Life-threatening scam in Karnataka's ambulance service?

Bengaluru: Potentially life-threatening levels of mismanagement are being alleged in 108 Arogya Kavacha ambulance operations, with drivers complaining that their contractor is putting lives at risk by “forcing” them to shift critical patients into multiple ambulances en route a hospital.

On July 19, patient Syed Iftikhar suffered a heart attack and a stroke in Chitradurga. He was rushed to the district hospital and later Jayadeva Hospital in Bengaluru in six ambulances in six hours. His brother Syed Mumtaz and his relatives waited for at least an hour at Chitradurga, contacting the 108 helpline.

“Initially, we were told that no services would be provided. It was around 11.30 pm. Later, an ambulance came but the driver told us he couldn’t go further than 20 km due to company orders and made us wait on the highway until another vehicle arrived,” Mumtaz told DH.

He alleged that Iftikhar was shifted in four vehicles from the Chitradurga district hospital to Sira, Tumakuru (around 82 km), before being taken in two more vehicles until Jayadeva.

Syed Mumtaz has captured several videos of the transfer showing different ambulance number plates, two of which were reviewed by DH. In one such video, a man could be overheard saying “this is the fourth vehicle” with Iftikhar being shifted in the background. “This has traumatised us,” said Mumtaz.

Alleged scam

Locally, such a transfer is called a “double dispatch”, which is done to ensure that patients reach points of care faster or gain access to an advanced life support (ALS) ambulance quickly. With due permissions, a maximum of three transfers is allowed over longer distances.

However, ambulance drivers DH spoke to alleged that was the tip of a large scam run by the company EMRI Green Health Services.

Two drivers, one in Mysuru and another in Davangere, also alleged that company representatives threaten drivers if they don’t comply or cut their already poor pay. “Many of our ambulances run without an emergency medical technician too so we are also helpless if something were to happen to the patient on the way,” one of them said on condition of anonymity.

While company representative Hanumanthappa denied the allegations and termed them “baseless”, a company insider told DH that this is being done to wrongly inflate the number of ambulance trips and patients transported to draw higher bills from the government.

In a similar incident on August 5 in Kalaburagi, a pregnant woman lost her baby. The woman’s family alleged that while she was taken to the Sulepeth community health centre in a 108 ambulance, doctors asked them to take her to Gulbarga Institute of Medical Sciences (GIMS) about 60 km away. She was shifted between three ambulances and reportedly lost her foetus before reaching GIMS.

Repeated attempts to reach Dr Prabhudev Gowda, the current Deputy Director, EMRI 108 services at the state health department were not fruitful. 

‘New tender will be better’

Health Minister Dinesh Gundu Rao told DH, “I am aware of this issue of double or triple dispatches. Some discussions had happened before the elections this year to see if exemptions can be made for emergency cases to take patients directly over a long distance. I was told this existed but I am not sure what happened in these cases. We will look into this.”

The department had GPS units installed in each ambulance to track their movement but its control room is at the company’s office in Basaveshwaranagar.

“We need to have better technology at the control room. There is not enough of our oversight there,” Rao noted. He added that the department has prepared the request for proposal (RFP) and will float new tenders by the end of this month to see how systemic changes can be brought in for better accountability.

‘Must conduct an audit’

Health Commissioner D Randeep admitted to DH that he wasn’t aware of the issue as no such reports had reached him.

“We must conduct an audit of the company’s monthly trip reports to check for this. If parties involved are found to be guilty after verification, we will take corrective action.”