How PM-JAY surgery deaths point to a systemic rot in Gujarat

The Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (PM-JAY) is suddenly at risk of a credibility crisis in Gujarat following the November 11 deaths of two beneficiaries who underwent angioplasty—allegedly without their knowledge, permission and due care.
The procedure was performed by the Ahmedabad-based Khyati Multispeciality Hospital on seven people after a medical check-up camp in their village of Borisana in Kadi taluka of Mehsana district, and the claims submitted under PM-JAY.
Angioplasty is a medical intervention to improve blood flow in blocked coronary arteries. The two victims—Mahesh Barot, 52, and Nagar Senma, 75—reportedly did not have any history of cardiac ailment.
News of their deaths sparked outrage in the village and beyond and opened up the veritable can of worms about systemic loopholes in Gujarat lending PM-JAY vulnerable to misuse by empanelled private hospitals.PM-JAY is a flagship central health insurance scheme launched by the Narendra Modi government and entitles low-income families and all above 70 years of age to free medical treatment. According to the National Health Authority Dashboard, 26.2 million Ayushman cards have been created in Gujarat, with 180,000 cards issued in the past 30 days.
Sensing another case of urban negligence that could cast a long shadow on governance in Gujarat, the health department suspended Khyati Hospital from the PM-JAY list and filed cases against Dr Prashant Vazirani, who had conducted the ill-fated surgeries; the hospital’s owner and chairman Kartik Patel, CEO Chirag Rajput, directors Rajshri Kothari, Dr Sanjay Patolia, and marketing officer Milind Patel. The charges include culpable homicide, attempted culpable homicide, forgery, cheating and criminal conspiracy.
Sweeping arrests were also made of Dr Vazirani and Milind Patel and Rahul Jain from the hospital’s management.
Kartik Patel is believed to have left for Australia in early November and several of the trustees and staff were reported absconding.
The state government also dropped six other hospitals from the PM-JAY empanelment. Two of these are in Ahmedabad and one each in Surat, Vadodara, Rajkot and Gir Somnath. The government said these hospitals had been violating PM-JAY norms.
Four doctors have been suspended—cardiologist Dr Vazirani, Dr Hiren Mashru (paediatrician, Nihit Hospital, Rajkot), Dr Ketan Kalariya (radiation oncologist based in Rajkot) and Dr Mihir Shah (surgical oncologist, Sunshine Hospital, Vadodara and Surat). Complaints have been received by the state government against all the suspended hospitals and doctors of allegedly fabricating reports and meting out inappropriate treatment to patients to avail benefits under PM-JAY.
The probe was swiftly handed over to the police crime branch, which conducted raids at the offices and homes of the hospital’s owner and trustees and even moved in to freeze the assets of the hospital and its top management to trail the money alleged to have been fraudulently claimed under PM-JAY.
The crime branch probe has revealed some sinister details. Sources said that in the past two years, Khyati Hospital had conducted 19 medical camps in villages of north Gujarat. Dozens of angioplasties had been conducted in recent times, with at least half a dozen allegedly suspicious ones having come to light and likely to be included in the probe.
The sources claimed some village heads were aware of the scam and had been bribed. Patients’ medical data collected during the medical camps was allegedly being traded.
Sources said the role of senior health department officials was also being internally investigated, since it is understood that a scam like this could not have been perpetrated without official patronage at some level. “These deaths have blown the lid off a well-laid-out scam being operated by Khyati Hospital for years. It is particularly disturbing that with the help of the sarpanch, they identified and targeted backward and aged people in the village to perform these surgeries, recognising their vulnerability and lack of understanding about their health complications,” Congress spokesperson Hiren Banker said.
There is now a strident demand from the Opposition and rancour on social media for action against hospitals suspected of PM-JAY irregularities and a quick investigation against whom complaints have been received. Under fire to defend the credibility of the central scheme, the Gujarat government has indeed cracked the whip on Khyati Hospital, but whether it uses the opportunity to effectively address the systemic rot remains to be seen.
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