In a significant move to safeguard maternal health, the district collector of Erode, S Kandasamy, has issued a formal directive stating that echocardiograms performed during pregnancies must be conducted solely by trained cardiologists. This communication, addressed to the local unit of the Indian Medical Association (IMA), highlights a concerning practice in many private hospitals.
The Directive Against Technician-Led Echos
Collector Kandasamy pointed out that in numerous private healthcare facilities, echocardiograms are being administered by technicians instead of registered cardiologists. He emphasized that this deviation from protocol has led to instances of misdiagnosis across multiple centers. This misdiagnosis has resulted in delayed treatment for some pregnant women, a situation that "endangered" their lives, according to the collector's letter.
The official communication was not only sent to the IMA but was also marked for the attention of the directorate of public health (DPH) and the directorate of medical and rural health services (DMRHS). In it, Kandasamy further clarified that anomaly scans, which are used to detect potential defects or deformities in the developing fetus, should be performed exclusively by qualified radiologists and not by technicians.
Official Stance on Patient Safety and Legal Compliance
Reacting to the concerns raised, public health officials from the state noted that, so far, no cases of pregnant women losing their lives or developing complications directly linked to this issue have been formally reported from any district. Dr A Somasundaram, the director of public health, acknowledged that inconsistencies in practice might exist across districts but confirmed, "no fatality of a pregnant mother corresponding to this issue was reported so far."
However, the legal framework supporting the collector's directive was strongly reiterated by Dr R M Meenakshi Sundari, JD of DMRHS (ACTs). She cited the Pre-Conception and Pre-Natal Diagnostic Techniques Act of 1994, which explicitly states that licenses to perform an echocardiogram are issued only to registered medical practitioners (RMPs).
Dr. Sundari drew a clear distinction in roles, stating, "If we're talking about registration with the council, we're referring to doctors, not technicians. The technician may drape the patient and apply gel, but touching the equipment and administering the test is itself not allowed as per the Act." She used a powerful analogy to drive the point home: "You don't ask a nurse to do a surgery if the surgeon faces high footfall. A procedure and a law must be respected."
Implications for Healthcare Providers
This directive serves as a stark reminder to hospitals and diagnostic centers about the strict legal and ethical boundaries governing specialized prenatal tests. It underscores the critical importance of having qualified specialists interpret sensitive diagnostic data that directly impacts the health management of both the mother and the unborn child. The collector's intervention aims to standardize care and eliminate risky practices that compromise patient safety despite the absence of reported fatalities.
