A doctor of dubious distinctions

ISLAMABAD: He claims to be one of the highest qualified orthopaedic and spinal surgeons of Pakistan, and many agree, but he has also been on the wanted list of US for healthcare fraud and medical malpractices since he fled from there to escape a trial.

Dr Atiq Durrani is among the busiest physicians in Lahore much like he was in Cincinnati (US), though it later turned out he did numerous medically unnecessary surgeries there, causing bodily harm to patients. An American hospital that he worked for had to pay fine of $4.1 million for Dr Durrani’s unethical practices whereas the hospital he works for in Lahore is shy of displaying his name on its website probably to avoid unnecessary exposure.

His licence has been suspended by Pakistan Medical and Dental Council (PMDC) whereas Punjab Healthcare Commission (PHC) is considering action against the elite hospital for allowing him to continue practice.

A notice has already been served and the hospital is dilly-dallying the response as it didn't submit response on a couple of times. The PHC has also taken a notice on a complaint about the death of a patient, herself a doctor, due to the “poor clinical judgment, incompetence and negligence” of Dr Durrani, alleges the family predominantly comprising of physicians.

This reporting is part of the Implant Files, an ICIJ-led investigation into the medical device industry and regulations. Readers can share their stories here. Dr Durrani fled from US in December 2013 and has since been settled in Lahore. The Federation of State Medical Boards (FSMB), a US organisation representing 70 state and osteopathic boards, wrote to PMDC conveying that Durrani’s licence was revoked by Ohio state for malpractices and that his registration licence will be permanently revoked on the basis of proven allegations.

The PMDC after several hearings suspended his registration in March this year with a note that his licence will be renewed only after he gets himself cleared from the FSMB. “Punjab Healthcare Commission shall also be written a letter to inform that his licence is suspended and he is not allowed to practice,” reads a declaration of the PMDC disciplinary committee, available with The News. “As per record, Dr Atiq Durrani’s registration licence expired on 31-12-2015. He can’t practice until he doesn’t have valid licence,” it further notes.

There is a corruption trial pending against Dr Durrani in US. The charges were investigated by Ryan Houston, Special Agent with US Department of Health and Human Services. Included among them were healthcare fraud, allowing unauthorised persons to write prescriptions in his absence and conducted medically unnecessary surgeries. He had the privilege to work at five different hospitals at different times which was withdrawn. One of them, the West Chester Hospital, had to pay $4.1 million in terms of damages for billing two insurance companies for unnecessary surgeries done by Dr Durrani.

Much like Pakistan where he is among the top earning physicians, Dr Durrani at times was the biggest biller of Medicare Company in Ohio. He had billed over $11 million in a little under three years, or about $300,000 per month, according to the federal charges framed by the special agent.

“Durrani derived significant profit by convincing patients to undergo medically unnecessary spinal surgery and by billing private and public healthcare benefit programmes for those fraudulent services,” according to the statement of the special investigation agent, available with The News.

At times, his statement continues, Durrani would persuade the patients that surgery was the only option when in fact the patient didn’t need surgery or other treatment would have been more effective. “At times, Durrani would tell the patients that the medical situation was urgent and that surgery was needed right away. He would also falsely tell the patients they were at risk of grave injuries without the surgery,” reads the statement of the special agent submitted before the court.

When a patient experienced complications resulting from the surgery, Dr Durrani at times failed to inform the patient of the issues or misrepresented the nature of the issues, according to the special investigative agent. Incidentally, somewhat similar happened with a patient who went to him in Lahore.

Dr Rozina Haroon, herself a doctor, had a pain in her leg and back. She went to consult him. He advised an immediate surgery and warned that any delay would result in complete paralysis. Procedure was carried out and the patient discharged a day after. She didn’t note any improvement; instead the pain aggravated reaching to the previously unaffected leg as well. Worse still, the surgical wound started oozing. It turned yellowish and was blood-tinged. Headache, severe shivering and high fever followed. Rozina went again to Dr Atiq who prescribed only an injection. Neither a spinal MRI was conducted to see any surgical or post-operation complication nor was hospitalisation done to monitor her deteriorating health.

On her third visit amid critical situation, he carried out another surgery without following the due procedure like MRI and without any documented reason requiring major surgery, her family alleged in a complaint filed to PHC. The condition further deteriorated as she was now having high fever, headache, neck pain and finally had fits as well. She was put on ventilator and expired at Doctors Hospital Lahore 20 days after the first surgery.

Rozina’s sister, herself a doctor, has blamed “poor clinical judgment, incompetence and negligence” of Dr Atiq for this death. Rozina, a practicing physician in Toba Tek Singh, was 47 when died. Her three sisters are also doctors, brothers-in-law too. The family took the matter to the PHC. Initially, the husband of the deceased was the complainant who was replaced by Rozina’s sister who is also a doctor. Talking to The News, Dr Durrani said the charges regarding Rozina couldn’t be substantiated and there was not much progress on this count. Not a single hearing was conducted, he said. The death of patient had nothing to do with the surgical procedure, he said.

“Patient was known case of epilepsy that was never declared to us as admitted by her own family to the doctors later on… During that epileptic fit she aspirated and later died due to complications from the aspiration pneumonia during the fit. It had nothing to do with the surgery,” he said.

Dr Arifa, the sister of Rozina, out rightly dismissed this point saying she had no history of epilepsy before. Why the family withdrew from the case remained a puzzle as they insist the charges were well-founded. A PHC official said the family was asked not to withdraw the complaint, nevertheless, they did probably fearing any reprisal.

Dr Durrani didn’t answer the question regarding his name on the wanted list of US Health Department. He was silent on the questions about $4.1 million fine to West Chester hospital due to him, reasons of fleeing US and that how did he become top billing physicians in Ohio. About cases pending against him in the US, he said some of them were decided in his favour. He didn’t offer any comment on the trial pending there. Regarding the suspension of licence by the PMDC, he said he challenged it before Islamabad High Court early this year where the PMDC admitted that its action was not legal and withdrew the letter.

Contrary to his claim, the PMDC wrote a letter to the PHC in September wherein it sought the enforcement of its decision regarding the suspension of licence and a direction to PHC to ensure he is not allowed practice anywhere in Punjab until he gets himself cleared from US and his licence is renewed by PMDC. It was in this context that PHC has put Doctors Hospital on notice to submit explanation for allowing Dr Durrani to practice when his licence is under suspension.