Online pharmacies will need to register with the Govt. of India

Morning MEDtalks with Dr KK Aggarwal 

New Delhi, September 04, 2018 :

A private hospital in Delhi was fined Rs 10 lakh for being deficient in its services. In 2001, Surendra Tyagi, 43, complained of numbness, which gradually spread all over his body. In 2002, he was diagnosed with Motor Neuron Disease, a neurological disorder. Around September the same year, at Apollo Hospital he was diagnosed with Guillain-Barre syndrome. They alleged that Tyagi was discharged from the hospital even though he had not recovered. Tyagi was discharged on April 21, 2004 at 3:45 pm. “Tyagi was taken to his residence in Hapur in a ventilator-equipped ambulance which reached about 6:45 pm. Upon withdrawal of ventilator, he died within 15 minutes,” Tyagi’s counsel told the court.                        

“The patient had an untreatable motor neuron disease. He was initially treated for GBS which is a treatable disease. No harm was done to him,” the court was told. A medical board held that there was no medical negligence on the part of the doctor and the hospital because at times, certain features in case of MND can also be seen in GBS. “In other words electrophysiological features could be the same in case of MND and Axonal variety of GBS. The doctor was misled by the commonality of said features in MND and GBS,” said the report of medical experts.

However, the Delhi State Consumer Disputes Rederessal Commission upheld the report of the medical board that ruled out medical negligence but held them accountable for ‘deficiency in service’.

The commission observed, “In view of the foregoing reasons, the Commission is of the considered opinion that the hospital and the doctor are not guilty of medical negligence. However, the patient was not made clear of the prognosis. Nothing was explained to the relatives in relation to the commonality of the features of Motor Neurone Diseases and GBS. Relatives of the patient remained in dark in that they remained under an impression that the disease was fully curable and the treatment was as per standard protocol.”

In view of the present case, the hospital and the doctor were deficient in service as the relatives of the patient were never explained the prognosis, the Commission said.

Lesson: Explain everything in detail to the patient, and ensure that the thumb impression of the patient has been taken.

US FDA has advised people against eating, drinking or handling food products that have liquid nitrogen added immediately prior to consumption. The FDA says that, although liquid nitrogen is nontoxic, it can seriously damage skin or organs “if mishandled or accidentally ingested due to the extremely low temperatures it can maintain.” If someone were to inhale the vapor produced by liquid nitrogen, it could also be harmful to breathing, especially in people with asthma. Liquid nitrogen is used in food products and drinks immediately before being served to create a smoke-like vapor. These products “are often marketed under the names ‘Dragon’s Breath,’ ‘Heaven’s Breath,’ ‘nitro puff’ and other similar names.”

An elderly man died after suffering a suspected heart attack while swimming in the sea at a beach in Southbroom on the KwaZulu-Natal South Coast, South Africa on Sunday morning, the National Sea Rescue Institute (NSRI) said.

Online pharmacies will need to register with the Govt. of India to sell medicines through the internet. The new draft rules require online pharmacies to be registered with the Central Drugs Standard Control Organization (CDSCO) and obtain a trade licence — applicable across India — from any state government. The drugs sold online would need prescription and the pharmacy will have to maintain a detailed record. However, there should be strict confidentiality and no patient information should be leaked domestically or internationally. There should also be facility for customer support and grievance redressal. The draft rules also ban sale of narcotics, psychotropic drugs and tranquillizers.

Joint Commission 10 primary standards for restraint and seclusion of patients (Medpage Today)

1. “Restraint and seclusion should be used only when clinically justified or when patient behavior poses a physical danger to the patient or others
2. Patient restraint or seclusion should be implemented safely based on hospital policy as well as laws and regulations
3. Restraint or seclusion should be based on an individual order for specific patients, not standing orders; if the attending physician did not make the restraint or seclusion order, he or she should be consulted as soon as possible
4. Medical staff should monitor restrained or secluded patients
5. Hospitals should have written guidelines for restraint and seclusion
6. Patients who are restrained or secluded should be evaluated repeatedly
7. Patients who are both restrained and secluded should be monitored continually
8. Use of restraint or seclusion should be documented
9. Staff should be trained in the safe use of restraint and seclusion
10. Deaths linked to restraint or seclusion should be reported to the Centers for Medicare & Medicaid Services”

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI