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Published : 24 Jun 2023, 01:35 AM
[Disclaimer: The real names of the patients, their family members and hospitals have not been disclosed to protect patient confidentiality.]
About a year ago, Abu Naeem Jashim (not his real name) went to the Bangladesh Medical and Dental Council, or BMDC, to lodge a complaint of medical mistreatment against a private hospital in Dhaka after the death of his 29-year-old daughter.
“All they did was try to feed me nonsense. I’ve no faith in them. Doctors heading BMDC won’t penalise their own colleagues. So I also brought a claim to the High Court. We want to stop such injustice over crimes related to medical negligence,” he said.
The role of the licensing and the regulatory body of the medical profession came under the spotlight after the death of a newborn at another hospital in Dhaka and the mother's subsequent death due to post-labour complications.
Two female obstetricians were already arrested for their alleged mishandling of the baby's delivery leading to its death, and the authorities suspended all operative activities of the hospital.
The arrests of the doctors created quite a furore within the medical community. The Bangladesh Medical Association, or BMA, the largest affiliation of physicians in the country, which works to ensure its members are treated fairly in their respective fields, condemned the move, citing section 88 of the Bangladesh Penal Code, which protects medical professionals from liability for negligence, for instance, when a surgery is performed in good faith in an emergency situation.
People with bonafide concerns or complaints against certain medical professionals or hospitals alleged that the BMDC, which oversees the professional conduct and investigates medical malpractice of physicians, hospitals and clinics across Bangladesh, does not take adequate steps against mistreatment and negligence.
The BMDC also faces allegations that it discourages the filing of complaints and deliberately delays the complaint resolution process.
Questions have been raised about the agency’s limited authority and ability to take action against culprits.
Some disgruntled victims of the agency's alleged dilly-dallying tactics even went as far as suggesting that since the BMDC brass are all doctors themselves, they were unwilling to take steps against people in the same profession.
Officials at the BMDC, however, refuted these accusations and said instituting measures against someone is a process that takes “some time”.
There has been a long line of protests sparked by deaths or loss of limbs due to neglect or wrong treatment by medical authorities in Bangladesh. Such incidents often lead to the public attacking hospitals and doctors, who, in turn, go on strike to protest.
The health minister voiced concerns on multiple occasions about scores of patients travelling to India for treatment to avert mistreatment or misbehaviour of Bangladeshi physicians in Bangladesh. However, it was never followed by visible efforts to capacitate the one agency that could fix the situation.
The recent death of an infant and the mother due to “negligence” at a private hospital has brought the issue to the fore again.
COMPLAINTS FILED WITH BMDC AND THEIR RESOLUTIONS IN NUMBERS
● In the last 12 years, 268 malpractice complaints have been filed with the BMDC, and only 34 were resolved, a mere 12.68 percent resolution rate.
● In 2010, four complaints were filed, which doubled in 2018. In 2016, six complaints were filed, followed by 14 in 2018, and 26 in both 2018 and 2019.
● In 2020, eight complaints were filed at the height of the COVID-19 pandemic, while in the next two years, the number of complaints stood at 32 and 31, respectively.
● Seven more complaints were filed by the end of May this year.
● A total of 50 physicians involved in all the malpractice complaints are currently on the BMDC’s radar.
● Only 12 doctors have lost their BMDC registration for malpractice in the last 12 years, and registrations of 12 more have been suspended pending investigation.
BMDC’S SNAIL-PACE PROCESS OF INVESTIGATING MALPRACTICE
In September last year, an eight-year-old child Salma Karim (not her real name), died in the care of a private hospital. Her father, Mesbah Uddin (not his real name), filed a complaint with the BMDC against two physicians, alleging that the doctors subjected his daughter to the wrong treatment.
In March this year, the BMDC called one of the doctors and the child’s mother, Halima Khatun (not her real name), for a hearing. However, matters have yet to progress beyond that.
“We’ve heard nothing from them since. The health directorate did not reach out to us either. We’ve had only one hearing in 10 months. If an investigation doesn’t end in 10 months, only God knows when we can expect justice to be served.” Halima said.
Another father, who lost her daughter towards the end of 2019 during treatment at another private hospital, filed a complaint with the BMDC in 2021.
“Many people don’t know that complaints can be submitted to the BMDC. Then again, whether the BMDC authorities would probe and take action by considering those complaints is a completely different story,” the bereaved father said.
“It’s been more than two years since I filed the complaint. But the adjudication has yet to be completed. Moreover, the highest punishment is the cancellation of registration,” he lamented.
THE COMPLAINT RESOLUTION PROCESS
● The BMDC’s registrar acts as a gatekeeper in the complaint resolution process.
● The regulations of the constitutionally-mandated council dictate that the registrar has the sole authority to decide which complaints will be forwarded to the disciplinary committee, which then conducts investigations.
● If the treasurer does not deem a complaint worthy, it dies there. If it passes the first hurdle, the disciplinary panel issues letters to both the complainant and the respondent, and the respondent gets 15 days to present their version of events.
● On the day of the hearing, the committee takes the statements, paperwork and evidence of both sides into consideration. It has the authority to form a specialised probe body to dig deeper if the issue is complex. The disciplinary panel has the authority to conduct multiple hearings if necessary.
● Based on the probe body’s findings and after hearing from all sides, the disciplinary committee recommends the appropriate course of action to the BMDC executive committee.
● If the disciplinary panel calls for action against the doctor under scrutiny, the executive panel contemplates the matter further and makes its recommendations to the BMDC brass.
● The whole process takes quite a few months.
‘COMPLAINT RESOLUTION IS A TIME-CONSUMING PROCESS'
When contacted, BMDC’s acting registrar, Dr Md Liaquat Hossain, said that since the malpractice complaint resolution process involves many steps, it takes longer to wrap up matters which are sensitive in nature.
“We usually juggle multiple complaints simultaneously while more complaints pile up. Hence, the delay,” he said.
He also claimed that during his time as an acting registrar at the council, only one medical practitioner was found culpable enough to have their practising licence revoked.
“We have the authority to cancel the practising licence. However, we have so far had only one such case. Most practitioners who are found to be involved in medical malpractice get their registration revoked or suspended. The maximum punishment we go for is suspending the medical licence for a year.”
He also downplayed the public perception that BMDC is biased towards peers and termed it a "common misconception".
[Writing in English by Syed Mahmud Onindo and Adil Mahmood]
