Mumbai Mirror campaign: Govt report on pregnant accident victim’s death

Nanavati held guilty

Last month, hospital had refused to admit Reena Kutekar after her husband couldn’t afford to pay the Rs 25,000 advance


Lata Mishra


Posted On Thursday, May 17, 2012 at 03:33:51 AM


A government panel that reviews cases of maternal mortality has held Nanavati Hospital responsible for a pregnant accident victim’s death last month.

The indictment is a severe blow to the top hospital that is at the centre of a row over private medical facilities’ refusal to provide emergency care to the city’s poor. And it follows a series of reports by Mirror highlighting the issue.

Reena Kutekar, 24, who was five months pregnant, was hit by a car in Juhu on April 6. She was rushed to Nanavati, but was denied admission because her husband could not cough up a deposit of Rs 25000.

Her husband, Ram, managed to rusttle up Rs 5,000, and said he would pay the rest later, but Nanavati refused to budge. She was shifted to BMC-run Cooper and KEM hospitals, but they, too, failed to treat her because of unavailability of ICU beds and doctors. Reena, who was finally admitted to JJ after a delay of 16 hours, died two days later.

The Maternal Death Review Committee, which inquired into her case, said in its preliminary report last week that Nanavati should have followed government norms and provided “first-line treatment” to Reena. The panel also faulted the hospital for its failure to arrange a fully-equipped ambulance with a doctor on board for her transfer to another facility.

First-line care involves determining the patient’s condition and stabilising her. “The guidelines on preventing maternal deaths clearly say that all hospitals should give first-line treatment to pregnant women. Nanavati, however, didn’t admit the woman (Reena) and transferred her to Cooper without stabilising her,” Committee member Dr Asha Advani told Mirror, terming the case “shocking”.

The report, which has been submitted to the Health Department and the BMC, follows a month-long effort by Mirror to show how private-charitable hospitals in the city routinely turn away needy patients despite enjoying government concessions.

Reena’s case doesn’t strictly fall in the ambit of the five-member committee as she is primarily an accident victim. It still took up the case because Nanavati, KEM and Cooper’s failures to provide emergency care had contributed to a pregnant woman’s death.

“Initially, our report covered 22 maternal deaths that the city saw in April. But after a lengthy and heated debate, we decided to include Reena’s case. This is the first time we have made such an exception,” said Advani, who is also a special officer with the Family Welfare Department.

During their inquiry, the members sought detailed statements from all KEM, Cooper and JJ, where Reena was eventually admitted on April 6. They also interviewed doctors who examined her that day. “We are yet to seek Nanavati’s report,” Advani said, adding that Reena’s husband, Ram, would also be asked to appear before the committee.

Other members who were part of the inquiry are: Dr Rajeev Satoskar, an associate professor from KEM’s surgery department; Dr Madhu Garasia, head of KEM’s anaesthesia department; Dr Rekha Davar, head of gynaecology at JJ and Dr Madhuri Patel of Obstetricians and Gynaecologists Association.

They chronicled Reena’s entire journey from Nanavati to JJ. “We checked if she was provided an ambulance when she was shifted from one hospital to another and whether doctors were supervised the transfers,” Advani said. It will now send a circular to all 250 hospitals in the city, warning them that action would be taken if they turn away a pregnant woman without giving her primary treatment.