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Zakir Hossain Khan, who ran a tour operating business, did not know how much trouble and misfortune was waiting for him when he decided to go to a hospital near his home after feeling some discomfort due to chest pain on March 12.
The 51-year-old man and his family trusted the healthcare providers but they had no way of knowing that suspected errors in diagnosis, wrong treatment and malpractice would lead to Zakir’s death in just four days.
Talking to The Business Post, his wife Nurun Nahar said that Zakir went to Green Life Hospital at Dhaka’s Green Road on the morning of March 12. After hearing about his problem, Green Life Medical College and Hospital’s Associate Professor and medicine specialist Dr Rashedul Hassan Kanak ordered several tests.
Later, based on the reports, the physician said Zakir was suffering from gastritis and discharged him in the afternoon.
An unsatisfied Zakir, who was still feeling sick, decided to visit BRB Hospital at Panthapath that evening and consulted gastroenterology and hepatology specialist Dr Mahbubul Alam Prince, who saw some irregularities after analysing the electrocardiogram (ECG), carried out at Green Life at around 8am, and advised Zakir to consult a cardiologist.
Zakir and Nahar then decided to consult this hospital’s clinical and interventional cardiologist Dr Shekhar Kumar Mondal, who immediately prescribed a fresh ECG test.
Dr Shekhar conducted the ECG and an echocardiogram (ECHO) at around 8:10pm, 12 hours after the first ECG was done, and informed Nahar that Zakir had suffered a heart attack that damaged his heart and its efficacy.
Feeling unsettled about the findings, Zakir planned to go to United Hospital at Gulshan for further treatment. But Dr Shekhar discouraged him, saying it would take more time to get treatment there and advised him to go to Labaid Hospital at Dhanmondi.
However, after speaking with Labaid’s clinical and interventional cardiologist Professor Dr MG Azam, Dr Shekhar said that the hospital’s catheterisation laboratory was unavailable at that time of night.
Soon after, following Dr Shekhar’s advice, Zakir and Nahar rushed back to Green Life Hospital, where Dr Shekhar and Dr Azam carried out a stent installation operation in so much hurry that they did not even take consent from the patient’s family.
Afterwards, Prof Dr Azam claimed the operation was a success but Zakir’s condition kept worsening. He was even put on life support before he succumbed to death within three days of the operation.
Allegations
Zakir’s wife and family members have made several allegations against Dr Rashedul, Dr Shekhar and Dr Azam about errors in diagnosis, wrong treatment and malpractice.
Dr Shekhar and Dr Azam performed the emergency percutaneous coronary intervention (PCI) on Zakir but after his death, Zakir’s family consulted with several cardiologists and learned that it should have been performed within 12 hours after the ailment’s onset. But the operation took place around 13 hours later.
“Initially, we didn’t want the operation to happen at this hospital but before we could decide they carried out the operation. After the operation, Dr Azam claimed they pulled a miracle. But many doctors later told us that considering Zakir’s pathology history, the emergency PCI was not mandatory at that moment,” Nahar said.
Both doctors did not go through Zakir's diagnosis, ignored his diabetic status and put his life at risk which led to his death, she alleged. The on-duty doctor later informed them that Zakir’s blood sugar level was 17 before the operation. It eventually went up to 26 when Zakir was in CCU after the operation, but the on-duty doctor did not give him any insulin.
This ignorance caused the development of ketone bodies in Zakir and Dr Shekhar told them about the matter on March 13 afternoon, she said.
Moreover, the documents of treatment procedures provided by the Green Life Hospital showed no signature of Dr Azam even though he was one of the doctors who operated. Dr Azam was also shown as a consultant only, which seemed very strange to Nahar and her family.
Probes on, findings in early June
After Zakir’s death, an aggrieved Nurun Nahar on April 18 lodged complaints at the Directorate General of Health Services (DGHS) and Bangladesh Medical and Dental Council (BMDC) against Dr Rashedul, Dr Shekhar and Dr Azam.
On April 30, DGHS formed a four-member technical committee. BMDC also started looking into the matter around the same time.
As the matter is under investigation, several cardiologists and incentive care unit experts The Business Post reached out to were unwilling to comment on the record. However, they said that the timeline of the treatments and procedures had some things that raised questions.
Performing emergency PCI after 12 hours of its onset, denouncing the patient’s preference, pushing towards a certain hospital, and ignoring pathological history and development of ketone bodies indicated something suspicious was behind the result, they said.
Again, the type and quantity of contrast (dye) used while performing PCI with stenting to LAD as contrast could have been a reason that led to kidney damage and failure, they opined.
According to the American Board of Professional Liability Attorneys, medical malpractice occurs when a hospital, doctor or other health care professional, through a negligent act or omission, causes an injury to a patient. The negligence might be the result of errors in diagnosis, treatment and aftercare.
Failure to recognise symptoms, failure to diagnose or misdiagnosis, misreading or ignoring laboratory results, failure to order proper testing, premature discharge, disregarding or not taking appropriate patient history, unnecessary surgery, surgical errors or wrong site surgery and poor follow-up or aftercare are some of the examples of medical malpractices, it said.
Dr Mohammad Shayekh Abdullah, member secretary of the DGHS committee, told The Business Post that they have already spoken to the complainant and all the defendants.
“The committee is scrutinising every detail of the treatment procedures elaborately so that no technical issues are left out,” he said, adding, “We are hoping to submit the detailed report in early June.”
Dr Azam and Dr Shekhar were found unavailable for comments despite several attempts made to reach them over the phone. Regarding the allegations, Green Life Hospital Managing Director Dr Mainul Ahsan said a five-member BMDC team has already visited the hospital and the DGHS is also investigating. “The hospital will give its statement after the investigations’ findings are out.”
Sources said the BMDC team in a letter on May 21 asked all three doctors to submit their statements within 15 days of receiving the letter. Once that is done, they will talk to the complainant.
Meanwhile, DGHS Deputy Director (Hospital and Clinic Unit) Dr Abu Hussain Md Moinul Ahsan said that considering the importance of the complaint, the directorate will take all necessary actions based on the probe report.
“And not just the physicians, the concerned hospital will also face action if any involvement is found,” he added.
Zakir was the sole earner of his family. He had two girls, aged 1 and 12, with Nahar. He was also taking care of both his and his wife’s parents and the three children of his late elder brother Moinul Hossain.
Nahar said, “Zakir didn’t leave behind any significant asset or money. We don’t know what fate has in its store for us. We don’t know what we’ll do. We’ve heard that Dr Azam has powerful political connections and can even affect the outcomes of the investigations. If that happens, we will go to court. If needed, we will have independent physicians from abroad to scrutinise the documents and get justice for my husband.”
