Good morning. Three stories today, and the first one should change what you write in your notes this week. Also inside: what each rank was actually worth in the first round of PG counselling, and the three people in Delhi who now decide whether the rules on pharma hospitality carry any teeth.

— DR. ADITYA SETH, EDITOR-IN-CHIEF

01  ·  THE LEAD
MEDICOLEGAL

A hospital missed its 45-day reply window, and a Jamnagar commission ordered it to pay ₹7.3 lakh

The patient was himself an ENT surgeon in Jamnagar. He had pain running from his left buttock down to his foot, and an Ahmedabad hospital told him he needed a total hip replacement. The surgeon who would operate assured him the pain would go completely. Ten days later he was on the table, on a bill of ₹4 lakh. The pain never settled. He could not sit for 15 minutes or manage 50 steps with a walker, and within a fortnight he was back home in bed, where he stayed until the following August. At his six-week follow-up the team prescribed vitamins and told him to walk up to 5 km a day. At two months, the hospital’s own neurologist confirmed what the walking was never going to fix: foot drop from a damaged sciatic nerve.

He had been recording those follow-up visits. When his complaint reached the district consumer commission, the hospital’s written reply arrived at the tail end of the 45-day window, and the commission set it aside. Citing the Supreme Court, it held that a party which misses that deadline keeps the right to argue and nothing more. So his evidence went in unanswered: textbook pages from Campbell’s and Hoppenfeld, affidavits from his driver and his nurse, and a pen drive. On the recordings, the commission found the senior surgeon and other hospital doctors saying the nerve had been injured while retractors held the muscles back. It treated those statements as admissions. Another ₹50,000 in costs rides on top, the whole amount is due within a month, and 9% annual interest starts after that.

WHY IT MATTERS
  1. Diarise day 45 the moment a notice arrives. Filing inside the window is what keeps your version of events on the record at all.

  2. If you tell a patient a nerve was injured, write it in the file the same day. The corridor conversation is evidence either way; the file is your only chance to put it in context.

  3. For pain running buttock to foot, record how you excluded a nerve cause before you list a hip. The commission also faulted the absence of any work-up for piriformis syndrome, and held that an uncontested file needs no expert opinion to decide.

02  ·  EXAMS AND ADMISSIONS

Medicine and Radiology took 79 of the top 96 ranks. Anaesthesia, the biggest branch in the round, waited until AIR 503.

MCC’s provisional Round 1 list runs to 1,735 pages and 28,723 allotments, from AIR 1 down to AIR 1,59,922. AIR 1 took MD General Medicine at RML, Delhi, and by AIR 100 another fifteen doctors had picked the same course at the same hospital. Delhi’s colleges took 52 of the 96 top-100 ranks that appear on the list. Nuclear Medicine, which has only 13 All India Quota MD seats, closed its last Open seat at AIR 838, earlier than any other branch. No non-clinical seat went at all until AIR 961, for Pathology at Maulana Azad.

Round 2 registration opens on 6 November and choice filling closes at 10 am on 12 November, which makes these the only numbers you have while you rank.

 
WHERE GOVERNMENT OPEN SEATS RAN OUT
Last rank to get an Open seat, All India Quota, Round 1
 
Radiology
   
3,058
General Medicine
   
4,703
Dermatology
   
5,628
Paediatrics
   
9,574
General Surgery
   
14,012
Obs & Gynae
   
14,190
Orthopaedics
   
15,591
Anaesthesia
 
24,614
 
Government MD/MS seats only. EWS, OBC, SC, ST, PwD, DNB and deemed closing ranks are in the full table →
03  ·  PHARMA

Gifts and paid foreign trips: three people now have two months to decide whether the marketing code should become law

The complaint came from the medical representatives themselves. Their federation told the Supreme Court that drug companies reward doctors indirectly, through expensive gifts and sponsored foreign travel, to tilt prescriptions toward particular brands. The two judges hearing it ordered a review of the existing rules, including the Uniform Code for Pharmaceutical Marketing Practices, which no company is legally bound to follow.

The Department of Pharmaceuticals named the panel in an order dated 22 October: NITI Aayog member Dr M. Srinivas as chair, former Union Health Secretary Preeti Sudan, and Medanta’s Dr Naresh Trehan. It can recommend regulations, a law, or something else, and its report is due two months after its first meeting. The court takes the case up again at the end of January.

The department has moved on this before. Two years ago it reprimanded a US drug major, acting on anonymous complaints, for sponsoring a pleasure trip for 30 doctors.

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