Suo motu on stents

January 19, 2017

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WITH the number of people fitted with coronary stents growing at a very rapid pace, the Supreme Court now wants to know how many patients have actually needed the medical device. The court has asked the FIA for an investigation. Besides wanting to ascertain if a stent implant was necessary or even carried out, another concern of the chief justice is to find out if the patients were charged an ‘exorbitant’ price. Some other questions that need answers relate to the quality and efficacy of the devices as well as the level of awareness regarding the procedure among the attendants. Media reports indicate that patients and their attendants are often in the dark about what a stent implant entails, and may end up being swindled by a greedy medical enterprise that preys on the sick.

Punjab Chief Minister Shahbaz Sharif was recently told that hospitals in his province were using unregistered coronary stents — despite the existence of DRAP, the drug regulatory authority. It is a shocking piece of information since the general public appears to think that at least this is an area that is being closely watched given the sensitivity of the life-saving ‘business’ — or families might be too worried about patients to ask too many questions about routine procedures and devices that are used to save lives. Indeed, it is quite likely that a majority of cardiac patients would be at risk without the insertion of a stent, and are, in fact, being given the right medical advice by expert doctors. But then, if there is any unusual medical procedure taking place in their vicinity, doctors, especially the specialists among them, have a duty to report it and to help stop it before it becomes a regular practice. Now the reports, even without being backed by FIA findings, threaten to bring stent implantation into disrepute, opening the floodgates to yet more criticism that could condemn the entire healthcare system of the country.

It is said that the big hospitals in the more privileged and supposedly more secure Lahore — Mayo, PIC, et al — have all been getting their supplies of unregistered coronary stents. They will now be under probe by the FIA amidst fears that matters could be worse in smaller towns, given that ‘stenting’, as it is sometimes called, has emerged as a safe, routine procedure to treat coronary blockages. The fact that healthcare in the country needs constant monitoring by the authorities cannot be emphasised enough. Indeed, it would seem that, in a variety of illnesses, even well-qualified doctors are capable of acting as quacks and are not averse to prescribing expensive drugs and procedures that may not be needed — all this in order to make extra money. Unless there is greater vigilance and suitable penalty for those who play with their patients’ health, such unethical practices will not stop.

Published in Dawn, January 19th, 2017