Inside Kashmir investigates ; how unchecked incompetent clinical laboratories have deepened ‘Trust Deficit’ among patients.
This article was prepared by IK’s Spotlight Team: Editor Kamran Ashraf Bhat
Srinagar: Fayaz, a well-qualified science student told his mother, after coming back from market that; weatherman has predicted heavy snowfall from tomorrow,” Mausam Gasie Pagah Wariya Kharaab, Ga”aed Hund Kya Karov”, ( It will be bad weather from tomorrow, what should we do with the car).His mother advised Fayaz to make sure Car is parked outside: “it is better to park the vehicle on the main road for any emergency”. For Fayaz, it becomes impossible in winter to take out his caron the snowy lane leading from the main road towards his home.
Fayaz while relaxing on bed after spending a long hectic day in market, purchasing monthly kitchen stock, told his mother to set table for dinner,” Mouji ( mother ), I am hungry and ‘rats are running in my stomach’, please set the table for dinner”.
Sitting near to a firewood heater, Fayaz’s mother replied: ” Fayaz, all of a sudden my whole body is drowning in sweat and I feelfever “.
Fayaz didn’t give a good ear to his mother and took it for granted,” it might be due to high temperaturebecause of firewood heater instillation, doze it off for a moment”, Fayaz said to his mother and continued surfing on social media sites.
After eating dinner, Fayaz started praying ‘Salat ul Isha’ at home and in middle of prayer he was distracted by mother’s moaning, due to shooting abdominal pain.
Fayaz couldn’t keep focus in prayersashis mother’smoaning was unavoidable, ” what happened”, Fayaz asked his mother; ” pain in my abdomen is unbearable, I can’t take it anymore “, his mother replied.
“I rushed towards the window to take a look at the situation outside, snow was falling heavily and it was not possible to take her to anynearby medical facility. I told her to hold up till morning “, Fayaz said.
On the next day,In early wee hours; Fayaz took his mother to a private clinic in Kupwara for Check-Up. Doctors at the clinic suggested an Ultra Sound- a medical test that uses high-frequency sound waves to capture live images from the inside of the body.
Fayaz went on and said,” after ultrasound scan was completed, the so-called expert, who took a view of scan film, within a fraction of seconds he told me; ‘ inflammation of spleen is at the unbearable size and it will cause spleen rapture at any time. We don’t have any competent doctor here, you should rush to Srinagar as soon as possible”.
For Fayaz it was like ‘Sky has fallen on him’, he felt uneasy and panic. ” For a moment, I was feeling dizzy and nausea; like something stuck in my head “, Fayaz said in disgust while recalling that moment.
“I told my motherto lie down on the back seat of the car and with heavy acceleration burn, I started driving towards Srinagar. My goal was to be there on time. On the same day, everything was engulfed with snow due to last night’s heavy snowfall, roads were slippery.I am not a good rush driver, don’t know how on earth I crossed Narbal area. As we crossed the same area my car skid off from snowy highway after I took a slight turn on road. Thanks to heavy chunks of snow, mounted on the road edges, otherwise, we would have fallen into wide open sewerage drain”, told Fayaz.
After two hours, Fayaz reached a will Sophisticated Government Hospital in Srinagar and requested doctors to take look at his mother.” When I requested doctors to check my mother, one of doctor told me to put this ultrasound scan in trashbin. These are not often correct’. We again completed the procedure andwaited for results”, added Fayaz.
While holding his mother’s hand tightly, Fayaz was nervous about the results. The doctor came into their room and asked for health history test records. ” I gave him old tests of my mother, Doctor started laughing loudly. I asked him, why is he laughing?. The Doctor replied’ are you people sane or what. Your mother’s spleen has been taken out through splenectomy five years ago. Your mother is fine but she has slight food poisoning and will be fine with single tablet”, Fayaz said while laughing.
Fayaz added that he was not remembering about this procedure on his mother after people at private clinic in Kupwara scared him; everything wiped out from his memory.
” A wrong test couldn’thave harmed us but any fatal accident due to the slippery road would have costed our lives. They need to be checked and scrutinized, otherwise, patients will suffer like this”, said Fayaz.
Two Same tests of Irfan’s mother from differentclinical laboratories in Kupwara showed extremely different results.
Irfan Ali Bhat, a research scholar in zoology, hailing from Kupwara told his mother was not feeling well and consulted a doctor; who as usual told them to run a few tests.
” Initially I took my mother to Apex clinical laboratory. When I received a copy of the test result- the haemoglobin was shown as 8.0 pints. Somewhere in my heart, I felt unsatisfied with the results and approach of members lab”, said Irfan Ali.
Furious Irfan, on another day, took his mother to another lab namely HI-Tech Lab where Hemoglobin was shown as 12.5 pints.
” I was shocked to see both results and fail to understandto whom weshould question,who will take responsibility and who will claim that their test result is authentic and genuine. How will this naive Public come out of these laboratories- where people are defrauded with bogus test results “, said Irfan while posing serious questions on administrations competence.
Fortunate Shafeeqa’s last-minute decision saved her life.
The doctor had almost diagnosed Shafeeqa as a diabetic patient after he reviewed her local clinical laboratory’s report. She was advised by the same doctor to ‘start taking medicine for maintaining blood sugar level’.
“We decided to crosscheck the blood sugar level from another lab; which was sharply different than the first one. When we revisited the doctor with a new test result, he diagnosed her Diabetic free and strongly recommend ‘not to take medicine’. Now, it has been almost 2 years, she is doing well”, said Shafeeqa’s son, who requested anonymity.
When IK’s Spotlight team interacted with local individuals, It was widely claimed by them that, whenever they visit any doctor in Srinagar with laboratory test results from Kupwara, Doctors don’t accept them and suggest for new test, resulting deep trust deficit between Patients and local labs.
In 2013, Kashmir Observer, had reported that a lady in Srinagar namely Jana Begum wife of Sanaullah Najar of Pattan was administered O-Positive blood instead of A-Positive as the investigation report prepared by a private diagnostic centre had shown her blood group to be O-Positive.
“I took my mother to Medicare Diagnostic Centre, Karan Nagar where her blood test was done by a lab technician. The report showed her blood group as O-positive. The doctors in SMHS Hospital accordingly administered her this group of blood but she developed shivering and her condition went from bad to worse,” Kashmir Observer had quoted Jana Begum’s Son.
CMO KUPWARA SAYS ‘ACTION AFTER REACTION’.
When Inside Kashmir’s Spotlight Investigation Unit contacted Chief Medical Officer Kupwara and asked her that, is there any regular check on Such laboratories from Department ? , she said,” Until and unless we don’t get any complaint, we won’t be able to act against anyone”.
Is Laboratory blameworthy for wrong Report ?
”No Laboratory can assure 100% assurance for perfect result but variation between two reports can’t be more than 20% different. If there is a difference of 10 % between two reports ,we consider it a manageable difference, but if it goes beyond 2450%- it is radical dissimilarity”, a Srinagar based Doctor said, having good expertise
According to ISO accreditation standards (ISO 15189:2012) the laboratory is responsible for its reports. When there is a query, complaint or a nonconformity, the laboratory management should conduct a detailed analysis to identify the root cause of error and bring in the necessary corrective actions.
What Pathology Expert Say about precautions.
According to Pavin Kulkarni’s report patients are suggested following SOPs while getting lab reports done:
1.Before any test, be very clear on why the test is required, What preparations need to be in place, what will the procedure look like, when will you get the results, and what role does the test have to play in your treatment.
2.Take care to provide samples to labs in the closed containers or cases meant for you, with your name or patient number on it.
3.Make sure the lab personnel are using sterilised equipment for drawing blood sample and other procedures.
4.Follow the instructions given by the laboratory personnel for tests, and be prepared as required, ie, empty stomach, abstaining from stimulants, having no physical activity and so on, as applicable.
5.Provide the samples of bodily fluids and solids within stipulated time. Delay might cause aberrations in the result.
6.Make sure that the name, age, blood group and other details in the report are yours. There have been cases where reports have been exchanged because of negligence in labs.
7.Check for consistency or difference, in case you are getting tests done twice, and expecting it to be either same or different, as the case may be.