Apollo Hospitals not absolved fully

By P. Sunderarajan

NEW DELHI, OCT. 4. The much-awaited report of the experts committee that probed the treatment of late Union Minister, Rangarajan Kumaramangalam, has said the lack of proper treatment during the period between his discharge from Apollo Hospitals and his admission to the All- India Institute of Medical Sciences (AIIMS) was an important cause of his death. But, at the same time, the committee has not absolved Apollo fully and nor has it agreed with the diagnosis of Kumaramangalam's illness at AIIMS.

``Overall, the committee feels that the most significant contribution towards the outcome in the case of Shri Kumaramangalam was the fact that the patient did not recieve appropriate medical advice for over three months following his discharge from Apollo Hospital, till his final admission at AIIMS'', says the panel's report, which was officially released here today by the Union Health Minister, Dr. C.P.Thakur.

But, even while putting much of the blame on the course of treatment during the intervening period, the panel has not absolved the doctor at the Apollo Hospital either. Likewise, it has not agreed with the diagnosis of Kumaramangalam's illness by doctors at AIIMS.

According to the panel, the doctor at Apollo Hospital could have consulted a clinical haemotologist and carried out investigations to evaluate the immuno-haemotological status of Kumarangalam. This could have helped to arrive at a definite diagnosis. These further tests were necessary considering the findings of investigations such as TLC, DLC, raised ESR and FNAC.

The panel in this regard noted that the doctor treating Kumaramangalam, Dr. P. Rao had also considered evaluation of the immune status, but this line of investigation was not pursued.

The committee also observed that Dr. Rao should have informed Kumaramangalam that his blood counts were a ``bit unusual'', and he should definitely get the tests repeated in two to three weeks after discharge from Apollo.

On the diagnosis of Kumaramangalam's illness at AIIMS, the committee said the symptoms - history of irregular fever, weight loss, episodes of sepsis, leucopenia, focal hypodense lesions in the spleen (on CT) and atypical lymphocytes in the bone marrow were consistent with Non-Hodgkins Lymphoma, a cancer of lymph nodes. The AIIMS doctors had, on the other hand, diagnosed it as a case of acute myeloid leukemia.

On the kind of treatment taken by Kumaramangalam in the intevening period between his discharge from Apollo Hospital and his admission to AIIMS, the panel quoted the family members of the late Union Minister as stating that though no doctor was consulted officially and no investigation carried out, he was taking anti-tubercular drugs on the advice of Mrs. Kumaramangalam's father and a friend-cum-doctor, Dr. Tyagi. ``It is important to point out that no prescriptions were made available and neither the dose nor frequency of the drugs administered could be ascertained'', the panel said.

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