Durdans Hospital Fails Again In Duty Of Care

• Heartless And Negligent

By Nirmala Kannangara

Durdans Heart Surgical Center (Pvt) Ltd. is once again under the spotlight – this time for neglecting a patient who underwent open heart surgery on April 4, 2011. The patient has been undergoing residential treatment in the Cardiology Unit of the General Hospital Colombo over the past five months.

Eyebrows have been raised as to how Durdans Heart Surgical Center, which boasts of having the best heart care centers in the country, failed to take care of Mrs. P. K. A. Perera of Boralesgamuwa who was brought back to the hospital – ten days after she was first discharged following an infection in the incision on her chest.
Durdans Heart Surgical Center, Cardio Thoracic Surgeon Dr. Kesavara Dev who recommended and performed the coronary artery bypass graft (CABG) surgery on Perera too has come under severe criticism for his failure to attend on his patient whose condition was deteriorating when she was brought back due to an infection in the chest incision.
The Perera family noted with anger, that the patient was only a secondary case to this so called ‘best heart care center’ and queries as to why Dr. Dev wanted them to discharge the patient who was still suffering from the infection.
“We were not in a proper state of mind to fight back and ask them how they could dare to ask us to take the patient away after keeping her for 15 days in hospital during which there was no improvement. My mother was still sick and there was a yellow colour discharge from the incision wound in her chest when she was discharged on May 5 for the second time without our consent. Is it for this kind of treatment that we gave lakhs of rupees to Durdans? Why did they fail to take care of my mother till her wound healed? This should be an eye opening example for those who want to get treatment from Durdans for any illness in the future. Durdans Hospital is only concerned about the money and not the wellbeing of their patients,” claimed the disgusted son.
According to him, although his mother was discharged on May 5, he was asked to bring her back to Durdans from the following day (May 6) to administer antibiotics and to change the dressing and this cost him Rs.7,000 a day, excluding taxicab fees.
“We were not worried about spending money; we just wanted our mother to get well. Every morning my father had to take my mother to Durdans for the antibiotic injection and to change the dressing and once again in the evening at 9:00 p.m. for yet another injection. This was done for one week continuously. She was then asked to come back once in two days. This went on till May 19, until I got the opportunity to talk to a Cardio Thoracic Surgeon who asked me to admit my mother to his ward at the General Hospital. She was admitted to Ward 25 on May 20 and she is still in hospital under his able care,” said the son.
Accusing Durdans hospital of negligence, the Perera family told The Sunday Leader of the events that followed her readmission to Durdans after the infection in the incision on her chest worsened.
“We were asked to bring our mother for a check-up on April 19. After examining my mother, the lady doctor who attended on her said that the wound had to be cleaned as it had got infected. After a new dressing she was taken back home but the next day she got high fever. Realizing that this could be because of the infected wound we admitted her again at Durdans Hospital on April 21. Although Dr. Dev visited my mother he did not attend on her. Only two junior doctors –Dr. Prem and Dr. Sridhar another two Indian doctors and the nursing staff were apparently assigned to clean the wounds of an open heart surgery patient,” alleged the son.
According to him, his mother’s sutures had to be removed once again to clean the wound which too took a few days though his mother was suffering immensely.
“Despite the fact that she was in pain and a yellow coloured fluid was oozing from the wound, the hospital still delayed to remove the sutures and clean the wound. They were applying ‘Iruxol’ on the wound and were trying to figure out what would happen next. I believe they wanted to do experiments on my mother. On two occasions she had been advised to fast prior to the operation but after having kept her for so long without even water the operation was postponed for no valid reason. Later on I came to know that it was due to shortage of needles. Although she was re-admitted on April 21 she was taken to the operating theater to reopen the wound, clean it and put in new sutures only on May 1. This clearly shows the indifference with which this hospital treats its post-operative patients,” said the son.
According to the Perera family the hospital bill for 15 days cost them nearly Rs.300,000 followed by yet another Rs.70,000 for injections for ten days.
“Although the open heart package was Rs. 470,000 for the operation we ended up paying closer to Rs. 900,000 for Durdans Hospital’s negligence. Even though we spent all that money we still could not get our mother cured,” they added.
Speaking to The Sunday Leader from her hospital bed at the General Hospital P. K. A. Perera said that Durdans Hospital delayed her operation by two days due to lack of staff.
“Since one of my arteries was completely blocked and two others were 90 percent blocked my doctor advised me to get a bypass operation immediately. I was then taken to Durdans Heart Surgical Center,” said Perera.
According to her, after the initial tests were done she was asked to get admitted to the hospital on April 1, 2011 for the operation. Durdans promised that the operation would be scheduled for the next day – April 2.
“The total CABG package consists of nine days stay in the hospital – one pre-operative day in the cardiac ward, three days in the surgical intensive care unit (SICU) after the surgery and thereafter five days in the cardiac surgical ward in the event the patient does not get any unanticipated complications.  In the event of an extended stay the patient has to bear the extra charges according to the instruction note, which is fair enough,” claimed Perera.
“Even though I was asked to get admitted on April 1 and the operation was scheduled for the following day, it was postponed by two days to April 4, since apparently there was a shortage of staff due to the world cup finals that was played on April 2,” she said.
The cost of this delay had to be borne by the patient, even though it was the fault of the hospital.
“Although my mother was operated on April 4, two days after the scheduled day it was not our fault but theirs. They would have known that most of their staff was going on leave to watch the world cup final match. Who knows whether Dr. Dev and his team who are Indians too went on leave to watch the match? These are poor administrative decisions. Had they informed us early we would have admitted my mother on April 3 instead of April 1,” claimed the son.
Upon admission to the General Hospital, the Cardio Thoracic Surgeon had once again removed the sutures in her chest and had started to treat the wound since her condition was critical.
“I was told that the condition of my wound was so bad, that instead of putting new sutures, medicines were administered to first heal the wound,” said Perera.
“I was told that a large part of my heart and the rib cage were visible through this wound when I was first brought to the General Hospital in May. The doctor first want to get the wound healed and only after that put stitches to cover the hole,” said Perera.
According to her, if not for the General Hospital’s Cardio Thoracic Surgeon she would have died by now. “He is my saviour. Even the entire medical team and the nursing staff at Ward 25 are gods on this earth. It is impossible to compare the two medical teams and the two hospitals.
Durdans was so nice to us till they got the money but after that they discarded me when we went back to them for the second time. At General Hospital it is completely the opposite. Everything is done free of charge and they still provide the best medical care for which I am so grateful. This will be a good lesson for those who keep faith in Durdans Hospital,” said Perera.

Consultant Cardio Thoracic Surgeon General Hospital
Speaking to The Sunday Leader, Consultant Cardio Thoracic Surgeon General Hospital Colombo said, “Her (Perera) condition was very bad at the time of her admission to my ward and she did not have 25 percent chance to live. She would have certainly died had her wound been kept closed any longer and continued treatment with antibiotics,” he said.
“The patient’s condition was serious and she was in a septic state. Whoever attended to the wound had not put the sutures the way it should have been done. As a result we had to open the wound immediately,” said the Consultant Surgeon.
He further stated that Mediastinitis (the space where the heart lies) was grossly infected and the tissues and part of the skin was completely dead. He said the patient’s heart and sternum were clearly visible from outside once the dead skin, tissue, subcutaneous fact and part of the breast was removed.
According to the Consultant Surgeon, the patient’s condition has now improved after four and a half months and added that the open wound can be closed with plastic surgery. “She will be ready for plastic surgery in three weeks,” he added.

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The Manager Medical Services, Durdans Heart Surgical Center

Refuting the allegations leveled against the Durdans Heart Surgical Center, its Manager Medical Services Dr. Ruwan Senatilleke told The Sunday Leader that all possible treatment was given to the patient.
“There were other medical conditions that had a bearing on the speed of recovery. That was the reason why the healing of the wound got delayed. In regard to the allegations leveled against us for delaying re-suturing the infected wound, the delay was solely because the infection persisted. It is only the Consultant who knows what the best time is to re-open the wound, clean and re-suture it. They would not take any chances by re-opening the wound when the condition was not good,” said Dr. Senatilleke.
When asked as to why the patient’s operation was postponed by two days and whether she was charged for the extended stay in hospital, Dr. Senatilleke said that the operation had to be postponed due to unavoidable circumstance which was out of the Cardio Thoracic Surgeon’s control.
With regard to the allegations levelled against the hospital and Dr. Dev for their failure to take care of the patient till she had fully recovered, Dr. Senatilleke said that Dr. Dev, his medical team and the hospital did their utmost to heal the patient’s wound.