Country's Richest Civic Body Failed To Protect Citizens: State Human Rights Body Fines BMC ₹12 Lakh After Sweepers Perform ECG On Patients

The Maharashtra State Human Rights Commission (MSHRC) imposed a hefty fine of Rs 12 lakhs on the Brihanmumbai Municipal Corporation (BMC) after it learnt that the civic body had not recruited 'trained' practitioners to perform Electrocardiogram on patients in one of its hospitals.

In doing so the human rights panel said that allowing a ward boy or a sweeper to carry out an Electrocardiogram (ECG) on a patient is a clear case of violation of basic human rights.

The coram presided over by Justice (retd) Anant Badar, MSHRC Chairman, pulled up the BMC for its 'utter failure' to protect the human rights of the citizens.

"Hospitals run by the BMC, which may be the richest Municipal Corporation in India having hundreds of crore rupees in deposit, apart from the biggest budget, headed by the top bureaucrat, is expected to provide safest, affordable, accessible and high quality healthcare to the citizens especially when they are coming from weaker sections of society. It cannot be said that this is a case involving under resourced Municipal Corporation of the State. Health care facilities in private Hospitals are not within reach of even a middle class citizen who hope and expect that his life is safe, if the treatment is taken at the Hospital run by the richest Municipal Corporation. He expect that he is in safe hands of a well-trained medical staff in such Municipal Hospitals," Justice Badar said in the order passed on October 6.

About the instant case of sweepers/wardboys conducting ECG on patients at the civic-run Pandit Madan Mohan Malviya Shatabdi Hospital, in Govandi Mumbai, the judge said shows the "grim reality" of the big hospital run by the richest civic body in India.

The crux of the complaint was to the effect that sanitary workers (Safai Karamachari) of this Shatabdi Hospital run by the Municipal Corporation is taking ECG of the patient. The BMC responded that the actual work of taking the ECG is done by a 'trained employee'. The Commission queried as to who is a trained employee. To this the medical officer of the hospital said that ECG Technician of that Hospital is vacant since last one year and therefore, this work is being done by the 'Ward Boys' working in the Hospital.

"It is thus clear that averments made by complainant Mrs. Pallavi Patil are true as ECG of the patient due for surgery at this Shatabdi Hospital run by Municipal Corporation is taken, not by the ECG Technicians but by the 'Ward Boys' of that Hospital," the commission said.

The commission took note of a photograph is filed by the complainant showing that a Sweeper is taking the ECG of the patient in the said Hospital.

"This documentary evidence coupled with the response of the MCGM certainly establishes a fact that as trained ECG Technician is not available at the Shatabdi Hospital, work of taking ECG of the patients is done by 'Ward Boys' of the Hospital or by the Sweepers as alleged in the complaint," the commission said.

"This shows the dark side of the picture of health care facilities in the Municipal Hospital and speaks volumes about negligence in protecting human rights of patients by the BMC. The fact situation emerging on record shows that there is utter failure on the part of the BMC to protect life of the patients or least to say, it has failed to protect human rights of patients which had undergone surgeries at the said Shatabdi Hospital since last one year. In such situation there is no point in taking pride that the BMC has hundreds of crores in deposit when basic health care facility is not taken care of," Justice Badar remarked.

The strongly-worded order comes on a complaint filed by one activist Pallavi Patil who brought to the notice of the MSHRC that since last one year, the ward boys or the sweepers in the Shatabdi Hospital were performing the ECG as the BMC failed to recruit professional or trained personnel to use the said machines.

Justice Badar noted that the medical jurisprudence makes it clear that ECG report is a standard part of the pre-anaesthesia checkup conducted to assess of cardiac health of a patient before performing surgery on him as it aims to identify existing heath issues and uncover new ones that could impact on survival of the patient during and after surgery and to make the surgery safer to protect life of the patient.

"Taking out ECG by a trained Technician prior to undergoing high risk surgical procedure specially if a patient has one or more clinical risk factor like coronary artery disease which is in present days a very common ailment, is a sine quo non for safety of the patient who has to undergo the surgery. Thus, ECG is an important part of preoperative investigation which has direct nexus with safety of the patient, so also his life. By not providing a trained staff and getting the work of taking ECG done by the untrained staff like Ward Boys and Sweepers, clear case of violation of human rights and not taking care of protection of human rights of patients at the Shatabdi Hospital by the MCGM is established from the record,' the judge held.

From the reply affidavit of the BMC officials in the instant case, the judge noted that at least 3.344 patients were subjected to the ECG and the same was performed by the 'untrained staff' in last eight months.

"Thus, affected patients are large in number who are victims of gross negligence of the officer at the helm of the BMC due to his failure or inaction in providing services of ECG Technicians at the Shatabdi Hospital. Slack supervision of the health care facility of the BMC is evident from the facts borne from the record. Even it is not the case of BMC that taking out the ECG is a procedure which does not require any medical expertise and it can be performed by any Tom, Dick and Harry," the judge said.

The BMC, Justice Badar said, is headed by a Municipal Commissioner, who is duty bound to manage the Municipal Hospitals to ensure that proper health care facilities are provided through the expert and trained staff for protecting safety and life of patients who generally belongs to poor strata of the society.

Providing proper health care facility is an essential service of the BMC for maintaining public health but facts of the instant case shows that the top brass of the civic body is least concerned with this obligatory duty of the Municipal Corporation, as for a last one year this busy Municipal Hospital is functioning without an ECG Technician and by delegating that work to the Ward Boys and Sanitary Workers, the judge said, adding "This shows utter contempt to the fundamental right enshrined in Article 21 of the Constitution of India."

The judge therefore, noted that for the period of about one year, a large number nearly 5,000 patients were exposed to untrained staff for important medical procedure.

"Hence, interest of justice would be served if compensation payable by the BMC is assessed modestly at Rs. 1,00,000/- (Rupees One Lac Only) per month which comes to Rs. 12,00,000/- (Rupees Twelve Lacs Only) for a year during which period of time this violation of human rights was going on," the judge explained.

As victims of violation of human rights in the case are unidentifiable patients who visited the Shatabdi Hospital for their treatment, then in such a situation, cause of justice would be served in the best possible manner, if the compensation is directed to be paid to the Maharashtra State Legal Services Authority (MSLSA).

"This (MSLSA) Authority is constituted by the Legal Services Authorities Act, 1987 for providing free and competent legal services to the weaker sections of the Society to ensure that opportunities for securing justice are not deprived to any citizen by reason of economic or other disabilities so also to promote cause of justice on a basis of equal opportunity. Payment of compensation to the MSLSA by the BMC will certainly result in better utilisation of such amount as it appears that due to lack of legal knowledge, not a single victim out of such a large number of victims of violation of their right to life had approached this Commission for ventilating their grievance on this issue," the judge opined.

Thus, the MSHRC directed the BMC chief to immediately recruit trained ECG technicians for the said hospital and also to pay Rs 12 lakhs to the MSLSA within one month.

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