Confidentiality of Health Information…misapplied by Apollo hospital?..Jayalalitha Saga

The story of the former Tamil Nadu Chief Minister Ms J.Jayalalitha’s hospitalization and the mysterious secrecy that shrouded her treatment has now become a topic of discussion on what is “Privacy” in the context of health care in India.

Initially, there was a silent appreciation that Apollo hospital was committed to patient information privacy when no information leaked out of the hospital about the health condition of Ms Jayalalitha. But when arrests were made on any person who publicly wondered what has happened to her, it was clear that the “Confidentiality” concern had turned into some thing more sinister. The attempt was to suppress the information about her health by the force of the law enforcement.

If rumours could cause law and order problem and hence the health information needed to be kept confidential, for the same reason health condition of Ms Jayalalitha was a matter of public interest and the “Confidenitality” or “Privacy” was not sustainable because of the over riding “Public interest”.

Now there is a serious doubt that extends to the charge that perhaps Ms Jayalalitha was murdered and if so the hospital authorities would be considered as “Accomplices”.

It is unfortunate that apart from the doctors of Apollo hospital, there were doctors from AIIMS and one London doctor who were also privy to her health condition and have played along the tune “She was recovering”. They will now be considered as also accomplices if things take an adverse turn.

The fact however is revealing.

Ms J. Jayalalitha, fondly addressed by her followers as “Amma”,  was admitted to the Apollo  hospital on September 22nd, 2016 on what appeared to be some simple health problem of dehydration and fever. Then she continued to be treated until she was put on ECMO and Ventilator and perhaps a dialysis machine simultaneously indicating a dead heart, dead lungs  and dead kidneys.  However no proper health information flowed out and all health bulletins said that she was “recovering” and close to being “Discharged as a living individual”.

People were naturally left shocked when finally she was declared dead on the night of 5th December 2016.

After her death, an e-mail leak of the NDTV journalist Ms Burkha Dutt has surfaced. The email clearly indicates that there was a clear

ground to believe that there was wrong medicine administered to her to worsen her diabetes condition. When she was admitted to the hospital, she was perhaps in a serious condition because of the wrong treatment for diabetes leading to failure of some of the organs and internal infection. Apollo may claim that they were not responsible for this but they definitely had no business to hide it from their medical bulletins.

Apart from this prima facie evidence of what can be loosely termed as “Causing death by negligence”, some of the relatives of Jayalalitha have complained that they suspect some wrong doing and also that the hospital failed to allow them to meet the patient during the last few days. They even conducted a second funeral for her in Srirangapatna holding her burial unsatisfactory last rites.

It is therefore now obligatory on the Government to conduct a thorough investigation to find out the truth. However, considering that the death of a king is always to be suspected to have been caused by the successor, and the prime suspect in this case as per the relatives of Jayalalitha is her potential successor, the investigation cannot be trusted under the hands of the Tamil Nadu police. It has to be handled by CBI and using officers who are not from TN cadre to avoid conflict of interest.

During the days when Jayalalitha was in the hospital, several decisions were taken under her name as part of the Government decisions including one on which her finger print was supposed to have been applied. A forensic investigation on the finger print would reveal if it was a finger print of a living person or a person whose blood circulation and sweat glands donot indicate life. There must be all the medical records and statements of the staff including that of the man political leaders who visited her which all should be collated as evidence.

If any evidence is missing, then it would corroborate the offence and call for additional charges of destruction of evidence and obstruction to justice.

The primafacie evidence indicates that Apollo hospital is in the docks.

Under health care privacy we always say that when the patient is in a mental condition in which he/she is not capable of taking a rational decision, the “legal heirs” have the right to assume charge and the attending physician needs to provide the health information to them. In the instant case, Apollo authorities seem to have decided that “Ms Sasikala” was the “legal heir” to Jayalalitha.

It will be interesting to see how the Supreme Court will interpret this aspect. If a close political associate can be considered as the “Legal Heir”, then in any business concern, if the Managing Director dies or is in a serious condition, it would be the “Deputy Managing Director” who will be considered as the “Legal Heir” to whom the health information would be trusted and not the son, daughter or the kin of the patient. The action of Apollo is therefore unsustainable in law and this may make Apollo a co-accused in witholding heath information from the blood relatives of the patient. The daughter of Jayalaitha’s sister by name Ms Amrita  and another cousin by name Deepa have claimed rights as the surviving legal heirs.

Law cannot be changed just because in this case, the political interests are involved. If Deepa and Amrita are the surviving legal heirs, law should determine not only the inheritance of the deceased wealth, but also answer the question why Apollo did not take instructions from these persons during the stage when the patient was not in a mental condition to provide any “Authorization”.

India is now on the verge of framing a law for “Health Care Data Privacy and Security”and it should address situations such as these in no uncertain terms.

Naavi

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Will the Ministry of Civil Aviation respond?

The honourable Minister of Civil Aviation Mr Ashok Gajapati Raju has earlier taken many customer friendly measures to improve the aviation service and now here is another occassion for the ministry under his leadership to show that it cares for the customer.

All of know that Air India as a National Indian Carrier  has quietly given away its leadership in the industry to private competitors and today is struggling to remain relevant. While there are some die hard people like us who still want to support the air line, time and again it has the habit of coming up with some misdeed or the other.

Unfortunately, this time I was personally the victim of  what I deem as a “Corrupt” practice as explained in my previous article . Following the event, I have now brought it to the notice of the Ministry both Mr Ashok Gajapathi Raju and also Mr Jayant Sinha and will await their response.

I would like all the employees of Air India to understand that “Unauthorized Modification” of data inside the computer is a cognizable offence under Sec 66 of the Act. I am sure that there will be an attempt now to erase some of these data which will also be an offence under Section 65 of the Act. Whether it is the operator at the counter who is responsible for the offence or his boss who has authorized the changes, has to be decided by the evidence. Obviously there will be vicarious liability on the executives since they have to set the policies of how such alterations can be made. In the current instance, I have pointed out that the Air Port manager has tried to justify the offence until the last moment and but for my determined counter argument would have abetted the completion of the crime.

I also would like to point out passengers such as Ms Priyanka Gupta that being the beneficiary of such a fraud makes them also part of the conspiracy and answerable to the law however innocent they may otherwise be.

I am fully aware that some times registered passengers do turn up late for check in due so some problems such as traffic issues etc and at those times we have heard Air India staff turning down their check in  for even a few minutes delay. In the instant case however, they dared to randomly chose some passenger who has already checked in and waiting some where in the Air port for the delayed flight to start and deleted his check in.

I donot understand how they planned to handle the situation at the boarding gate and whether the affected person could be bullied into accepting a situation where he is off loaded for no fault of his.  Probably they made the mistake of chosing a person who was already inside the airport and would definitely arrive at the boarding gate instead of some body who had not yet reached the airport when the preferred customer was sought to be accommodated.

I have requested the ministry to investigate in the matter.

Let’s us wait and see how they respond. If possible we can watch over an RTI trail how they handle this complaint in the next few days. Since I have made this a Cyber Crime Complaint, I hope police in Delhi will also take note and suo moto start an investigation of their own.

I I have forwarded a request to APAI ( association of air passengers to take up this matter for further follow up.

Anybody else who have had similar experience in the past should also take up their complaints with the minsitry so that they know the seriousness of the situation.

Naavi

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Indira Gandhi International Airport employees commit Section 66 offence..Action called for from Ministry of Aviation

I hereby report that On 13th December 2016, a Section 66-ITA 2000/8 offence has been committed by some of the employees of the Air India counter at the Indira Gandhi International Airport and seek action both by the Police in charge of the IGI terminal and the Ministry of Civil Aviation. This is an offence which carries three year’s imprisonment and is cognizable.

The incident involves unauthorized cancellation of a checked in passenger and allocation of the seat to another passenger for some consideration to be established in the further investigation.

The proof of the offence is available in the computers at the Air India check in system and the CCTV cameras in the airport between around 6.30 PM and 11.30 PM on 13th December 2016. The CCTV footage and the Computer records pertaining to the incident is an evidence of a cognizable offence and  need to be seized as evidence and should not be destroyed.  If deleted, it would amount to another offence under Section 65 of ITA 2000/8. Since I am marking copies of this open complaint to the authorities in the Civil Aviation Ministry as well as the IGI terminal, all of the authorities will be considered as notified and any action not to hand over the evidence under any pretext will be considered as further compounding the offence.

The intended victim of the offence was the undersigned (Vijayashankar Nagaraja Rao) registered passenger by AI 504 scheduled to leave at 20.30 hours but delayed first upto 22.30 and subsequently upto 23.30.

The suspected beneficiary was another registered passenger by name Ms Priyanka Gupta.

The offence was authorized by the “Station Manager” or such official and was endorsed by the Airport Manager.

The victim fought for his rights and ultimately ensured that the intention of the perpetrators of the offence was thwarted. However the incident remains to be a punishable offence and requires further administrative investigation as to the possibility of corruption of some of the officials.

Though the grievance was redressed,

The charge of Section 66 ..Unauthorized damage to information residing inside a computer resource  on the employee at the counter who under his log in deleted the passenger Vijayashankar Nagaraja Rao whose cheque in sequence was 8 and allocated the seat 6D in AI 504 of 13th December 2016 stands.

The offence extended to further modify the computer record by insertion of another passenger Ms Priyanka Gupta who was granted check in under the sequence 174 and allocated the same seat 6D.

The conspirators include the “SM” who authorized the deletion and addition.

The airport Manager who called at the final entry counter around 11.15 endorsed the offence and first declared that Mr Vijayashankar Nagaraja Rao has to be off loaded, then threatened that both Mr Vijayashankar and the beneficiary Ms Priyanka Gupta would be off-loaded, until he finally relented to the demand of the undersigned and let him travel. He is also therefore part of the conspiracy and the main accused because of his authority as the overall in charge of the operation.

The airport manager whose photograph is found here in even tried to use physical force to prevent the undersigned from boarding.

The main witness to be examined is the Duty Manager Mr Akbar whose photograph is also enclosed.

All other details should be available in the CCTV footages.

I demand that an extract of all relevant CCTV footage at the time of checking in of Ms Priyanka Gupta as well as Mr Vijayashankar passing through the security check and finally the encounter at the boarding gate for about 45 minutes prior to departure should be provided to the undersigned along with the log records showing the deletion and additions to the check in list mentioned above.

I request that the above information is taken note off by all relevant authorities and a proper investigation is conducted on how the employees can arbitrarily delete any of the passengers who have checked in earlier to accommodate their favourites. I understand that the flight was overbooked and several passengers were off loaded to accommodate some late comers. Investigation is necessary to find out who all were given priority check ins by offloading other legitimate passengers and who authorized such action and on what consideration.

I request honourable minister Mr Ashok Gajapati Raju to immediately order an enquiry and take suitable action against all the erring employees including the Airport Manager.

I am looking forward to receive details of action taken in this regard to follow up later with an RTI application if necessary. The photographs of relevant persons for enquiry purpose.

 

airport_manager

akbar_witnesses
deleted2 priyanka_login

Description of Photos:

Top Left: Airport Manager: Top Right: Duty staff at the last boarding gate

Bottom Left: Screen showing deletion of passenger already checked in-sequence 8

Bottom Right:  Screen showing new passenger sequence 174

 

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Is RBI directly involved in fraudulent note exchange?

One of the issues bothering ordinary citizens is the fact that Enforcement Directorate has been seizing a lot of new currency notes in many raids even while there is a shortage in the Banks.

So far, the suspicion was only on bank managers and we are aware that both in Delhi as well as in Bangalore several branch managers have been questioned and a few perhaps have been also arrested. The rumour that RBI may cancel the license of Axis Bank also emanated from the reports that several branches of Axis Bank were involved in systematic conversion of old notes to new notes in a fraudulent manner.

Now a report has emerged in social media in Bangalore that RBI may also be directly involved in the exchange of currency at least in one instance in Bangalore.

The whistle blower’s report is specific and it has been forwarded to the PMO. I hope there will be immediate action in this regard.

If this incident has happened in Bangalore, then RBI will not have any moral right to take action against either Axis Bank or any other Bank for the malpractices. Also similar incidents should have happened in many other RBI offices.

It is very sad that these institutions which we need to respect are themselves untrust worthy.

I have already requested the PM to announce a whistleblower policy in this regard and if Mr Modi himself makes a request and provides a channel of communication, then many bank employees both in commercial banks as well as RBI will turn into whistle blowers and we can unearth the huge amount of new currency that is being diverted to the black money holding people, most of whom are the politicians who are crying for the blood of Mr Modi.

If Mr Modi does not take immediate action, these fraudsters who are well connected will drag on this conversion until the end of 5o days limit which Mr Modi has asked to set things right and ensure that the situation will not improve.

Then the budget session of Parliament will also be a wash out with a demand for resignation of Mr Modi.

Waiting to see how this incident is handled by the PMO.

Naavi

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Axis Bank license is not going to be cancelled

After the earlier post in which I had indicated the unusual interest on the topic “Axis Bank” ,”License Cancelled”, one of my friends sent me a news paper report in a vernacular paper in Mumbai reproduced below.

axis_bank_license_denotification

It appears that the number of note exchange frauds reported from Axis Bank is what has triggered this report. However it appears that this is a speculation and is not true.

The article of 2013 was written in the context of the security vulnerabilities . In fact we have written many articles here criticizing Axis Bank for their deficiency in security both in the ATM as well as the Core Banking system. We have also pointed out the unfair attitude of the Bank in handling the customer’s complaints.

However, the current controversy is in the matter of exchange of new notes to favoured parties and assisting in the “Conversion” of demonetized currency. This is more a corruption of the individual Bank managers in different branches. We can fault the Bank for not building a culture of protecting the national interests. But the penalties have to be on individual staff of the branch and probably their regional heads.

In the current situation, it would not be wise for the RBI to take any action to cancel license of Axis Bank and the news report is only a journalistic over reach. However, penalties may be imposed on the Bank for the malpractices in the branch and the penalties may be heavy.

Before RBI moves in, it is the responsibility of the Bank management to take its own action against the erring branches and suspending the branch managers suspected to have committed such frauds.

I hope if the Bank takes sufficient action internally, RBI would be happy.

For the time being therefore let us kill the rumour about cancellation of license of Axis Bank.

Naavi

Added: Both Axis Bank and RBI has clarified later in the day that there is no proposal to cancel the license of Axis Bank.

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Unexplained Sudden Surge in interest in Axis Bank

Since yesterday, a strange surge in interest has been seen in “Axis Bank” in the Netizen community particularly connected to fraud and ATMs and surprisingly on “Cancellation of license”. This was observed by a large number of visitors to Naavi.org particularly to one article published in 2013. This is intriguing and indicates that there is an expectation somewhere that public are expecting some serious penal action by RBI on Axis Bank. I have no clue on the same and just reflect the reading of the data received.

On June 15 2013, we had published an article titled “Axis Bank ATM license should be cancelled by RBI” . In this article, we had highlighted frequent ATM frauds occurring in Axis Bank and had commented

“there is a clear indication that Axis Bank has failed to maintain a reasonable level of security at its ATMs which has caused the losses. It is therefore time for RBI to revisit its ATM security instructions and if it is found that Axis Bank has been systematically neglecting the security at its ATMs, RBI should consider suspending or cancelling the ATM licenses of Axis Bank”

In the last two days there have been nearly 400 visits to the particular page of this article some of the visits being directly out of a Google research “Axis Bank+license+cancel” indicating that there is some specific query on these terms. What is also surprising is that some of these Google queries has come from abroad like USA but most queries has come from India.

This is an unprecedented event and I expect some specific information in the air.

Let’s wait and watch.

Naavi

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