Editor in Chief Dr KK Aggarwal, Padma Shri Awardee

Dated: 10th July, 2019

Martin Walker Earns Texas' Largest Medical Malpractice Verdict of 296 crore

$43M ( 296 crore INR) gross negligence verdict named to Texas Lawyer list of top verdicts

PR Newswire: Trial law firm Martin Walker has earned honors for winning the largest medical malpractice verdict in Texas in 2018 for the $43.32 million jury award against Tyler-based East Texas Medical Center and one of its doctors.

A jury found ETMC grossly negligent for allowing Dr. Gary Boyd to treat 61-year-old Billy Pierce, despite having been placed on probation by the Texas Medical Board. Mr. Pierce was admitted in April 2014 with stomach pain and vomiting. During the trial, Martin Walker attorneys argued the hospital bylaws should have prevented Dr. Boyd from practicing at the facility. Testimony showed that Dr. Boyd diagnosed Mr. Pierce with an abnormality he said would make surgery to remove bile duct stones impossible. For more than a month, Mr. Pierce was in a medically induced coma during which time Dr. Boyd and the hospital abandoned him, according to testimony. Once the hospital sought a second opinion, a new doctor rejected Dr. Boyd's diagnosis and operated without complication.

Jurors agreed that Dr. Boyd's improper care led to the loss of Mr. Pierce's quality of life and his ability to provide for his family. The $43 million verdict included $18.57 million for past and future pain, anguish, loss of earning capacity, and medical care and expenses. The jury also awarded $25 million in punitive damages, after concluding the hospital's conduct involved an extreme risk of potential harm to others.

The case is Billy Pierce v. East Texas Medical Center and Dr. Gary Boyd and the ETMC Digestive Disease Center, Cause No. 16-0853-C in the 241st District Court in Smith County.

Budget Highlights: Income-tax (Part 2)

8. PAN allotted to a person shall be deemed to be invalid, if he failed to intimate the Aadhaar to the Dept.

9. A new Section 194N has been inserted to require deduction of tax at source at the rate of 2% if aggregate of cash withdrawn during the financial year from any account maintained with a banking company or cooperative bank or post office exceeds Rs. 1 crore.

10. The sunset date for transfer of residential house property, for claiming exemption under Section 54GB in respect of investment made in eligible start-ups, has been extended from 31st March, 2019 to 31st March, 2021. Further, the conditions of minimum shareholding or voting rights has been relaxed from 50% to 25%.

11. Application under Section 195(2) and 195(7) for lower or nil deduction of tax from sum paid or payable to non-residents person can be filed electronically.

12. A new Section 194M has been inserted to require any individual or HUF (who is not required to deduct tax under Section 194C or 194J) to deduct tax at source from sum paid to a contractor or professional if aggregate payment during the year exceeds Rs. 50 lakh. The tax can be deposited under this provision without any requirement to obtain TAN.

13. As per Section 194-IA, a buyer is required to deduct tax at source from the consideration paid to buy an immovable property. An explanation has been inserted that 'consideration for immovable property' shall include all charges paid towards club membership fee, car parking fee, electricity and water facility fees, maintenance fee, or any other charges of similar nature, which are incidental to transfer of the immovable property.

14. In case of failure to file an Income-tax return, the prosecution proceedings are initiated under Section 276CC if the tax payable by the assessee is Rs. 3,000 or more. This threshold limit has been increased to Rs. 10,000......to be continued

Courts should make guidelines and leave it to the medical boards and not handle the cases themselves?

Dr KK Aggarwal & Advocate Ira Gupta

Now and then women approach the courts for termination for pregnancy on medical grounds. Instead of approaching the courts, the government should come out with clear cut guidelines, based on which the medical board can take a decision in such cases.

Like in MCI ethics regulation 6.7 “ …the question of withdrawing supporting devices to sustain cardio-pulmonary function even after brain death, shall be decided only by a team of doctors and not merely by the treating physician alone…”.....read more

Diagnostic testing of concurrent suspected dengue or Zika in symptomatic patients

The United States Centers for Disease Control and Prevention (CDC) has issued updated guidance for diagnostic evaluation of Zika and dengue virus infection in symptomatic patients. According to the guideline, nucleic acid amplification tests (NAATs) are the preferred method of diagnosis for patients with suspected dengue or Zika virus disease.

The key recommendations are:

  • For symptomatic nonpregnant persons, dengue and Zika virus NAATs should be done on serum collected =7 days after symptom onset. A positive NAAT in symptomatic persons with possible exposure to dengue and Zika virus typically provides evidence of acute infection, and no antibody testing is indicated.

  • If NAAT is negative or serum is collected >7 days after symptom onset, dengue and Zika virus IgM antibody tests should be done.....read more

Panchamrit body wash

Panchamrit is taken as a Prasadam and is also used to wash the deity. In Vedic language, anything which is offered to God can also be done to the human body. Panchamrit bath, therefore, is the original and traditional complete bath prescribed in Vedic literature. It consists of the following:

  • Washing the body with milk and water, where milk acts like a soothing agent.

  • This is followed by washing the body with curd, which is a substitute for soap and washes away the dirt from the skin.....read more

Healthcare News Monitor

100-bedded paediatric ICU to be set up in SKMCH, Muzaffarpur within a year: Centre to SC

ET Healthworld-ANI

The Centre on Monday filed a reply in the Supreme Court on the AES outbreak in Bihar, saying that a decision has been taken to set up a 100-bedded paediatric ICU at Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur in one year with funds from it. Five virology labs were set up in different districts of the state and 10-bedded pediatric ICUs will also be established in different districts, it said. The reply submitted that despite the fact that health is a state subject, the central government had taken all steps for giving necessary help and assistance to the Bihar government to contain the outbreak. The death toll due to Acute Encephalitis Syndrome (AES) mounted to 140 in Muzaffarpur district on Friday. As per official data, 119 deaths have been reported at the government-run SKMCH, which is handling the largest number of patients in the district, while 21 deaths have been confirmed at Kejriwal Hospital.

IPC releases Addendum 2019 to Indian Pharmacopoeia 2018


To strengthen the quality of drugs in India, the Indian Pharmacopoeia Commission (IPC) has released the Addendum 2019 to Indian Pharmacopoeia 2018. Union health minister Dr. Harsh Vardhan officially released the IP Addendum 2019 at a function on 5th July, 2019 at Nirman Bhawan, New Delhi in presence of senior officers of the Health Ministry and scientific staff of the IPC, Ghaziabad. The IP Addendum 2019 to IP-2018 contains 66 new monographs including those of chemicals (61), herbs and herbal products (03), and radiopharmaceuticals preparations (02). One general monograph on lotion has also been included in this Addendum. Special emphasis has been given to the dosage forms of API whose dosage forms were not in the IP 2018. General chemical tests for identification of an article have been almost eliminated and more specific infrared, ultraviolet spectrophotometric, HPLC and HPTLC tests have been given emphasis. Special emphasis has been given to include/upgrade dissolution test in existing monographs. Most of the existing assays and tests on related substances have been upgraded to liquid chromatography method. It is hoped that IP Addendum 2019 to IP-2018 would play a significant role in improving the quality of medicines which, in turn, will promote public health and accelerate the growth and development of pharma sector in the country. On this occasion, Dr. G.N. Singh, Secretary-cum-Scientific Director, IPC highlighted various salient features of IP Addendum 2019 to IP-2018 and emphasized the need of the same with a view to meeting the essential requirements for harmonization of analytical methods with those accepted internationally and said that necessary steps have been taken by the Commission for monitoring and upgrading drug standards in IP Addendum 2019. Further, he also said that publication of IP and its Addendum on regular basis is an important mandate of IPC and is aimed at improving the health of the common man in the country by ensuring the quality, safety and efficacy of medicines.

ICMR to identify and certify Poliovirus Essential Facilities as part of govt’s polio eradication programme

Pharmabiz- Shardul Nautiyal

The National Authority for Certification of Poliovirus Containment (NAC) under the Indian Council of Medical Research (ICMR) has called for applications by August 07, 2019 to recognise and certify Poliovirus Essential Facilities (PEFs) in the country as part of polio eradication programme. Government of India established NAC in August 2017. Poliovirus vaccine manufacturers, R&D laboratories, diagnostic and testing laboratories and diagnostic reagents manufacturers are a few examples of laboratories requiring to continue to handle poliovirus type 2 in post-eradication periods. As per the Union Health Ministry's mandate, only the certified PEF will be permitted to continue work with poliovirus type 2 in India. NAC will follow the globally accepted protocol for facility certification as described in World Health Organisation (WHO) Containment Certification Scheme (CCS). Government’s polio immune strategy is aimed to make a switch over from trivalent oral polio vaccine (OPV) to bivalent oral polio vaccine (OPV) in a phased manner to completely stop OPV and switch to inactivated polio vaccine (IPV) by 2020. The trivalent OPV that was used till April 2016 contained three types of poliovirus vaccines (P1, P2 and P3) and protected against all three types of wild polioviruses – type 1, type 2 and type 3, while bivalent OPV contains two types of poliovirus vaccines (P1 and P3) and protects against type 1 and type 3 wild polioviruses. Type 2 component from OPV was removed as a part of global polio end game strategy. Therefore, organisations retaining Poliovirus type 2 materials (wild, vaccine and/ or genetically modified strains) or PEFs are required to obtain certificate of compliance in line with requirements of polio virus containment envisaged under the Global Action Plan III (GAP III) and WHO CCS. Eradication of wild poliovirus type 2 was certified in September 2015. Global withdrawal of OPV2 (Sabin2 vaccine) was achieved in April 2016. Since the poliovirus type 2 (prototypes, wild poliovirus isolates, vaccine strains and their derivatives) are under containment as described in GAP III. Poliovirus type 2 is now an eradicated pathogen.

NIN Hyderabad collaborates with UKIERI to offer training in pre-clinical drug discovery

Pharmabiz- A Raju

With an aim to provide hands on experience to lead researchers in the field of medical and healthcare, pharmaceuticals, biotechnology and professionals from other related fields, the National Institute of Nutrition (NIN) Hyderabad in collaboration with UK India Education Research Initiative (UKIERI) is offering a 4-day training programme from 8-12th July, 2019 at NIN premises at Tarnaka in Hyderabad. Termed as ‘Train the Trainer’ course, the training programme is mainly aimed at developing human resources in the field of pre-clinical drug discovery. According to Dr. R. Hemalatha, programme partner from ICMR-NIN, this training programme is listed by Ministry of Skill Development and Entrepreneurship (MSDE) under the development of industry-relevant learning outcomes and curriculum for education, training and continuing professional development (CDP) of lab animal pharmacologists. Informing about the training programme, Dr. Hemalatha said that all professionals from AYUSH, ICMR, CSIR, NIPER, JIPMER, ICAR, DRDO, AIIMS, PGIMER and academic institutions, Universities, Medical Colleges and Industry can take part in the training under this programme. “We at NIN have state-of-the-art facilities for conducting pre-clinical drug discovery research. We are having advanced animal facility and preclinical toxicology facility. Overall NIN is adequately poised to lead this initiative and we are proud at imparting new skill sets which is much needed for the lead researchers in the field of new drug discovery,” said Dr. Hemalatha. The training programme is mainly focused and is being carved out to impart education and training to the next generation of animal scientist involved in drug discovery. It is giving stress on up-skilling and continuing professional development of existing pre-clinical pharmacologists and entrepreneurs.

Doctors at 3 Major Delhi Hospitals Go on Strike Over Alleged Assault on Medical Student, Demand More Security


Doctors at Maulana Azad Medical College, LNJP Hospital and GB Pant and Guru Nanak Eye Centre called a strike on Tuesday a day after an on-duty doctor in the emergency ward was assaulted allegedly by patient's relative. As part of the strike, which started in the morning, both of LNJP Hospital's regular and emergencies services are currently shut, affecting patients at the biggest Delhi government-run hospital, the medical superintendent said. The Resident Doctors' Association of the Lok Nayak Jai Prakash Narayan (LNJP) Hospital has claimed that the stir has been triggered by an alleged assault on a third-year student of Maulana Azad Medical College, who was on duty last night in the emergency department. "A patient was brought to the ER department and later died of some complications. An attendant then assaulted one of the doctors," RDA president Saiket Jena alleged. "In the last few days, several such incidents of attack on doctors have taken place in the hospital premises. So, we have gone on a strike," he said. Their main demand is augmenting of security deployment, including having marshalls in the emergency department, Medical Superintendent Dr Kishore Singh said. A meeting is currently underway between the RDA and hospital authorities, he said. The incident comes days after two junior doctors at NRS Hospital in Kolkata were assaulted allegedly by the relatives of a patient who died at the hospital. Junior doctors in West Bengal went on a strike following the incident over lack of security at the workplace.

Hospital continues to treat poor patients despite Rs 13cr loss

Pune Mirror- Vicky Pathare

In its battle to ensure that charitable hospitals keep to their commitments under the Indigent Patient Fund (IPF), the charity commissioner’s office has found a poster institute in Inlaks and Budhrani Hospital (IBH) of Koregaon Park. The medical facility run by the Sadhu Vaswani Mission has chosen to continue offering heavily discounted treatment to poor patients approaching it, despite the commitment running well past the realms of the earmarked fund and bleeding its bottomline. This, despite the charity commissioner also allowing the hospital to take a break until its funds are refurbished. The phenomenon is a marked shift from the position taken by the Group of Charitable Trust Hospitals in Pune, which (as reported by Mirror on December 14, 2017, in the article ‘Hospitals claim charity commissioner forces them to treat the poor’) moved Bombay High Court (HC) in 2017, challenging the charity commissioner for compelling its members to keep spending on indigent patients despite outstripping the allocated funds. IBH was a signatory to this petition. “Being a member of the body of charitable hospitals, we went along with its decision. But as per a Supreme Court ruling, we cannot deny emergency treatment without valid reason and the charity commissioner permitting us to stop treatment under IPF,” explained Dr Rhea Punjabi, medical director of IBH.