Gurgaon-based Fortis Hospital today refuted allegations that it had overcharged the family of a seven-year-old girl who died of dengue, claiming the patient's kin was informed about the bill on a daily basis.

It said in a statement that there was no medical negligence and all standard protocols were followed in the treatment of the patient at the hospital. "We understand the angst of the aggrieved parents but would like to assure all and the family of the child that there has been no medical negligence or overcharging towards the care of the child as is being misrepresented in the social media, it said. The statement, which came after the Union health ministry asked the Haryana government to order an inquiry into the incident, said the hospital had followed all clinical guidelines. "All standard medical protocols were followed in treating the patient and all clinical guidelines were adhered to," it said.

The Haryana government has ordered a probe into the matter after the Centre wrote to it. The case relates to the death in September of the dengue patient who was admitted to Fortis Memorial Research Institute (FMRI), Gurgaon, a multi super-speciality care hospital. Earlier in the day, Union Health Minister J P Nadda sought a "detailed report" from the hospital, which billed the family around Rs 16 lakh.

Nadda said that the government would take "action" based on it. "Patient Adya Singh was admitted at FMRI on August 31 at 11:16 am with an initial diagnosis of severe dengue. At the time of admission, the child's condition was serious and deteriorating. She was initially treated at Rockland Hospital, Dwarka (in Delhi) and her investigations revealed NS1 antigen positive for dengue," the statement said. Initially, the child was managed on intravenous fluids and supportive treatment as there was a "progressive fall in platelet count" and hemoconcentration. "She also received multiple transfusions platelets, FFP (fresh frozen plasma) and albumin. Subsequently, she needed to be put on high frequency ventilation because of worsening oxygenation," it said.

She was also on continuous renal replacement therapy (CRRT) because of oliguria and deranged renal functions, it added. The Gurgaon-based facility claimed that "at each step, the patient's family was briefed" about the "critical condition" of the child. A friend of the child's father took to Twitter in the past few days, alleging the hospital charged a huge sum of money during the treatment, and the girl later died. "On September 12, a multidisciplinary consult team (MDCT) also met with the patient's relatives including her father and told them about the guarded prognosis of the child, which was documented in IPD records and signed by the patient's father. "On September 14, an MRI of brain was done after explaining to the parents, the possible complications of transfer in such a critically-ill child," it said. "Patient's family was again explained about the critical condition of the child, after which they took the decision to take the child Leave Against Medical Advice (LAMA)," the hospital said. A total of 750 pairs of gloves and 600 syringes during a 15-day stay is "justifiable and acceptable" when the patient is in an ICU setting.

Syringes are being misrepresented as "injections" which are very different from each other, it claimed. "As the attendants of the child wanted to take the child LAMA, an outsourced ambulance was arranged which could transport the child back home as per hospital LAMA Protocol. "As per the hospital policy (followed by most private hospitals), LAMA patients are not offered hospital's ambulances, but the family is assisted to arrange an ambulance, which was done in this case," Fortis said. "Ventilator usage, CRRTs, multiple blood transfusions, ICU rent also add on to the cost to the patient. The total bill for the 15-day duration of hospitalisation was Rs 15,79,322. An amount of Rs 5,21,433 was paid by the insurance, and the balance Rs 10,37,889 was paid by the family of the child," the statement said.