Monday, December 10, 2018

AIIMS-Patna flouts SC order on signing of lab reports

The SC had on December 12, 2017 ratified the stand of the Medical Council of India (MCI) and ruled that laboratory report could be countersigned only by a registered medical practitioner with a postgraduate qualification in pathology.PATNA Updated: Dec 10, 2018 11:32 IST

Ruchir Kumar 

Hindustan Times, Patna

All India Institute of Medical Sciences (AIIMS)-Patna campus(HT FIle Photo)

The All India Institute of Medical Sciences (AIIMS), Patna, has been found to be violating a Supreme Court (SC) order on signing of laboratory reports, a fact the institute did not agree to.

The SC had on December 12, 2017 ratified the stand of the Medical Council of India (MCI) and ruled that laboratory report could be countersigned only by a registered medical practitioner with a postgraduate qualification in pathology.

At AIIMS-Patna, however, Dr Ajit Kumar Saxena, a non-medical professional, has been signing reports on karyotype, a test to identify and evaluate the size, shape and number of chromosomes in a sample of body cells.

One such report of November 24, a copy of which is with Hindustan Times, bears Dr Saxena’s signature with his office seal, which reads, “professor and head, department of pathology and laboratory medicine, All India Institute of Medical Sciences, Patna.”

For professor in department of pathology, the MCI’s minimum qualifications for teachers in medical institutions regulations, 1998, stipulates that one should be an MD (pathology) or Ph.D (pathology) or D.Sc (pathology).

Interestingly, Dr Saxena holds a postgraduate degree in zoology, and Ph.D in anatomy, with ‘genetics’ as his topic, as confirmed by the director AIIMS-Patna, Dr Prabhat Kumar Singh.

Dr Saxena was, however, nonplussed.

“My signing karyotype report is not a violation of the Supreme Court order. Karyotyping is a kind of genetic study and not a lab report. The National Accreditation Board for Testing and Calibration Laboratories (NABL) guideline says that a few of the reports can be signed by highly specialised persons. Investigation reports pertaining to genetics, which is a highly specialised field of science, can be signed by M.Sc, Ph.D in applied biology. Even at SGPGI, PGI-Chandigarh and AIIMS-New Delhi, investigation reports of highly specialised subjects like immunology are signed according to the NABL guidelines,” said Dr Saxena.

Dr Singh also cited the qualifications for signing lab reports, as mentioned under NABL, and said the PGI-Chandigarh had set aside the MCI order, citing that it was an autonomous body, as was the AIIMS.

“As per the qualifications mentioned by NABL, a MS in anatomy, Ph.D with M.Sc in human anatomy, Ph.D genetics and Ph.D in applied biology can sign genetics report,” said Dr Singh.

He further said the NABL also mentioned that an MD in pathology could sign genetics and even nuclear medicine reports.

Asked about his position on the issue, Dr Singh said, “As far as the institute is concerned, I will continue with the present arrangement. That is the only way. I need to provide correct facility to patients. I cannot train a person who has not read the ‘G’ of genetics and why should I? Science should work for law and law should work for science. I might take this issue to our statutory body.”

A senior professor, who superannuated from AIIMS-Delhi, and was familiar with the issue, had a different take on it.

“AIIMS-Patna or even cancer hospitals should at the very least demand a degree in subjects such as the one CMC-Vellore offers in cytogenetics and molecular biology,” said Ex-professor, AIIMS-New Delhi

“The SC order stating that medical reports must be signed by those with MD pathology clearly spells out who can and who cannot sign medical reports. The SC order is a safeguard against people with dubious qualifications and half-baked understanding and poor grounding in the subjects starting medical labs, including cytogenetics and molecular diagnosis. Judged against the SC order, therefore, non-MD professionals signing cytogenetics reports does not appear to be tenable,” said the retired professor of AIIMS-New Delhi, requesting anonymity.

He further said, “There is an additional factor that must be considered. Clinical cytogenetic services in major medical institutions, covering areas such as cancer cytogenetics or paediatric cytogenetics, both in India and abroad, are often handled by non-medical graduates who have a Ph.D, rather than MD degree. They have been, however, part of a strong clinical group that consists of clinicians and pathologists, etc. so that the specialty develops properly and becomes well equipped to take on the responsibility of patient care.”

“Strong groups such as this exist in our country, for example in CMC-Vellore, which offers separate two-year courses in laboratory cytogenetics and molecular biology as a foundation for laboratory services and research in the subject. Admissions are through an all-India test. An institution such as AIIMS-Patna or even cancer hospitals should at the very least demand a degree in the subject such as the one CMC-Vellore offers in cytogenetics and molecular biology,” the doctor added.

“If what is done in CMC-Vellore is taken as a guide, it is expected that an institution like AIIMS-Patna, being developed as a premier teaching and research institute, should have people of such reputed qualification and skill to develop subjects of cytogenetics and molecular biology, as a foundation of diagnosis and research,” he signed off.

Dr Saxena is facing the heat after separate probes by the ministry of health and family welfare and a high level internal committee of AIIMS, comprising directors of AIIMS-Bhubaneswar and AIIMS-Patna, and deputy directors (administration) of AIIMS-Bhubaneswar and New Delhi, have questioned his credentials for the post he has been appointed.

Dr Saxena refused to send a written response in defence of his claim, saying he was “busy”. “You give me some time, I’ll think about it,” he said.

This reporter waited for four days after requesting the director and Dr Saxena, but neither sent a written response either on e-mail or WhatsApp.

First Published: Dec 10, 2018 11:31 IST

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