(Originally published in October 2016 On the first death anniversary of my sister)
This is the story of a patient who followed her doctor’s advice in letter and spirit and prescriptions fully and completely, only to suffer extremely because of the fact that the doctor did not recommend the most suitable treatment to her at the right time, albeit he was aware of it.
I suspect it was simply because he does not offer that treatment himself and perhaps he did not want the patient to go to some other doctor for fear of losing his revenue stream from the patient. The purpose of writing this note is not to malign that particular doctor. My sincere objective of this note is to ensure that the doctors in general can be prevented from causing suffering and pain to their unsuspecting patients and to protect the life and well-being of scores of patients who may still be getting wrong or incomplete medical advice from their respective doctors. This note cannot bring back my beloved sister however it can ensure that the concerned physician is reprimanded for the blatant mistakes committed by him. I hope that in future, someone’s sister or mother or brother would not be subjected to the hardships due to the incompetence of this or the other physicians. The suffering of the patients’ near and dear ones is another highly disturbing factor.
The problems started when a physician working for AKUH recommended Dr. Ashfaq , Gastroenterologist to us for treatment of my sister in 2008. Dr. Ashfaq is a GI affiliated with Aga Khan Hospital, Karachi (see his official profile at aku website). My sister was suffering from Hepatitis-C at that time. She was treated with some medications and some injections were prescribed which she followed strictly.
After several years of treatment with Dr. Ashfaq, her Hep-C changed into cirrhosis of liver. Dr. Ashfaq recommended TACE procedure to reduce or shrink the tumor that had resulted from cirrhosis related complications. The radiologist at AKUH performed TACE in July 2014 and we believe that the amount of medicine to be delivered was not calculated correctly. This resulted in severe side effects including a three-week long fever due to overdose.
Once the TACE was done, the results showed that the tumor had subsided. At this time, we requested Dr. Ashfaq to outline the future course of action for the patient. He recommended just to follow up with him without giving us the viable option of liver transplant. We suspect that he did not want to recommend anything that could not be done or controlled by him in order to retain the patient. That is why he mentioned that he would repeat TACE when or if the problem resurfaces.
We came to know later that a cirrhotic liver can develop more tumors in the long run and the best and safest option was to perform liver transplant. We were willing to undertake any treatment without regard to its cost. He knew it very well as we had shown our commitment to my sister’s well-being.
However, despite collecting hefty fees over a period of years, he never even once mentioned the option of liver transplant. Ultimately, in March 2015, CT-SCAN of her body revealed a very serious occurrence of liver tumor which had reached portal vein.
We sent the report to Dr. Mohammed Reila, a well known surgeon who performs liver transplants in India. After detailed study of the CT-SCAN reports, Dr. Reila gave his professional opinion that it was too late to do anything. He ruled out the transplant due to the fact that the tumor had reached the veins. Replacing liver would not do any good as the tumor would damage the new liver as well. Dr. Reila commented that had the patient been brought when the TACE was carried out (i.e. July 2014), she had bright chance for a successful liver transplant.
Similarly, Dr. Wasim Jafri of Gastroenterology Department at AKUH said that the best time to do the liver transplant was when TACE was carried out in July 2014 and the tumor had subsided. Unfortunately, his own GI had hidden this advice from us due to his desire to retain the patients with him as much as possible.
My sister passed away on Oct 24, 2015 due to complications resulting from liver tumor that had caused the liver to stop functioning. I requested that the senior doctors affiliated with Aga Khan Hospital conduct a disciplinary inquiry into this matter and ask Dr. Ashfaq the reason why he did not recommend liver transplant at the time TACE procedure was done. If it is proven to be a case of negligence, suitable action must be taken to ensure that such negligence is not repeated in the future for other patients. We have come to know that my sister’s case is not the only one which was mishandled by Dr. Ashfaq in the similar manner.
After writing letters and following up with the head of the department at AKUH, the doctors panel met me on December 28th 2015. I was surprised and shocked that the panel blamed my sister that being a doctor herself, why she did not suggest the option of liver transplant. Unfortunately, they insisted on this idiotic argument knowing fully well that my sister was not a GI and she had retained the services of an experienced and most expensive GI to get the best advice possible. Has anyone ever heard of a patient being blamed that why the patient did not suggest a specific treatment option? The patient who was suffering from the worst trauma due to failing liver was supposed to miraculously suggest a cure for herself while paying huge amount of consultation fees to the GI.
The investigation report from AKUH clinical affairs department established the fact that Dr. Ashfaq is an incompetent GI and the more he stays with AKUH, the more damage he would cause to the reputation of the hospital. In fact, our family had a good trust on AKUH which has now eroded after this sad episode of negligence, wrong medical advice and incompetence of one person.
In the end, I request the AKUH management to make sure that Dr. Ashfaq is prevented from providing such wrong medical opinion to his patients and let him send a written apology to our family. Our family has paid a huge amount of money for the treatment of my sister for last several years to AKUH and Dr. Ashfaq. I request AKUH to donate an amount of Rs. 500,000 to a charitable fund in memory of my sister.
Aga Khan Hospital Victims 