BRD Tragedy: Another Doctor Continues to Languish Behind the Bars

Dr Kafeel Ahmad Khan, who was arrested along with two doctors and six others in connection with the death of nearly 60 children, allegedly because of lack of oxygen at Baba Raghav Das (BRD) Medical College in Gorakhpur in August last year, is out on bail, but his forgotten colleague Dr Satish Kumar is still languishing behind the bars for the past eight months.

Dr Kumar – on a complaint filed by Uttar Pradesh’s Director General, Medical Education and Training, K K Gupta, on August 23, 2017 – has been charged under sections 308 (attempt to commit culpable homicide), 466 (forgery of record of court or of public register, etc.), 468 (forgery for purpose of cheating), 469 (forgery for purpose of harming reputation), 471 (using as genuine a forged document or electronic record) and 120B (criminal conspiracy) of the Indian Penal Code (IPC).

While a case under Section 7/13 (public servant taking gratification other than legal remuneration in respect of an official act) of the Prevention of Corruption Act, 1988 has been filed, sections 15 and 66 of the Indian Medical Council Act, 1956 and the Information Technology Act, 2000 have also been slapped against him.

The FIR

The First Information Report (FIR) filed on August 23 states that Dr Satish – who was the head of BRD hospital’s anesthesia department and maintenance in charge of the oxygen pipeline – left the headquarters without permission on August 11, 2017 because of which, the unavoidable circumstances occurred.

“He was aware of the fact that the disruption of oxygen supply could pose a threat to patients’ lives. Showing dereliction of duty, he did not inform his superiors about the shortage of oxygen (that had occurred after Pushpa Sales – a lucknow-based firm, which was official supplier of liquid oxygen to the BRD Medical College – stopped supply over non-payment of its dues of around Rs 60 lakh),” alleges the FIR.

If he had informed superior officers about the same, the FIR further alleges, the disruption in the supply of oxygen could have been prevented. Despite knowing that the deaths of the patients were expected (because of the disruption of oxygen supply), Dr Satish did nothing to save people’s lives.

Fact of the matter

Initially, after completing the academic course of medical science, Dr Satish had joined Provincial Medical Services, Uttar Pradesh, on January 25, 1991 and was sent on deputation to BRD Medical College, Gorakhpur, in the Department of Anesthesia on December 16, the same year. Subsequently, after duly selected from Uttar Pradesh Public Service Commission on October 31, 2003, he was appointed as an assistant professor/lecturer in the Department of Anesthesia at BRD Medical College.

He was promoted from time to time, and finally became a professor in 2013. He then took charge as the head of department, Anesthesia.

The then principal of the BRD Medical College issued a letter dated May 12, 2016, by which he was nominated as the in-charge officer relating to the job of execution of the central gas pipeline and oxygen gas tank. Newsclick is in possession of the letter.

Being in-charge officer, Dr Satish was responsible for the maintenance of oxygen pipeline, which is connected with the liquid oxygen gas tank/jumbo cylinders.

It is important to mention here that the doctor had no role whatsoever in purchasing the liquid oxygen. However, he used to report the storage balance of the liquid oxygen in order to ensure the continuous oxygen supply. He – being incharge – was also always in touch with the official oxygen supplier, and kept sending instructions about the balance stock of the liquid oxygen in the shortage tank and alternative jumbo gas cylinders.

In addition, as records suggest, he was always used to be in touch with the chief medical superintendent/superintendent in-charge, who are actually responsible for getting the supply of liquid oxygen/jumbo gas cylinders from the authorised supplier.

Dr Satish had no business with the payment for the liquid oxygen/jumbo gas cylinders. He had no power to draw or disburse, nor any authority for making payment of the liquid oxygen/jumbo gas cylinders.

According to his bail application filed in the Allahabad High Court, which has been accessed by Newsclick, he received information from the person posted for the maintenance of the oxygen tank and connected pipeline, that the liquid oxygen in the storage tank will be consumed within three-four days. “The doctor contacted the manager of Pushpa Sales and made a request for immediate supply of the liquid oxygen. The manager of Pushpa Sales informed the doctor it is not possible for them to supply the liquid oxygen because of the non-payment of their dues,” says the bail plea.

Consequently, Dr Satish wrote a letter dated August 3 last year, to the then BRD Principal Dr Rajiv Mishra, informing him about the stock balance and the conversation with Pushpa Sales’ manager, who had conveyed his inability to continue the supply of liquid oxygen. A request was also made for taking steps to make the payment to Pushpa Sales. A copy of the letter, accessed by Newsclick, was also sent to the chief superintendent Dr Ashok Srivastava.

Pushpa Sales, following repeated requests, sent liquid oxygen to the BRD Medical College on August 4, 2017. However, no liquid oxygen was supplied thereafter. This website has a copy of the mail sent to Pushpa Sales by Dr Satish.

The employees – Krishna Kumar, Kamlesh Tiwari and Balwant Gupta – responsible for liquid oxygen tank and connecting pipeline supply – wrote a letter on August 10, 2017, addressed to the head of department, pediatrics, BRD Medical College, stating that the meter reading of the storage liquid oxygen gas tank is 900, which is to be consumed by the night itself.

The letter has a reference to the dearth of the liquid oxygen, as its supplier had refused to continue the supply due to non-payment of the dues. A caution was made with a request for ensuring the supply of liquid oxygen.

The copy of the said letter, also accessed by Newsclick, was also sent to Dr Satish who had made his endorsement at the bottom of the letter: “refer to Superintendent Incharge for necessary action”.

Did Dr Satish leave the headquarters without permission?

The doctor had to visit Mumbai to attend the convocation ceremony of the Indian Institute of Technology, Powai, Mumbai, where the his son Tushar Rain completed his academic course and got the degree of bachelor of technology (B. Tech) on August 12.

Dr Satish got a casual leave (CL) from August 11 to 17, last year. The application dated August 9, 2017 seeking the CL was addressed to the principal, BRD, on the prescribed format. It is germane to mention here that the application was forwarded to the establishment clerk by the principal who had put his signature under the ‘Endorsement’ at the top of the application form.

Newsclick possesses a copy of the leave application.

The doctor booked an air ticket from Lucknow to Mumbai on August 11, 2017, to attend the convocation ceremony that was to be held on August 12. After getting information about the deaths of children at BRD, the doctor returned Lucknow on August 12 evening “without attending the convocation ceremony”.

He showed up at the BRD in late hours, soon after reaching Gorakhpur on August 12, 2017.

So, the doctor’s conduct of leaving the hospital for visiting Mumbai was – as papers suggest – was in all bona fide and as per the prevailing practice at the BRD, as the endorsement by the principal on leave application deemed to have granted leave. The principal had already made the endorsement and marked the application to the concerned clerk, thereby accepting the request for granting casual leave. Notably, there is no endorsement on the leave application about refusing the request by the principal or anyone concerned.

How valid are the charges of forgery of records?

The payment of the liquid oxygen or jumbo cylinders used to be made by the principal on the basis of the entries made by the chief medical superintendent/superintendent incharge (CMS/SIC). Neither in any of the documents, Dr Satish’s endorsement or signature has been found, nor did he make any entry about receiving liquid oxygen/jumbo cylinders. The liquid oxygen or jumbo cylinders is purchased by the Purchase Committee of which, he is not a part in any way.

The fact-finding inquiry by the commissioner administration as investigating officer, and other inquiries made so far by different administrative officers, have not found any lapse on part of Dr Satish.

The stock of the liquid oxygen or jumbo cylinders used to be maintained by the chief pharmacist and the CMS/SIC. The doctor was assigned the duty of maintaining the pipeline supply of the oxygen. No lapse was found in the system during the course of enquiry.

In fact, Balwant Gupta, one of the oxygen tank operators, has told the investigators – a copy of his statement is available with Newsclick, that chief pharmacist Gajanand Jaiswal was responsible for maintaining oxygen balance stock book and log book.

“He (Jaiswal) did not make any stock book or log book of oxygen after 2010. He called me along with my colleagues Kamlesh and Krishna Kumar on May 6, 2017 and handed us over a red diary, asking us to use the same as log book. At that time, Dr Satish was also present there. The diary was neither approved by the CMS nor based on the prescribed format. Nine entries used to take place in the log book. The entries used to be done on the dictation of Gajanand Jaiswal. The over writing and strike, which are there in the log book, have been done by him and only he can explain why he did so,” he told the investigators.

When asked if Dr Satish was responsible for maintaining the log book or if he did the overwriting, Jaiswal told the investigators, “It was the responsibility of Gajanand Jaiswal only to maintain the log book. Dr Satish used to oversee the gas pipeline. As far as the overwriting in log book and forging it is concerned, I never saw Dr Satish doing so.”

Finally, a high-level enquiry committee headed by the chief secretary (Uttar Pradesh) with its members UP Medical and Health Secretary Alok Kumar, Finance Secretary Mukesh Mittal and Medical Superintendent (SGPGI, Lucknow) Dr Hem Chand submitted a report by finding that the cause of the deaths of the children was not the shortage of oxygen, but the severity of disease.

“The common diagnoses in the children admitted in pediatric ICU also as in any other part of the state and warrant very complex management differing from patient to patient. Here also, oxygen therapy forms one aspect of the total management and even at times may not be needed,” the enquiry panel observed.

Even in the bail order of Dr Kafeel, the high court has said that when the government says no child died because of the shortage of oxygen, there is no point in prosecuting the doctors.