A hefty medical bill of $1.6 million has been submitted to the North Central Regional Health Authority (NCRHA) for a pensioner who subsequently died after undergoing a $4,500 tracheotomy. Medical Associates Hospital Ltd, one of the private hospitals patients are referred to if a specific medical service cannot be accessed at a public facility, has forwarded the invoice to the NCRHA for payment.
The exorbitant bill is not sitting well with Health Minister Dr Fuad Khan who yesterday told Sunday Guardian he has ordered an investigation into who and what led to the medical expense. "Somebody would have to account to me. A tracheotomy is a basic procedure and we have to a pay a bill of $1.6 million. People are not doing the proper checks and balances at NCRHA," an outspoken Khan said.
The bill is among the huge claims being forwarded to the regional health authority and which is being questioned. Confidential medical data obtained by Sunday Guardian revealed that Bhawandaya Lutchman was admitted to the NCRHA on December 23, 2010, after complaining of feeling unwell.
Four days days later, Lutchman was transferred to the private hospital because of respiratory problems. A tracheotomy procedure was conducted on the 77-year-old pensioner on January 10, 2011. The minor procedure involves making an incision in the trachea to allow a tracheotomy tube to be inserted, so a person can breathe if unable to do so through their nose or mouth.
Lutchman subsequently died on March 30 at the private hospital. Her death certificate listed the cause of death as cardio-respiratory failure, acute respiratory distress syndrome and diabetes.
So exactly what led to the staggering bill? A source at the private hospital confirmed to Sunday Guardian that Lutchman did not undergo any additional surgical procedure. According to the statement of accounts obtained by Sunday Guardian, Medical Associates is claiming that the whopping $1,224,789 is owed for medical services for Lutchman.
The sum does not include the $347,400 listed as doctor fees that is also overdue. The total outstanding payment of $1,572,189 is listed on invoice number 546415 of the financial document. Lutchman's medical files show that the doctor's fee for conducting the tracheotomy was listed at $2,000.
So exactly how much money was incurred for medication and accommodation at the private institution? Additional information revealed that Lutchman was admitted to the intensive care unit at the private hospital at a daily rate of $4,500.
Her medication expenses are listed at $433,285. While doctor fees are stated as:
• Prof Teelucksingh-$237,500
• Dr A Narinesingh-$97,000
• Prof V Narayansingh-$8,500
• Dr Teeluckdarie-$2,000
• Dr Poon King-$1,800
"Something is not adding up," a NCRHA medical official who spoke to Sunday Guardian under the condition anonymity said.
Son in shock over huge bill
Expressing shock over the huge medical bill, Lutchman's youngest son Khanhai said he was perplexed over what could have cost so much money. Clutching a photograph of his mother kept in the temple the family's Warren Road, Chaguanas, home Lutchman said he was considering reporting the matter to the police.
"I thought mummy gone to rest but in death her name is involved in this. The kind of people outside here would try anything to get money. What could cost that amount of money? The relevant authorities have to investigate this but the sad thing is that all the paperwork from the nursing home was taken back from us. Something is not right and I feel hurt. A bill of more than $1 million for mummy; something is not making any sense," the confused man said.
Lutchman's medical bill is among a list of 103 claims submitted to the NCRHA for outstanding payment, totalling the sum of $14 million. The outstanding monies are for the period April 2007 to January 2012. The bills of 16 patients totalling to approximately $600,000 remained outstanding to the private facility under the former administration.
Medical Associates is also requesting payment for a number of patients admitted from October 2010. Financial documents show that medical expenses outstanding in some of the instances are as follows:
• $647,564.35
• $419,518.40
• $415,095.90
• $346,533.00
• $246,746.50
• $218,326.00
The Anti-Corruption Investigations Bureau is now conducting investigations into alleged corrupt activities at the NCRHA. In a May 10 letter to the Authority's acting chief executive officer Colin Bissessar, senior supt Solomon Koon Koon requested all internal and external audit reports during the period September 2002 to present.
Khan fed up of wastage
Accusing private institutions of wilfully taking advantage of patients in some cases, Khan said he was fed up of the unnecessary wastage. "I gave specific instructions to stop outsourcing services. And in the exceptional case, proper checks must be kept. When you send patients to private institutions, the next thing is that we end up paying a million dollars for use of the private facility and are being held to ransom. Once we refer a patient to a private institution we have lost control."
Khan said in cases where patients are referred to private facilities, the onus was on the relevant heads to ensure that the patients are readmitted to the hospital. "If we leave it up to the private institutions to discharge the patients, they will never do that.
They keep them on ventilators and they do not send them back and then we get these exorbitant bills. I am trying my best to stop this. If a hospital has to outsource a medical service, at least keep a proper check, so they can be readmitted to the hospital. A patient being at a private institution for three months could not be right.
"I have been saying that we pay so much money to outsource expenses, but yet we find it difficult to hire the ear, nose and throat specialist in-house because of some procedure, claiming a conflict. I am also facing a similar problem with cardiology and that is why I have to change the legislation. "Could you imagine 15 patients at $1.6 million?"
