Thread Reg. Three #MaternalDeath in Madurai Medical College Hospital/GRH- Doctors fabricated case sheets& patient records after deaths-Collector’s recommendation to suspend doctor-GRH doctors decide to stop elective surgeries in protest
1. #SemmalarMaternalDeath:
Madurai Collector M S Sangeetha audited maternal death of Semmalar on September 3 at her camp office in the presence of Corporation Health Officer (CHO), JD Health, Duty Assistant Professor of GRH. A copy of case sheet was photocopied during this audit. Collector further instructed Duty Assistant OG to handover a copy of case sheet for detailed audit. On September 4, copy of sheet is received by PHC medical officer. Collector compared the case sheet given to her on Sep 3 with the one received on Sep 4.
She observed below fabrication during the comparison (Sep 3 ➡️ Sep 4):
(i) 28.08.23, 05.15 pm notes ➡️ The full page is rewritten. T.Aspirin is deleted from the treatment prescription.
(ii) 28.08.23, Call over to cardiologist ➡️ The call over is rewritten.
(iii) 28.08.23, 7 pm notes ➡️ The full notes is rewritten
(iv) 29.08.23, 7 AM notes ➡️ The full page is rewritten. T.Aspirin is deleted from the treatment prescription.
(v) 29.08.23, 1 PM and 7 PM notes ➡️ Signature is added
(vi) 31.08.23, 7 AM. It was observed by Collector that, BT(Bleeding time)/CT (Clotting time) was not documented in case sheet ➡️ But it is found that, the said values are documented in the case sheet after enquiry by Collector at camp office
(vii) 31.08.23, 5 pm and 5.15 pm notes ➡️ Notes included after the maternal death. One episode of chills & rigors, vomiting and abdominal distension added in the new notes
(viii) 31.08.23, 5.45 PM notes ➡️ ‘Chief Informed’ is documented post death. Signature is inserted
(ix) 31.08.23, 06.00 PM notes ➡️ ‘On Mechanical Ventilator’ is added after death
(x) 31.08.23, 02.00 AM notes ➡️ Noted about TEG and ordering cryo is added in the notes
(xi) 01.09.23, 07.00 AM notes ➡️ Page changed completely
(xii) 01.09.23, 08.00 AM notes ➡️ Page inserted completely
(xiii) 01.09.23 ➡️ Cardiology, radiology call over page is rewritten completely
Madurai Collector further writes, “It is obvious that, the GRH OG department fabricated the case sheet post maternal death in their favour”
1. #SemmalarMaternalDeath:
Madurai Collector M S Sangeetha audited maternal death of Semmalar on September 3 at her camp office in the presence of Corporation Health Officer (CHO), JD Health, Duty Assistant Professor of GRH. A copy of case sheet was photocopied during this audit. Collector further instructed Duty Assistant OG to handover a copy of case sheet for detailed audit. On September 4, copy of sheet is received by PHC medical officer. Collector compared the case sheet given to her on Sep 3 with the one received on Sep 4.
She observed below fabrication during the comparison (Sep 3 ➡️ Sep 4):
(i) 28.08.23, 05.15 pm notes ➡️ The full page is rewritten. T.Aspirin is deleted from the treatment prescription.
(ii) 28.08.23, Call over to cardiologist ➡️ The call over is rewritten.
(iii) 28.08.23, 7 pm notes ➡️ The full notes is rewritten
(iv) 29.08.23, 7 AM notes ➡️ The full page is rewritten. T.Aspirin is deleted from the treatment prescription.
(v) 29.08.23, 1 PM and 7 PM notes ➡️ Signature is added
(vi) 31.08.23, 7 AM. It was observed by Collector that, BT(Bleeding time)/CT (Clotting time) was not documented in case sheet ➡️ But it is found that, the said values are documented in the case sheet after enquiry by Collector at camp office
(vii) 31.08.23, 5 pm and 5.15 pm notes ➡️ Notes included after the maternal death. One episode of chills & rigors, vomiting and abdominal distension added in the new notes
(viii) 31.08.23, 5.45 PM notes ➡️ ‘Chief Informed’ is documented post death. Signature is inserted
(ix) 31.08.23, 06.00 PM notes ➡️ ‘On Mechanical Ventilator’ is added after death
(x) 31.08.23, 02.00 AM notes ➡️ Noted about TEG and ordering cryo is added in the notes
(xi) 01.09.23, 07.00 AM notes ➡️ Page changed completely
(xii) 01.09.23, 08.00 AM notes ➡️ Page inserted completely
(xiii) 01.09.23 ➡️ Cardiology, radiology call over page is rewritten completely
Madurai Collector further writes, “It is obvious that, the GRH OG department fabricated the case sheet post maternal death in their favour”
2. #KuppiMaternalDeath:
Collector Sangeetha convened a Maternal Death audit on September 7 for maternal death of Kuppi who died on September 5 at GRH, Madurai. She observed that the GRH fabricated the patient’s records.
Before Death➡️ After Death
(i) Treatment note: Patient has attended unit (II) OG on July 18 but no notes were written; only unit seal has been entered ➡️ HR number along with description/diagnosis entered at the patient treatment note as if they had made diagnosis previously. ECHO notes were entered at the same page. The advice regarding admission was entered in the patent treatment note retrospectively after maternal death.
Madurai Collector writes further, “It is informed that, Department of OG, GRH Madurai is not deputing OG specialist for conducting PMSMA, High Risk camps at Zonal PHCs as per the guideline. This is contrast to the GH doctors who are conducting camps at Block PHC's in Madurai District.
In continuation to this, it was instructed to suspend the Medical Officer at GRH Madurai who has done fabrication of case sheet and patient records and to conduct PMSMA high risk camp at Zonal, PHCs as per the guidelines.
Even after the instruction, no action is taken till date by the Dean and HOD, OG. Hence, I request that Dean, GRH, Madurai may be suitably instructed.
Collector Sangeetha convened a Maternal Death audit on September 7 for maternal death of Kuppi who died on September 5 at GRH, Madurai. She observed that the GRH fabricated the patient’s records.
Before Death➡️ After Death
(i) Treatment note: Patient has attended unit (II) OG on July 18 but no notes were written; only unit seal has been entered ➡️ HR number along with description/diagnosis entered at the patient treatment note as if they had made diagnosis previously. ECHO notes were entered at the same page. The advice regarding admission was entered in the patent treatment note retrospectively after maternal death.
Madurai Collector writes further, “It is informed that, Department of OG, GRH Madurai is not deputing OG specialist for conducting PMSMA, High Risk camps at Zonal PHCs as per the guideline. This is contrast to the GH doctors who are conducting camps at Block PHC's in Madurai District.
In continuation to this, it was instructed to suspend the Medical Officer at GRH Madurai who has done fabrication of case sheet and patient records and to conduct PMSMA high risk camp at Zonal, PHCs as per the guidelines.
Even after the instruction, no action is taken till date by the Dean and HOD, OG. Hence, I request that Dean, GRH, Madurai may be suitably instructed.
3 #ThilagavathiMaternalDeath & subsequent complaints by 53 medical college doctors and 22 PHC doctors against each other:
On September 29, Maternal death of Thilagavathi reportedly took place. According to sources, CHO and PHC doctors claimed the death was due to postpartum hemorrhage (PPH). However, medical college (GRH) doctors claimed that the death may be due to Dengue as Thilagavathi’s husband had taken treatment for dengue in a private hospital. CHO’s team allegedly took blood sample from Thilagavathi’s body at GRH to prove their claim. In a letter to Dean, GRH, the medical college doctors opposed the CHO’s team for entering GRH, taking photocopies of patient records and their other actions.
After this, the 22 PHC Medical Officers wrote a letter to their corporation commissioner stating that most of the material deaths in Madurai district took place in medical college (GRH) hospital after their referral. They cited the district Collector’s observation about fabrication of case sheets.
On September 29, Maternal death of Thilagavathi reportedly took place. According to sources, CHO and PHC doctors claimed the death was due to postpartum hemorrhage (PPH). However, medical college (GRH) doctors claimed that the death may be due to Dengue as Thilagavathi’s husband had taken treatment for dengue in a private hospital. CHO’s team allegedly took blood sample from Thilagavathi’s body at GRH to prove their claim. In a letter to Dean, GRH, the medical college doctors opposed the CHO’s team for entering GRH, taking photocopies of patient records and their other actions.
After this, the 22 PHC Medical Officers wrote a letter to their corporation commissioner stating that most of the material deaths in Madurai district took place in medical college (GRH) hospital after their referral. They cited the district Collector’s observation about fabrication of case sheets.
4. Tamil Nadu Government Doctors Association (TNGDA) passes resolution demanding to stop about three out of six Maternal Death Audits and suspend CHO. TNGDA alleged that CHO has given information to a newspaper alleging that the maternal deaths are concealed. TNGDA decided to stop performing elective surgeries from Sep 3 if their demands are not fulfilled.
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