On Friday, three year old Sahiba (name changed) from Srinagar was diagnosed with hyperthyroidism after her investigation report from a reputed private diagnostic lab showed elevated levels of thyroid hormone. When three year old Sahiba was taken to doctors by her parents they decided to put her on anti-thyroid medications after seeing the report. But at last minute they decided to get another investigation done from another lab.
Sahiba's parents were shocked to see that the tests done at another lab showed her thyroid levels were within normal range. A third lab also confirmed the normal levels of the hormone.
Such discrepancies and lab errors, doctors said, were a cause of concern and could sometimes prove fatal. "Had I relied on the first report and prescribed the medicine based on it, this could have caused serious complications in the child," the parents quoted the doctor telling them.
Kashmir has been witnessing a huge increase in number of diagnostic labs over the years and with this, doctors said, there has been a corresponding increase in the reported number of erroneous lab reports. While doctors said that they try to minimize chances of wrong diagnosis with repeat tests and correlating clinically, wrong diagnosis was unavoidable in some cases due to lab reports.
While Directorate of Health Services Kashmir (DHSK), the nodal agency for licensing and registering diagnostic labs in Kashmir has a detailed manual in place specifying requirements mandatory for a lab to operate, these conditions are often not met by most labs, doctors said.
While experts said that a number of labs are operating even without proper registration and licenses in most districts, even the registered ones had shortcomings.
Recently, an inspection team of Health Services sealed three diagnostic labs in Srinagar on the complaints of operating without registration. Officials in the department had said that the 'surprise checks' were conducted to 'streamline the functioning of diagnostic centers and clinic establishments and to curb menace of quackery' upon instructions of Divisional Commissioner Kashmir.
While doctors across Kashmir had hailed the surprise checks they said that such checks were a few and far between, leaving a huge scope for compromises on quality and reliability.
In some cases "unqualified" manpower to carry out the tests at most labs has been cited as the primary cause of errors by labs. Reportedly while labs take samples and give reports for most kinds of tests, the manpower doing these tests has got no training in all fields of diagnostics.
Noted pediatrician and member of Civil Society, Dr Ashiq Hussain said, "Any person can get a lab registered as per the Jammu and Kashmir Nursing Homes and Clinical Establishments ( Registration & Licensing) Act, 1963 and start fleecing people. The whole debate and discussion about private labs is about their being registered or not registered," Dr Hussain said. "Need of the hours is to employ qualified registered professionals to run these diagnostic centers. Staff needs to be accredited, registered, qualified," he said.
Dr Sabiha Majid, HoD Biochemistry GMC Srinagar, while talking to Greater Kashmir said, " There is a need for external quality controls and checking squads that consist of experts. In this era of specialisation, you cannot ask a physician to comment on whether a pathologist is doing his job well," she said.
Lack of infrastructure has also been cited as another major reason for quality compromises. According to the norms laid down by the Department of Health, J&K, any general clinical laboratory must have 'a testing area, bleeding area and waiting area along with a toilet attached with rooms and adequate water supply and electricity.'
However, many of these labs operate from 'unkempt shacks' with no power back up resulting in deterioration of sample quality. According to sources, even the well equipped and fancy looking labs have inexperienced or under-qualified people to conduct the tests.