji to reject his nomination as Dr. Saha recently brought serious criminal charges against Dr. Maji for “criminal conspiracy” (IPC Section 120b) and “criminal defamation” (IPC Section 500/501). Dr. Maji was indicted and surrendered but released on bail as he awaits the criminal trial to begin. Dr. Saha also raised complaint against Dr. Maji seeking cancellation of his medical registration as he planned to have his pet dog’s dialysis at a premier government hospital in Kolkata using his personal influence. MCI is currently investigating the complaint against Dr. Maji. Although WBMC election has already started through postal ballot, they have to use a new ballot with Dr. Saha’s and Dr. Das’s names as directed by the Calcutta HC. Appearing in-person, Dr. Saha argued his own case before the court yesterday (see news below).

Statesman (July 24, 2018)

PBT president Dr. Kunal Saha filed a writ petition in Calcutta High Court today challenging the decision by the West Bengal Medical Council (WBMC) to reject Dr. Saha’s nomination paper to contest in the upcoming council election on the ground that he did not put his name in the proper “style” as “Saha Kunal” as shown in his registration certificate, instead he wrote the name on the nomination paper as “Kunal Saha”. There was no specific direction on the nomination application that the candidate should write their last name first. Ironically, Dr. Saha contested in the last council election and no objection was raised by the WBMC.

In the lawsuit filed today, Dr. Saha has also alleged that the WBMC perhaps rejected Dr. Saha’s nomination papers with a vindictive purpose at the behest of its president and ruling TMC party MLA, Dr. Nirmal Maji. Recently, Dr. Saha lodged a separate criminal case against Dr. Maji under IPC Section 120b (“criminal conspiracy”) and 500/501 (“criminal defamation”). Dr. Maji has been indicted criminally and released on bail awaiting trial. Dr. Saha has also lodged a complaint with the MCI against Dr. Maji seeking to cancel Dr. Maji’s medical registration after he was involved in planning to perform dialysis of a pet dog using the dialysis machine at SSKM Hospital, a premier government hospital in Kolkata potentially putting the lives of countless human patients at serious danger. Dr. Saha’s appeal with MCI is still pending for final adjudication. Dr. Saha has come to India to argue this and other cases on behalf of victims of alleged medical negligence in person.

While hearing PBT’s challenge to recent direction by Calcutta High Court to deposit Rs. 10 lakh as a pre-condition for hearing PIL seeking exhumation and postmortem of a 6-month old baby-girl victim of alleged medical negligence, 3-judge bench of Supreme Court presided by chief justice Mr. Dipak Mishra granted “leave” to approach the same Calcutta High Court bench asking to remove the Rs. 10 lakh advance deposit. The Apex Court also indicated that there is no provision in law to impose a pre-conditional deposit even before hearing a public interest litigation (PIL). Appearing for PBT, Senior Advocate Mr. Bhim Singh argued that it is unheard of that a court can impose financial burden even before hearing a PIL or judging whether it is maintainable or not. The order passed last month by division bench of Calcutta HC presided by chief justice shocked all NGOs and conscientious citizens who take the duty to fight social injustices by filing PILs for benefit of the entire society. The PIL was filed after the poor father of the baby-girl victim, who died at HLG Hospital at Asansol, came to PBT seeking help in finding medical justice for his departed child. Postmortem even after burial may shed more light to identify the exact cause of death of this unfortunate baby. The original PIL will now be heard and decided by the Calcutta High Court (see news below).

NDTV (July 14, 2018)

The Indian Medical Association (IMA) Bengal Branch held a highly publicized program to celebrate “Doctors’ Day” on July 1 at their head office near Park Circus, Kolkata where many doctor, political, and even government leaders participated to discuss various problems with the healthcare delivery system. While most doctor-leaders expressed their concerns about physical assaults by shocked friends and family members following death of a patient from alleged medical negligence, little was discussed about the “real” underlying reason for occasional unfortunate incidences of doctor bashing and hospital vandalism. Unlike in the Western countries like UK and USA where ordinary people cannot even imagine attacking doctors following death of their loved one from gross medical negligence because they almost always get medical justice through an honest and transparent investigation process by the medical council and also by the court of law unlike in India. However, PBT never condones doctor bashing or hospital vandalism even in the event of death from genuine “medical negligence” because two wrongs can never make a right.

The height of the sham pro-patients demonstration by the IMA on Doctors’ Day was invitation of veteran Dr. Sukumar Mukherjee, the most negligent physician in Indian medical history who was found guilty for gross medical negligence causing death of Anuradha Saha and ordered to pay the highest-ever compensation of Rs. 11.5 crore (along with AMRI Hospital and two other doctors). In the scathing judgment holding Dr. Mukherjee guilty for medical malpractice, Apex Court also severely criticized Dr. Mukherjee’s character as the court expressed that his behavior was “unbecoming of a doctor” and that he brought “great disrespect to the medical profession”. Shockingly, Dr. Mukherjee delivered a lecture before a packed house of IMA doctors on medical negligence and doctor-patient relationship. Do we still wonder why the “good” doctors still do not understand why public is losing trust on our healers?

PBT has filed a special leave petition (SLP) in the Supreme Court against the Calcutta High Court interim order passed two weeks ago. The Calcutta High Court directed that PBT must put an advance deposit of Rs. 10 lakh before the court may hear a public interest litigation (PIL) in which PBT had sought court’s permission to conduct postmortem of a 6-month old baby-girl, Kushi Ghosh, who died due to alleged medical negligence at HLG Hospital, a private medical center in Asansol. The hapless parents of the unfortunate child, who are from a very poor socio-economic background, came to PBT seeking help in search of justice for their departed daughter. PBT moved the PIL, with supporting opinion from forensic medical expert, to allow exhumation of the body of the deceased baby-girl and perform a postmortem to correctly identify the exact cause of death of the child. But Calcutta HC passed this unprecedented interim order asking PBT to put down a huge deposit even before the court may hear the PIL on its merit. The SLP will soon be decided by the Apex Court.

In an unprecedented and shocking blow to all registered humanitarian organizations (NGOs) that are working to help ordinary people of India find social justice through public interest litigations (PILs), Calcutta High Court (HC) passed an unprecedented order directing PBT to make a hefty advance deposit of Rs. 10 lakh even before hearing to decide whether a PIL is “maintainable” or not. PBT recently moved a PIL (W.P. No. 197/2018) seeking direction for exhumation and postmortem of a 6-month old baby-girl after the unfortunate and poor parents came to PBT seeking help to find justice as they alleged lack of care and gross medical negligence responsible for death of their child at a private hospital (HLG Hospital) in Asansol. The hapless parents also lodged a police complaint soon after death of their child but police remained non-responsive as no postmortem was performed to ascertain the exact cause of death.

Victim’s family came to PBT more than two months after death of their baby-girl and PBT approached Calcutta HC through this PIL, with supporting opinion from forensic medical expert, seeking court’s permission to exhume the body to perform postmortem to find the cause of death as also wanted by the hapless parents. Postmortem often sheds light on the exact cause of death of a patient that in turn may prove useful to establish medical negligence. But division bench of chief justice Mr. Jyotirmay Bhattacharya and Mr. Arijit Banerjee of Calcutta HC has directed PBT to make an advance deposit of whopping amount of Rs. 10 lakh for hearing after two weeks to decide whether the PIL is “maintainable”. The HC has further said that the entire money would be forfeited if the court finally decides that the PIL is not maintainable or frivolous. This unprecedented order by a high court obviously sends a chilling signal to all NGOs for filing PILs seeking social justice in future. PBT will challenge this seemingly shocking order in the Supreme Court for the ends of justice.

In the written exam held earlier this month at the King George’s Medical University in Lucknow for doctors in the program for obtaining post-graduate degree in medicine (M.D.), a question simply asked, “Write briefly on violence against doctors: Causes, effects and solution“. A valid point may be raised whether this question at all belongs in the examination for would be medicine specialists but more importantly, having been involved with the unequal fight for justice for the victims of medical negligence, we wonder what would be the standard for the examiners to judge the “correct” answer to this unusual question for M.D. examinees? Apart from the debatable answers for the “causes” or “effects” of violence against doctors, what is the right “solutions” to solve the crisis of wide-spread medical negligence and sporadic attacks on doctors?

PBT never supports the idea of doctor bashing or hospital vandalism under any condition, even in the event of death from genuine incidence of “medical negligence” because two wrongs can never make a right. But there is no argument that most cases of violence against doctors happen due to deep erosion of public trust on the medical community. When a loved person dies in front of your eyes from apparent act of gross medical negligence, friends and family of the victim want medical justice. Unfortunately, it is a common knowledge today that, unlike in the West, doctor-members of the medical council primarily work to shield their errant medical colleagues without caring for the loss of life of an ordinary citizen. The idea of violence against doctors is simply unimaginable in the Western Countries including USA and UK because medical councils in these countries (composed of doctor and non-doctor members) investigate complaints against doctors in an impartial and transparent manner and routinely suspend/cancel license of the negligent doctors. There is no need for the ordinary citizens in these countries to take law into their own hands in a futile attempt to find medical justice by physical violence against doctors/hospitals as in India. No new law to put the victim’s friends/families in jail for their momentary lose of control under acute grief and lack of hope for justice in the medical council after losing their loved one from gross medical negligence cannot be an effective solution to prevent attacks on doctors. Compassion and proper understanding from victim’s perspectives are necessary to eradicate the social evils of medical negligence and violence against doctors. But will the examiners in Lucknow give appropriate credit for this answer to the M.D. candidates?

In a stunning development during hearing of a PIL filed by PBT seeking court’s permission to exhume the body of 6-month old baby and perform post-mortem to help in search of justice, Calcutta High Court division bench presided by the chief justice said that they may allow the writ petition provided PBT makes an advance deposit of Rs. 10 lakh which will be returned only if it is proven that this death involved medical negligence. Akshay Ghosh, a poor man from Asansol (200 km from Kolkata) whose 6-month old daughter, Kushi Ghosh, died last March at HLG Hospital in Asansol from alleged gross medical negligence after an injection was given the child, recently came to PBT seeking help to find justice. The HLG Hospital denied all charges of medical negligence and tried to botch up medical records. In order to find the cause of death, PBT moved a PIL with supporting opinion from forensic expert seeking exhumation and post-mortem of the baby. Although post-mortem after almost three months of death provides no guarantee that the exact cause of death may be identified for obvious decomposition of the body, there is some chance that the cause may become clear following the post-mortem. But post-mortem report may at most be useful as a piece of supporting evidence. Proving a case of “medical negligence” before the court of law requires many such supporting evidences and testimonies from the witnesses. Is it possible for PBT, a purely charitable organization working selflessly to help the hapless victims of medical negligence find justice, to put up Rs. 10 lakh in advance with a guarantee that “medical negligence” will be proven in the court of law? Nobody can be prejudiced with exhumation and post-mortem of Kushi Ghosh and her unfortunate parents also provided written submission requesting the court to allow exhumation and post-mortem of their deceased child. So why to impose this heavy financial burden to a bona fide NGO like PBT before the court may allow their PIL to exhume the body of Kushi and perform post-mortem examination?