Tinsukia: Private pathology lab, linked with state government, in Tinsukia District, Assam, went under scanner after posting ‘incorrect’ report on COVID-19 patient’s platelet count , “mentally disturbing” and “affecting his treatment”.
The HindLabs diagnostic center, the laboratory against which the patient has now filed a formal complaint, is attached to the Tinsukia Civil Hospital.
In his complaint to the director of the civilian hospital, the patient, Sailen Changmai (42), called for an investigation and action against the laboratory.
On June 17, HindLabs collected the patient’s blood sample and the report printed on June 22 showed his platelet count to be 85 per 10â3uL (ie 85,000 per cumm). The same person’s blood sample, tested at a reputable private lab four days later on June 21, showed the platelet count to be 245,000 per cumm.
A normal platelet count ranges from 150,000 to 450,000 per cumm.
In his complaint, Changmai said the report released by HindLabs showed his platelet count to be 85,000 cumm, after which the doctor on duty immediately sent his blood samples to another private pathology lab where the reports showed that the platelet count was normal at 245,000.
HindLabs’ incorrect pathology report disturbed him mentally and affected his COVID-19 treatment, the patient said. âTo protect the best interests of patients, I urge action against HindLabs for providing false reports that can negatively impact a patient’s line of treatment,â Changmai added.
Controversies around HindLabs
Confirming the incident, Civilian Hospital Superintendent Mridul Gogoi said this was not the first instance of an incorrect report published by HindLabs. “In one of the cases a few days ago, they released a report from another COVID-19 patient showing his blood test value of creatinine was 23 mg / DL, which is not possible” , did he declare.
Serum creatinine is expressed in milligrams of creatinine per deciliter of blood (mg / dL) or in micromoles of creatinine per liter of blood (micromoles / L). For adult males, 0.74 to 1.35 mg / dL (65.4 to 119.3 micromoles / L) is considered the normal range.
âThe amount of creatinine in your blood should be relatively stable. An increase in creatinine level may be a sign of poor kidney function and any value greater than 2 may warrant dialysis of the patient. Also, in COVID-19 treatment, a patient with high creatinine cannot receive Remdesivir injections, âGogoi said.
In the current case, the platelet count reading shown in the HindLabs report was so low that we were unable to start her COVID-19 treatment, Gogoi said. “The first line of COVID-19 treatment for patients admitted to COVID hospitals requires the injection of low molecular weight heparin, which cannot be given if a patient’s platelet count is below 100,000” , added Gogoi, stressing the impact that a wrong report can have on patient treatment.
Gogoi said that such incorrect reporting can mislead doctors and deprive patients of correct and accurate treatment, leading to loss of life as well as gaining a bad reputation with doctors and the hospital.
âThere is a stipulated deadline for providing blood test reports, which has been set at 3 hours from the time the blood sample is taken,â Gogoi said, adding: âThe laboratory, more often than not, provides us with running blood test reports two to three days, in which case the accurate and timely treatment of the patient is seriously affected.This can have a huge impact on the health of the patient.
âWhen we question the delay they sometimes give bogus excuses like the machine was not working properly for which they have to send reports to their sister labs in other cities and so on. At other times, they don’t respond correctly, âGogoi added.
According to a former pathologist at Sir Gangaram Hospital in New Delhi, a patient’s very low platelet count can lead to internal and external bleeding and even death. âWe generally consider platelet counts below 50,000 to be dangerous and anything below 20,000 requires immediate infusion of platelets on the blood lines,â he said.
Another claim that has surfaced is that the lab often does not perform all of the tests prescribed by doctors due to the pricing formula. âDecrease testing, increase profits,â sources said.
Business and government join forces
HindLabs, a unit of HLL Lifecare Limited, has 70 laboratories located in various public hospitals in the state of Assam. The company initially provides free tests to patients admitted to public hospitals on behalf of the government of Assam, which is then paid for by the National Health Mission (NHM) according to the tariff agreement between the two. parts. He began his operations at Tinsukia Civil Hospital on October 2, 2017.
According to sources, the government has provided HindLabs with a list of 58 tests for which the government will pay them Rs 360 per patient regardless of the number of tests performed, an arrangement which has been reviewed by members of the medical fraternity.
On condition of anonymity, a medical professional said the arrangement may result in undue gains for the pathology lab. âFor example, if the lab is required to only perform a blood sugar test or a hemoglobin (Hb) test on a patient, the government will end up paying them Rs 360 even for one test or both tests. The same tests can be easily performed in private pathology labs for Rs 50-60 and Rs 60-80, respectively.
Talk with EstMojo, Florentius Toppo, HindLabs Laboratory Manager at Tinsukia Civil Hospital Florentius Toppo, said: âWe have learned such a big difference in reading in the platelet count of a COVID-19 patient. However, I cannot guarantee which of the two reports is faulty – ours or that of the other private lab. “
Admitting an error in a previous blood report from another COVID-19 patient, Toppo said: âIt was my fault because the patient’s creatinine level was shown to be too high in the test report that we published. I have asked my staff to check the reports before sending them.
The role of pathologists hired by the company also falls under the scanner. “How can a pathologist sign without verification?” The company has hired a pathology graduate for its lab inside Tinsukia Civil Hospital, âsources said.
Explaining the process for preparing the reports, Toppo said that usually reports are prepared by lab technicians and pathologists compare them with the machine reading before signing them.
Responding to further allegations, Toppo said there was some delay in providing blood test reports due to a biochemistry machine failure on June 7. âAs a result, we collect the samples throughout the day and send them to our relevant sisters located in different cities and towns. Since there is a curfew in the evening, we only send samples the next morning, âhe said.
When Toppo was reminded that medical services are exempt from curfew restrictions, he said: “We are also facing a labor shortage.”
Toppo, however, denied the accusations of not performing all the tests to increase profits. “We do all the tests prescribed by the doctors,” he added.
The role of government
From incorrect pathology test reports to delayed reports, the controversies surrounding HindLabs in Tinsukia have given enough reason for the government to step in and act.
The superintendent of the civilian hospital, Mridul Gogoi, said these concerns have been repeatedly raised with the concerned authorities. “The last complaint was forwarded to the joint director of health services and the deputy commissioner of Tinsukia for the necessary measures,” he added.