… deliberately manipulating medical  test results

Lhakpa Quendren

Gelephu—Two medical screening centers and a labour agent in Gelephu were suspended from doing business for breaching medical protocols by deliberately providing false results for Hepatitis B surface antigen (HBsAg) tests of two foreign workers.

The New Life Diagnostic Center, Druk Diagnostic Center, and Songtse Labour Agent were found to have tampered with HBsAg test results of  two Bangladeshi workers, who traveled from Paro to Gelephu with a road permit, and stayed in Gelephu.

The Bhutan Qualifications and Professionals Certification Authority (BQPCA) investigated the matter and, considering its criminal nature, referred the case to the Gelephu police.

New Life Diagnostic Center reported positive HBsAg results for two workers, but at the request of the Songtse Labour Agent, the results were not uploaded to the national database. The labor agent requested the center to alter the positive results to the negative, stating that the agent had incurred significant expenses for their travel.

While HBsAg is not an airborne disease, it can be transmitted through physical interaction, posing a risk to the community or individuals and potentially leading to an increase in HBsAg-positive cases.

The foreigners who tested positive for HBsAg came as food quality inspectors for orange export were among the 13 clients tested at the New Life Diagnostic Center on November 26, 2023.

The investigation revealed that Tshering Zangmo, the wife of the proprietor of Songtse Labour Agent, requested Phul Maya, the accountant of New Life Diagnostic Center, to keep the test result status pending after it tested positive.

The proprietor of the agent, Nirmal Chettri, also alleged influencing the proprietor of the New Life Diagnostic Center to change the report from positive to negative.

When the two foreign workers returned to the agent’s office for a re-check in another diagnostic center, the labor coordinator of Songtse Labour Agent, Rajesh Gurung escorted them to Druk Diagnostic Center to avoid getting caught.

Songtse Labor Agent subjected the two foreign workers to a second diagnostic test at a different center. However, the center was not informed that these tests were to confirm the initial positive HBsAg results.

Druk Diagnostic Centre issued the results as negative, which were found to be false upon verification at different centers, including the Rabgay Diagnostic Center and Gelephu Central Regional Referral Hospital (CRRH).

The manager of Druk Diagnostic Center, Kuenzang Dorji, reported that the test results appeared negative at his center based on the record list maintained by his office.

The false results could be due to manipulation of test results by the laboratory technician or presentation of wrong clients to the technicians for testing, according to the investigation report.

Based on the findings from the health ministry Health, the regional office of the Ministry of Industry, Commerce, and Employment (MoICE) in Gelephu imposed penalties of Nu 45,000 on Druk Diagnostic Centre.

The proprietor of the New Life Diagnostic Center, D.B. Rasaily reported the case on December 1, 2023, regarding the variation of test results at different screening centers.

Recommendations

The investigation team recommended that relevant agencies take necessary action against the Songtse Labor Agent and its employees based on laws, policies, or guidelines for unethical and unlawful practices.

New Life Diagnostic Center was also found liable, as per MoICE rules and standards for not uploading the test result to the Bhutan Labour Market Information System (BLMIS). “The manipulation would not have occurred if they had sincerely uploaded the test results.”

Druk Diagnostic Center was recommended to find the actual cause of the false result, specifically to identify whether the health professional manipulated the results or the wrong clients were presented to him.

The inquiry committee also recommended several measures to prevent future occurrences. These included implementing standardised operating procedures for labor agents and diagnostic centers, ensuring the timely uploading of medical reports, and enhancing monitoring mechanisms.

Additionally, the inquiry committee proposed the installation of functional CCTV cameras in and around diagnostic centers to enhance security and transparency.

The team highlighted systemic vulnerabilities that must be addressed promptly to safeguard public health and maintain the integrity of medical services in Bhutan.