Two ‘guilty’ doctors exonerated

The Executive District Officer (Health) has exonerated already declared guilty two doctors of the Mayo Hospital in an enquiry launched under the Punjab Removal from Service (Special Powers) Ordinance, 2002, whereas the complainant deems it a foul play on the part of the inquiry officer.
On August 23, the then Secretary Health Punjab Rashida Malik suspended two senior medical officers of the Mayo Hospital on ‘charges of misconduct, negligence in official duty and failure to seek opinion of on-call senior staff before discharging a patient’. She appointed the EDO-Health Hafiz Abdul Qayyum as the Inquiry officer under the Section 5 of the PRSO, 2002.
According to the order issued by the Secretary Health, there were “sufficient grounds to proceed against Dr. Javed Hassan and Dr. Khalid Mehmood Awan, Medical Officers, Mayo Hospital, Lahore on the charge of misconduct, i.e., negligence in official duty and failure to seek opinion of on call senior staff before discharging the patient Mr Tasawar Ali.”
Tassawur Ali (actual name Muhammad Tassawur) walked into the Accident & Emergency Department of the Mayo Hospital on June 16 with open wound on his left leg. He was attended by the on-duty North Surgical Ward. Both the suspended doctors treated the patient and discharged with follow up instructions of coming back to the OPD after a week and getting external treatment of the wound. On June 18, Tassawur reported again at the Mayo Hospital Emergency and was admitted in the South Surgical Ward with diagnosis of gas gangrene involving the injured limb. In Emergency Operation Theatre, the Senior Registrar performed procedure of debridement. However, the gas gangrene occurred and below knee amputation was performed by Associate Professor South Surgical Ward as a life saving procedure.
In July, the enquiry committee of the Mayo Hospital, comprising Head Orthopaedic Department Prof. Dr. Iqbal Ahmed Bhutta and Additional Medical Superintendent A&E Department Dr. Manzoor Alam Ch, declared Dr. Javed Hassan and Dr. Khalid Awan of the orthopaedic surgery guilty for the amputation of leg of Tassawur. It was recommended in the report that they should be transferred to other wards. “The staff on duty carried out treatment in the acceptable routine manner. However, Dr. Javed Hassan and Dr. Khalid Awan failed to identify an ominous indicator of gas gangrene and did not seek opinion of the on-call senior staff before discharging the patient for which both of them may be transferred,” said the inquiry report.
The then Secretary Health proceeded with furthering the inquiry because “the nature of charge/allegations is such that it is necessary to hold an inquiry under Section 3 of the Punjab Removal from Service (Special Powers) Ordinance, 2000.” For this purpose, Rashida Malik appointed the EDO-Health as the Inquiry Officer “for proceeding against the accused officers.” The EDO was asked to conduct the inquiry in accordance with the provisions of the PRSO, 2000 and submit a report within 45 days of the issuance of the order, which he submitted on September 30 with the Secretary Health.
According to the report of the EDO-Health, after going through the reply to the charge sheet/statement of allegations, record of departmental representative and cross-examination during the personal hearing “it have (has) been proved beyond any shadow of doubt that patient Mr. Tasawar Ali, was properly treated by both the accused doctors according to standard protocol and after satisfactory examination and treatment, the patient was discharged at their own being experienced and qualified doctors. Dr Javed Hassan is FCPS in Orthopaedics and has got experience of about eight years In Orthopaedics and Dr. Khalid Mehmood Awan, claims that he is about to appear in M.S. Orthopaedic examination. Therefore both the doctors hove got sufficient experience and Dr. Javed Hassan, being FCPS in Orthopaedic is fully qualified to deal such type of cases independently.
“Keeping in view the above nothing can be substantiated against both the doctors and the charge against them stands unproved. It is therefore, recommended that both Dr. Javed Hassan and Dr. Khalid Mehmood Awan, Medical Officers, Mayo Hospital, Lahore, may please be exonerated from the charges levelled in the charge sheet / statement of allegation,” concluded the inquiry report.
The Enquiry Officer had written in the report that "… while working as Medical Officer, Mayo Hospital, Lahore you Dr Khalid Mahmood Awan…(and)… Dr Javed Hassan… Failed to consult the senior doctor as required before discharging the patient Mr Tassawur Ali.” Here, the Enquiry Officer did not mention the other allegations.
A senior orthopaedic surgeon, who has conducted many inquiries of this nature himself, on the condition of anonymity, maintained that the EDO-Health had not taken into consideration all the allegations in to consideration. “He has picked up the weakest of the allegations and exonerated the guilty doctors on unsubstantiated grounds. No doubt, the initial inquiry conducted by the senior doctors of the Mayo Hospital encompassed all the angles,” he added. He also questioned the status of one-man enquiry after two-senior man enquiry committee had declared the doctors guilty.
EDO-Health Hafiz Abdul Qayyum maintained that he had honestly carried out the enquiry from all possible angles. “I had examined the record thoroughly and had perused the previous enquiry as well. I believe that the charges levelled against the two senior doctors were baseless. As far as the mentioning of the allegations separately is concerned, what I did was one of the ways to write the report, and it has nothing to do with the carrying out of the enquiry,” he added.
Father of Tassawur Ali (actually Muhammad Tassawur), Amanat Ali maintains that he already doubted the “credibility of the Inquiry Officer and had submitted an application with the Secretary Health in which I have mentioned the Inquiry Officer does not enjoy good reputation and he is not hopeful of justice from him,” he added. Amanat wanted a minimum punishment of the cancellation of licences (of the Pakistan Medical Council) of both the doctors’. “Criminal negligence must be treated according to the criminal law. They should become an example for the other doctors so that such a gross negligence is not committed again,” he said. (October 30, 2005)