The Telegraph
Thursday , May 15 , 2014
CIMA Gallary

Implant supplier in OT, patient family cries foul
- Doctor says agent allowed inside restricted zone to assist him, permission taken 7 months back

Siliguri, May 14: A supplier of orthopaedic implants allegedly entered the operation theatre of north Bengal’s top state hospital allegedly without permission and said he was “assisting” a surgeon treating a case of a hip joint fracture.

The supplier, Niramal Mondal, was arrested after Uday Shankar Chanda, who had purchased an implant from him for his sister Bharati Das’s fractured hip, alerted the North Bengal Medical College and Hospital when he saw Mondal emerging from the OT wearing the regulation blue suit and green cap like other OT staff.

Chanda alleged a doctor-supplier nexus.

Mondal, when asked what he was doing in the OT, said he had been “assisting” the doctor to fit the implant — called a proximal femoral nail (PFN) — and that he had been helping surgeons in the OT “for the past six months”. He said: “Sometimes doctors are not familiar with implants and the technical details of fixing them. So I assist them because I have been dealing in surgical implants for the past six months. In this case, too, I helped the doctor.”

The OT is one of the most restricted zones in any hospital.

The superintendent of a leading government hospital in Calcutta, when told about the case, said: “Doctors sometimes seek the help of technicians during surgery if instruments and implants have to be inserted in a patient’s body. But permission has to be taken for each such case.” Otherwise, the entry of a technician into an OT would be deemed unauthorised. The superintendent cited the presence of technicians when stents are inserted in heart patients.

But doctor S.R. Mitra, whom Mondal “assisted” during Bharati Das’s surgery, said he had sought permission from the hospital for Mondal’s access to the OT seven months ago. He said Mondal’s presence “ is not an unauthorised entry. I had taken permission from the hospital for Mondal’s entry into the OT seven months back.” Asked again if he had taken permission for the specific case of Das’s surgery, Mitra stuck to his line of taking permission “seven months back”.

He said that as an orthopaedic surgeon, he knew “about the surgical part of the job but we do not have the requisite knowledge about the technical part of fitting implants”. The doctor said Mondal “has been dealing with surgical implants for years and he helps me in fitting implants. Today also he was assisting me.”

Hospital superintendent Amarendranath Sarkar said: “According to rules, only doctors, nurses and Group D staff are allowed inside the OT. Anybody else, apart from these people, who enters is unauthorised. When machines have technical problems, technicians are allowed to enter and fix them. I have filed an FIR against Mondal’s illegal entry into the OT,” he said. “An internal inquiry will be conducted to probe the charges against the doctor.”

Mondal’s and the doctor’s statements raise questions about OT restrictions during surgery when many patients are unconscious and unaware of what is happening around them, and their families have no access to the room.

Das’s brother brought another charge against Mondal — that he sold him the implant at much higher a price than the market rate. Chanda said that on Monday the doctor told him to purchase the proximal femoral nail from Mondal. “Dr. Mitra told us we would have to purchase the PFN from Mondal because it was not available in the hospital,” Chanda said.

This morning, when Chanda asked him about the implant before the operation, Mondal told him it had “already been taken inside the OT”, Chanda said. The patient’s family, therefore, did not get to see the implant before it was used in the surgery.

“He (Mondal) asked me to pay Rs 16,800 for the implant. When I told him to give me a bill, he wrote down the price on a piece of paper and gave it to me. I refused to take it and told him to get a valid bill. He then gave me a receipt of Calcutta-based Swapan Scientific Surgical Implants for the PFN. I paid the money,” Chanda said.

The operation began at 10.30am.

Chanda, however, had a doubt about the price and called up the number printed on the bill to ask about the price. “When I asked the person on the other side the cost of the PFN, he told me that the best quality (of implant) they had cost around Rs 6,000. I realised that I had been charged almost three times the market price,” Chanda said.

“This is a doctor-tout nexus,” Chanda said. “I called mediapersons to NBMCH. But there was greater shock in store for us when we saw him come out of the OT after assisting the doctor in my sister’s operation. I immediately filed a written complaint to the hospital superintendent alleging unauthorised entry into the OT,” he said.

Mondal claimed he was an employee of the Calcutta-based Swapan Scientific Surgical Implants.

Asked why he had overcharged Das’s family for the implant, Mondal did not deny the charge. He defended his action saying: “I always take with me implants of different sizes inside the OT because it is not known beforehand which size would fit the patient. The money we charge before the operation is for all the implants. After the operation, whatever excess money has been charged for the other implants is refunded to the patient party.”

Chanda, however, said the bill he had been given by Mondal mentioned only one implant, not multiple.

With inputs from Sanjay Mandal