Licence of Max Hospital, Shalimar Bagh, cancelled

An investigation by the deputy director general of the Competition Commission of India has concluded that Max Super Speciality Hospital Patparganj has been making 275% to 525% profit on sale of disposable syringes by abusing its dominant position to force inpatients to buy such products from its own pharmacy. The report also detailed how the extracting of such huge profits margins from inpatients was prevalent across all 14 hospitals of the Max group. The report in fact indicates that the practice of corporate hospitals making huge margins from inpatients is widely prevalent. CCI was looking into a complaint filed by a patient s attendant Vijay Sharma. Sharma said he had bought a disposable syringe made by Becton Dickson India Ltd (BD) at a maximum retail price (MRP) of Rs 19.50 when it was available for Rs 11.50 in the open market. In January 2016 CCI found the hospital and BD Ltd prima facie guilty of colluding to sell syringes from the hospital s pharmacy at double the open market price and asked its deputy director general to investigate the issue within 60 days. Almost two years later the investigation report prepared by CCI deputy director general Rakesh Vashishth lays bare the standard practice of manufacturers selling devices to hospitals at a fraction of the printed MRP at which hospitals sell to the patients raking in super-normal profits . BD Ltd s submissions during the investigation admitted that this was standard industry practice followed by all manufacturing companies in India . The hospital too stated that the sale of syringes at MRP is consistent with market practice followed by other hospitals generally . With both stating that they merely followed standard business practices what emerges is that inpatients at private hospitals in India are being forced to pay up to five times the actual cost of medical devices or disposables like syringes pushing up their bills enormously. In the private healthcare market consumables and medicines constitute typically 40-50% of an inpatient s bill. A senior Max group executive explained in the course of the investigation that medicines and devices were sold at MRP and that no discounts were given to patients by its pharmacy. The report noted that instead of charging a reasonable margin on the actual price at which the hospital procured the syringes Max group was charging at MRP. The hospital was acting as a trader whereby it purchased blister pack syringes from the market and sold it to inpatients at unfair and excessive profits noted the report. BD submitted that the difference between the two syringes bought by Sharma was in the packing the one bought from the hospital was in blister packing which costs more while that bought from the open market was in flow wrap. It further submitted that it sold syringes at different discounts to hospitals depending on their size volume purchased and as a strategy to bag a contract. Max Hospital being a chain could buy larger volumes and a range of other products and hence got a cheaper price than many others explained BD. According to the report similar or identical products were available in the open market at discounted rates but since the hospital insisted on inpatients procuring from its own pharmacy it was a clear instance of abuse of the dominant position and spatial monopoly enjoyed by the hospital in earning supernormal profits . The investigation also fixed individual responsibility within Max Hospital. NEW DELH: Four people from the medical staff doctors and nurses of Max Hospital at Shalimar Bagh were questioned on Monday. They were part of the team that was allegedly associated with Thursday s incident in which a baby who was declared dead was later found to be alive. A team led by the DCP additional DCPs and three ACPs from the northwest district has prepared a two-page questionnaire for the medical staff. DCP (northwest) Aslam Khan said that the questioning would continue on Tuesday. Police officers said the focus of the questioning was to find out the specific duties of each member of the medical team at the time of the incident seek justification for three expensive injections and a Rs 50-lakh bill that was quoted to the family. The police are trying to recreate the chain of events when the twins were declared dead and handed over to the family in a yellow plastic bag. They will also separately question the doctor who had last checked the babies and declared them dead. Investigating officers are also expert opinion on the need for the three injections which the baby s father Ashish had alleged cost Rs 35 000 and were meant to increase chances of the twin s survival. Cops are also probing Ashish s allegation that the hospital had asked them to pay Rs 50 lakh for keeping the baby in its nursery. He had claimed this baby was also declared dead while the family was discussing whether to keep the child in the nursery. The other baby was stillborn. Senior police sources said that if the allegations were found to be true the hospital might be charged for extortion. Max Hospital authorities said they were cooperating with the police. Breaking News When the twins were brought to the burial ground the parents just before performing the last rites realised that one of them showed movements inside the bag. New Delhi Dec 2 (ANI): Negating possibility of a criminal negligence on Delhi s Max Hospital s part the national president of the Indian Medical Association (IMA) Dr KK Aggarwal said no doctor would willfully declare a baby dead adding the concerned doctor might have made a mistake. There is definitely a mistake. The difference between a mistake and negligence is deliberate action. I don t think any doctor will do it willfully. But let the inquiry committee find out Aggarwal said. He considered the possibility of a mistake by the doctor as was made by Delhi s Safdurjung Hospital in June where the doctor had mistakenly declared a baby dead after its heartbeat stops amidst hypothermia. Aggarwal has asked the chairman of the IMA Grievance Cell and former Delhi Medical Council (DMC) president Dr AK Aggarwal to look into the matter and also informed the DMC had announced a suo motu inquiry into the case. We have asked the inquiry committee to check if the doctor was competent if the baby was really premature and what his weight was. Was the baby in hypothermia and did he have a cardiac arrest? Was the counselling given to the relatives and what were his chances of revival? Was the World Health Organisation (WHO) guidelines followed and did the relations sign for the resuscitation? the IMA head said. He also asked the committee to check if there was a dispute over money between the family and the hospital and if the case was referred to a government hospital after the family couldn t afford the expense. Issuing an advisory Aggarwal has asked all hospitals across the country to not declare a person dead if its body temperature is low since the patient can be revived even after an hour. The Shalimar Bagh Max Hospital on Friday handed over the twins thinking both to be dead to the family in plastic bags. When the twins were brought to the burial ground the parents just before performing the last rites realised that one of them showed movements inside the bag. They immediately rushed to a nearby hospital where the doctors informed one of them to be alive. (ANI)