Medical Negligence at Rajiv Gandhi Govt. Hospital in Chennai, Causes Death of a Sri Lankan

Rizviya, the deceased mother

Medical negligence is not unheard of and patients have died under such circumstances all around the globe. In this day and age one would think that doctors have no bias against a patient’s nationality. However, a  Sri Lankan family learned the hard way that there were doctors who showed no concern for a suffering patient.  On April 26, a Sri Lankan family of four left for India on vacation. Sitty Rizviya Zubair (51) with her sons Arshad Abdul Kalam M. Feroze (34), Amzal Abdul Kalam (29) and daughter-in-law Mrs. Amzal (21), had planned to go abroad to do some shopping before the Ramadan festive season and before Rizviya moved into her new house. However, three days before they were scheduled to leave for Sri Lanka, they met with an untimely accident and were rushed to the Rajiv Gandhi Government General Hospital, where they were not given any form of emergency treatment and which resulted in Rizviya’s death.  

The Accident  

On Sunday, April 30, after shopping at the Pothys, Arshad ordered an Uber to take them back to their hotel, the Eastern Palace Hotel in Mannady. As the driver was unfamiliar with the route, Arshad sat in front to direct him, a route he had become familiar with after many years of visiting Chennai. In the back seat sat his mother, his sister-in-law and his younger brother. While travelling along a bridge at Chennai Kamarajar Salai, Arshad felt the car speed up all of a sudden. Instinctively holding on to the dashboard and the hood of the car, he started screaming at the driver to hit the breaks. “We were on a bridge and there was a bend going to the left. We were going at a normal speed and then suddenly the car started speeding. Then, instead of taking the bend the car just went straight and hit the barricades.” Arshad told the Daily Mirror.  
Mrs. Amzal who had been having a quiet conversation with her mother-in-law too felt the car suddenly speed up. “I felt the car hitting the pavement and I could hear my brother-in-law screaming at the driver to hit the breaks. Then I hit my head on something and fell unconscious. Since I was seated in the middle, I had nothing to hold on to.” She did not remember what happened after that until she awoke at the hospital.  

Rajiv Gandhi General Hospital

Amzal who had been sleeping during the ride, woke up to his brother’s screams and the impact of the car hitting the pavement. He said that he too could not remember anything that happened between the time of the accident and waking up in hospital.  
According to Arshad, the car had accelerated so much that it had gone over the pavement, hit the barricades which consisted of iron bars, broken the boundary wall and flown off the bridge. “I felt like a piece of paper flying in the wind,” he said. Below them was a two-way road with a small pavement in the middle. The car flew over one road and toppled on to the second road landing upright. Upon landing, Arshad, the only passenger who was conscious throughout the incident despite being injured, saw the driver lying unconscious on his lap and quickly exited the vehicle. Ignoring his bleeding left arm, he looked towards the passenger seat where he saw Amzal, Mrs. Amzal and his mother unconscious and mumbling in pain. Screaming their names he put his hand through Amzal’s window which was smashed and patted his cheeks trying to wake him. Failing to do so, he opened the door and carried Amzal towards the divide of the two roads. By then, pedestrians and motorists had come running to their aid. Together they slowly pulled out Mrs. Amzal who was screaming that her shoulder and arm were in pain. Placing her next to her husband they tried to open Rizviya’s door which was jammed, resulting in her being slowly pulled across the seat out of the vehicle.   

“Mama was conscious and when she tried to move she started screaming that her back was hurting.” Arshad said.  
“I then took my brother’s wallet, cell phone and everything else that had fallen in the car. Mama was screaming that she couldn’t stay there, so I was trying to calm her down until the ambulance arrived. The tarred road was very hot, so she couldn’t even stretch her legs. Someone splashed water on her and my sister in law’s face because they were about to faint. While I was speaking to the police, my brother suddenly stood up and was looking around. When I shouted his name he didn’t hear me, he looked like he was in shock. Finally when I got his attention, I told him to take our shopping bags out of the boot of the car. To this day he does not remember doing this.”   
When the ambulance arrived, Rizviya was taken in a stretcher while a few passers-by had to carry Mrs. Amzal into the ambulance. According to Arshad, before the ambulance doors were closed, the driver held onto the door and asked them to forgive him.  
Whilst in the ambulance, Arshad made two quick calls to Sri Lanka, one to Mrs. Amzal’s father who had family friends living in Chennai and the second to his wife, informing them of the accident.   
“Mama was in severe pain in the ambulance. She had been given oxygen and was coughing up blood. She was screaming  that her back was hurting while  Mrs. Amzal was in pain because her shoulder was hurting. Amzal was saying he couldn’t breathe during the ride to the hospital. We soon arrived at the Rajiv Gandhi Hospital.” said Arshad.   
The police informed Arshad that on a weekday, that particular road they had landed on was usually very busy and had it not been a Sunday, they would have suffered worse injuries.  

Arrival at the Rajiv Gandhi Hospital  

“Our people also suffered there no? So let them be a bit, that’s ok”  

Once they arrived at the Rajiv Gandhi Government General Hospital, Arshad filled in the admission forms and his family was transferred inside one by one. They were admitted to the hospital at 4.30pm. Before they were transferred inside, he was told by a nurse to remove any valuables on his mother, brother and sister-in-law, which he did. As he was expecting the arrival of the Indian family friends (who wished anonymity) who were only ten minutes away, he waited in the reception area to hand over whatever valuables he had at hand as he preferred to keep them with friends rather that in a locker offered to him by the hospital. During this time, Arshad spotted two female hospital staff members entering the room and asking the nurse about the patients that had just been admitted.  
 Upon hearing that they were Sri Lankans, the staff members had laughed and said, “Our people also suffered there no? So let them be a bit, that’s ok”. “At that time there were no other patients in the area, so I could hear them very clearly.”   
As his wife had called and informed the hotel about the accident, a few hotel staff members had been sent to the hospital to see how their guests were doing. After the arrival of the hotel staff, came Sithy*, her daughter Fathima* and son-in-law, Mrs. Amzal’s family friends. Once everyone had arrived, Arshad was taken into a ward in a wheelchair where he saw his mother lying on a bed. To her left was the driver and to her right lay Amzal, while Mrs. Amzal lay on a bed opposite her.   
(*names have been changed to protect identities)  

Treatment and the Doctors’ Attitude  

The family was not taken to an ICU or an Emergancy Treatment Unit, instead they were taken to a casualty ward where there were other patients in a normal condition. As there was a doctors’ strike that day, there were only three or four doctors in the ward.  
“When I went in, I slowly walked towards my mama to check on her condition. She was screaming, saying her back, neck and chest were hurting. She had the oxygen mask on and it was covered with blood because she was coughing up blood. When she turned to the side and tried to breathe, she would cough up more blood. When we told the doctor she was coughing blood, he told us to lift the oxygen mask for her to spit it out. I told mama to slowly spit out the blood and not to panic, otherwise her blood pressure would go up. At the same time, my brother was screaming that he couldn’t breathe and I had to try to calm him as well,”said Arshad.  
He further said, “The ward doctors would keep coming in to check on my mother and brother before leaving. They didn’t give them any emergency treatment. I tried to tell Amzal not to stiffen his body but to loosen up and that he might be able to breathe more easily. My mother could hear him shouting and asked me to go and ask someone to give him oxygen and to get my wounds treated because my left arm was bleeding. She also told me to go and sit somewhere and rest because I was injured as well.”  

“When we spoke to a female doctor sitting at a desk, she said we were not the only patients there and that they had to take care of the others too. But the other patients looked to be normal and they weren’t screaming in pain like we were,” he added.  
Sithy had gone up to a lady doctor twice and asked her to help Rizviya and both times the doctor said she would come but she never went to Rizviya’s side. “I went to the doctor a number of times to tell her to see the emergency patients but they treated us indifferently,” she said.  
“Then suddenly, Mama was screaming that her neck hurt and I had to massage her neck. She was also feeling hot and because there was nothing to fan her with, I had to blow air through my mouth. Then Fathima found a piece of cardboard and we fanned her with that,” Arshad said.  
As Rizviya’s condition worsened, doctors continued to treat the patients indifferently. “Mama was turning this way and that, saying she couldn’t breathe and her chest was paining. I asked the doctors if they could at least fix a tube so that she would be able to breathe but they didn’t do anything.”   
The patients had only been given a drip and no emergency treatment had been performed on the family.   
“When we asked them to do something, the doctors said they couldn’t do anything until there was a scan or an X Ray. So we told them to do the scans. Then they were asking us to pay for them,” said Sithy. The Indian family friends and hotel staff collected what money they had and received the remaining amount from Arshad and paid for the X rays and scans to be done. “Even after paying them and showing the receipts, they didn’t do the scans or immediately take us to be X rayed,” Mrs. Amzal said.  

Half an hour before her passing, Rizviya’s pulse started dropping. Desperately, Arshad ran to the nearest doctors and cried for help saying that his mother was going to die. It was only then the doctors rushed to her side. “They were doing CPR on her chest. She started to pray and her legs were feeling cold. Then a male doctor came and took me away. They told me to go and sit on a bed. Then a few doctors gathered around her and nurses had also appeared. They brought the manual oxygen, which they were pumping with their hands. Only then did they attempt to fix a tube. When they did this, the blood flowed through the tube. When they were putting in the tube they brought a machine which showed the pulse. The plug wasn’t working and they had to find somewhere else to plug it. Then a lady doctor jumped on to my mother and started giving her CPR. When they tried to give her shock treatment, they didn’t have the gel and I could hear the nurse shouting for someone to bring the gel. Once they got the gel, they couldn’t carry out the treatment because it was too crowded due to the beds and people. They had to push the bed towards the corner of the hall where there were two blinds but I could still see the machines from where I was sitting. The Indian family friends followed them to that corner. Only at the last minute did they start running around and trying to do something,” he said.  
According to Sithy, in her last minutes Rizviya said, “I can feel my soul leaving me.” She was saying her prayers and closed her eyes. At that moment Fathima’s phone began playing the Maghrib Azaan (call to prayer). A small smile appeared on Rizviya’s face and she passed away. Even though she had passed away, the doctors and nurses kept trying to give her treatment. “Up to the time that her pulse dropped, they didn’t do anything for my mother. She was only given the drip and oxygen. None of us was treated. My mother passed away at around 6.30pm. From 4.30 they didn’t try and give her any form of treatment,” Arshad said.  
Sithy too backed up the fact that proper treatment was not given to Rizviya or to the others. “I never thought she would pass away there. I went up to the doctors a number of times to tell them to do something. Only in the end, when her soul was leaving her body were they trying to save her. They were climbing on top of her and giving CPR and getting all sorts of machines and tubes. I had gone up to them so many times and told them to have a look at her and they never showed any concern. They had given her oxygen and a drip but there were other treatments that should have been done. They never checked to see what was wrong with her.”  

While Rizviya was taken to the other side of the hall, Sithy’s son-in-law, the hotel staff and the others who had come managed to take Amzal for an X Ray. He too was only given a drip and no treatment was done. After the scan, he was brought back to his bed. “Amzal was in a lot of pain and he was shouting that he couldn’t breathe but they never gave him oxygen,” said Sithy.  
According to Amzal, he was not examined nor did the doctors ask him any questions about his pain. He could hear his brother talking to the doctors and his mother and wife screaming but he was unable to do anything. “A doctor came up to me and I told him I couldn’t breathe and needed oxygen but all he said was that I didn’t need oxygen and that I was OK. But I wasn’t, I was suffering.”  
When Mrs. Amzal was finally taken for a scan it was Sithy, Fathima and another who had to take her for the scan.  
When they took Mrs. Amzal for the MRI scan, they had to wait outside the scanning room for half an hour in a corridor. Then Fathima noticed something off about Mrs. Amzal’s facial expression and quickly went to notify someone. After speaking to a nurse they learned that Mrs. Amzal’s pulse was dropping. The nurse went to inform the doctor of this and was told to give a small injection, which was done at that time. “After the injection the doctor said she’ll be alright, but the fact that there was no doctor around at that time was very irresponsible, because we did not even know what was happening to her.” said Sithy. After the MRI scan she and her daughter had to wheel Mrs. Amzal to the ECG scan and for the X Rays. There had been no hospital staff to help them take the patient to get the necessary scans.   

Mrs. Amzal had been slipping in and out of consciousness but still remembers hearing her husband and mother-in-law screaming in pain. She said the only time she felt a little bit better was when her father had arrived at the hospital and rushed to her side.  ”Our family had informed everyone they knew of the accident and had asked anyone who was in India to come and check on us. So many people came to help us even though the hospital staff was not helpful. Our family had told anyone and everyone who was in India to come and check on us,” said Arshad.  Arshad realized how differently they were treated while observing the way the driver’s injuries were tended to. “They were treating him with more care. There were so many medicines on the table next to his bed and they were checking his pressure and his condition was much better than my mother’s. His condition was actually quite similar to mine but they didn’t give me any treatment.”   
Speaking of the inconsiderate nature of the doctors, Sithy said, “When we were looking for something to fan Rizviya with, they couldn’t even spare a file or a piece of paper. They were just scribbling things down on pieces of paper. How many times did I go up to the lady doctor but she just scolded me saying they had other patients as well. They just didn’t care and were very rude.”  
“I could have taken them to another hospital,” said Sithy. “But at the time there was no one else for me to properly discuss it with. No one in the hospital came up to me and said, ‘they are in a serious condition, if you want, you can take them to another hospital’. There was no one to advise or help us at that time.”  “They kept trying to chase us out of the ward. But since we didn’t know what would happen to the three remaining patients. we refused to leave. I was scared that I would return to their dead bodies,” she added.  
She further said that she had never seen anything like this before and it felt like she was watching a film. “Watching something like this and not being able to do much was very difficult. The way they were treating them angered me so much but I had to control my anger because if I expressed it, I didn’t know if they would have acted worse.”  

Arrival of Former Mla Hasan Ali And the Entrance of a Senior Doctor.  

Through family connections, Former Member of Legislative Assembly (M.L.A), Mr. Hasan Ali heard of the accident and rushed to the hospital along with his wife. The sight of the ward and the condition of the three Sri Lankans made him very distressed. He immediately started making arrangements for the family to be transferred to the Sooriya Private Hospital. Mr. Ali saw to it that Mrs. Amzal’s condition was checked to ensure that she was fit enough to be transferred. Then he called the Sooriya Hospital Managing Director(MD) and told him that they needed three beds in the ICU. Although the doctors were off duty, the hospital had organized for all their specialist doctors to arrive and prepare themselves for the incoming patients.  “It was thanks to him that we are alive. If he wasn’t there, I don’t know what would have happened to us,” said Arshad. Sithy too had expressed her gratitude for Mr. Ali’s arrival as she was able to see a major improvement in the situation because of him.  

While Mr. Ali was trying to organize their transfer, Arshad lay on a bed to rest. At this point a senior doctor in his fifties entered the ward. The other doctors in the ward were quite young compared to him. “Some other doctors were crowding behind him which was when I realized that he was important. They were doing their rounds I think. He came up to my bed and asked the other doctors if I was also a patient from the accident case. They told him I was. When he asked about my condition the female doctor sitting at the desk told the senior doctor that I was fine and was taken care of. She was looking at me while saying this. When they were about to go, I called the senior doctor and told him, ‘Excuse me doctor but I wasn’t treated at all. I wasn’t even touched. They haven’t done any X Rays or scans for me and my entire body is paining.’ He was quite shocked when I said this to him. He asked me what time we were admitted and I told him at 4.30. Then he turned to the doctors and asked them what they were doing without treating us for so long. He then held my left hand, on it there was a masking tape that said MASS No.4 which had meant that I was emergency patient number 4. Then in a loud voice he asked the doctors why we hadn’t been treated first. The female doctor at the desk said, ‘ There were a lot of patients and we couldn’t treat them’. The senior doctor then said that they were normal patients and that the emergency patients should have been given first priority. He then checked me and said that I should be taken for a scan. Afterwards, he turned around to the group of doctors. I could hear him questioning them. Then he said ‘one patient has already passed away. How are you going to take responsibility for this? How are you going to answer to this?’ some doctors were just looking down and the others were not saying anything.” Arshad said.  

Sithy, who had been close by when the senior doctor entered the ward, could hear him ask the other doctors why the emergency patients weren’t being treated. However, before she could hear anymore, a doctor came up to her and told her that she should not stay so close when the doctors were having such a conversation and told her to move away.  
Afterwards, the doctor continued his rounds and checked on Amzal before he was on his way. This was at around nine o’clock. However, even though they were told to perform the scans, they were done slowly and not in an efficient manner. By then, Mr. Ali had planned to move the three patients out of the hospital. He had spoken to the police and the hospital. However, the hospital said all the formalities needed to be taken care of before the patients could be transferred. Mr. Ali and the others in the hospital did not wish to leave the patients as they were afraid they would die. Although the hospital was delaying their departure, Mr. Ali managed to have the patients discharged. An ambulance had been arranged to take the patients to the Sooriya Hospital and at 11.30pm the three injured were rushed to the private hospital.  

Arriving at the Sooriya Private Hospital  

Upon arriving at the hospital, the hospital MD was there to greet them along with a number of doctors. Arshad, Mrs. Amzal and Amzal were taken straight to the ICU. “I couldn’t raise my arms because they had gone numb, so the doctors had to cut open my shirt to examine me. One doctor was checking my eyes and another was pressing me everywhere, asking where it hurt and was noting down my answers. They brought the scanning machines and X Rays to us and we weren’t required to move.”  

The patients noted the huge difference in the way they were treated at the private hospital. The MD stayed at the hospital till around one o’clock in the morning and there were doctors and nurses monitoring them constantly.   
All three patients agreed that the treatment they received at the private hospital was excellent. “I felt so bad that we were getting this treatment when my mother didn’t get it. The government hospital didn’t give her proper treatment or ease her pain. I can accept that it was her time to go but my mind would have been more at ease if I knew the doctors had done everything in their power to save her,” said Arshad.  
Rizviya’s cousin brother, Mrs. Amzal’s father and other relatives organized the funeral proceedings and worked together with the police to bring Rizviya’s body to the private hospital where the funeral was to be conducted. After all the paperwork was done and the requirements were met, she was finally brought to the private hospital on the evening of May 1. The MD of the hospital gave a special place in the mortuary for the Islamic funeral rites to be conducted and a small area in the hospital for the prayers and recitals.  

Injuries sustained  

Arshad, Amzar and Mrs. Amzal spent three to four days in the ICU at the private hospital. The doctors advised Arshad to rest for six weeks as his left shoulder was slightly dislocated but which would heal automatically. On the left side of the chest, his ribs, muscles and tissue were damaged due to the impact and his left lung was swollen. “When I breathe and sneeze, I can feel my lungs knocking against my ribs. I don’t have the strength to get up on my left side, I have to lean on my right side. When i walk for about two or three minutes, it starts to hurt behind my ribs and I start sweating and feeling dizzy,” he said.  

Mrs. Amzal has suffered from a lower right arm fracture, for which she had to undergo surgery where a plate was inserted. In two years, she can have an operation and have the plate removed. She has also suffered a clavical fracture on her left shoulder, which the doctor said will take six months to heal. “I can’t turn to my left or right side. The doctors have told me not to move too much, otherwise flesh can grow on my shoulder and I’ll have to have another operation.” She is also suffering from internal injuries that will heal over time. The doctors have advised her to rest for six months.  
Amzal suffers from internal injuries. He has crack on his ribs and backbone and his lungs are inflamed. He also has a muscle sprain and needs to lie on a pillow on his right side. The doctors have advised him to rest for two months. Both he and his wife find it difficult to sneeze and cough.  

The three victims are now in Sri Lanka recovering from their injuries, but one thing they’ll never recover from is Rizviya’s death

“Dept.HC  won’t get involved with the investigations...

-The Sri Lankan Deputy High Commission
 

According to Mrs. Amzal’s father, the Minister (Consular) from the Sri Lankan Deputy High Commission in Chennai H.M.K. Herath, arrived at the private hospital on the May 1. He was informed by the family of the accident and was told of the treatment that the Sri Lankan patients received while at the Rajiv Gandhi Hospital.   
However, when speaking to the Daily Mirror Mr. Herath denied any knowledge on the government hospital’s treatment of the patients and implied that the commission was not looking into the matter. “There were no complaints about the treatment by the hospital and we were not told anything. We only knew that it was an ordinary traffic accident and that investigations had been concluded. There was no concern raised about the hospital. Whatever assistance that we could have extended here, it was done for the time being,” he said.  
When asked whether anyone was taken into custody with regard to the investigation, he said, “The embassy won’t get involved with the investigations if they are not conducted properly. There was no complaint from the relatives or the family members, we were not told and our assistance was not sought in that case. The family members also told us it was an accident. We voluntarily went and assisted them and  helped them with the funeral and other related issues. We guided them on how to do the death registration. But our assistance was not requested with regard to the investigation.” 

No response from Rajiv Gandhi Hospital  

Although the Daily Mirror made a number of calls to the hospital, we were unable to get a statement from them. In the course of four days, several calls were made to eight different numbers and more than half those calls were left unanswered. When the call was finally answered, we were met with rude and unhelpful responses and were not transferred to any senior member or director of the hospital. At one point, when we mentioned that we were from Sri Lanka, the receiver of the call would disconnect without any response.