'Senior docs restricting cochlear implants'

A cartel involving a handful of senior ear, nose, throat (ENT) surgeons is alleged to wield its influence on companies manufacturing Cochlear implants to prevent these firms from supplying these devices to many other ENT surgeons, who want to do the surgery independently.

This is the charge from a section the ENT surgeons, who wrote to the prime minister and the National Pharmaceutical Pricing Authority seeking their intervention to break the cartel so that these devices are more widely available to Indian deaf children.

Cochlear implants are tiny electronic devices that are inserted into the ears of deaf kids to restore hearing. They are different from hearing aids as they stimulate the auditory nerves unlike the hearing aids, which only amplify the sound.

Each year an estimated 100,000 deaf kids are born in India, requiring a Cochlear implant. But only 3,000-5,000 surgeries take place.

This, alleged Chitradurga-based ENT surgeon N B Prahlada, was because of the cartel that prevented most of the ENT surgeons doing the procedure.

The Cochlear implant programmes, both in the government and private sector, are guided by the terms and conditions set by the Cochlear Implant Group of India – a society of senior surgeons. It is the CIGI that fixes the criterion for allowing newcomers into surgery.

For many state government-backed implant programmes, there is an eligibility criterion for willing surgeons to participate. They had to do a minimum number of cases that can vary between 10 and 100, depending on the state.

However, since Cochlear implant is not taught in most of the medical colleges, the only way to learn about it is from a mentor.

This is where Prahlada claimed, a nexus existed between a handful of surgeons and the companies making these devices.

“An amount ranging between Rs 25,000-150,000 is being charged by the mentors. The existing Cochlear implant surgeons, claiming to be mentors, have fixed their territories and they don't allow any other surgeon in their areas,” said Prahlada, who is professor in the ENT department at the Basveshwara Medical College in Chitradurga.

“The allegations are false and baseless. They have an ego because of which they don't want to learn. What prevented the companies to sell more implants to trained surgeons,” J M Hans, a Delhi-based ENT surgeon who was formerly associated with RML hospital and alleged to be a part of the cartel, told DH.

“There are nearly 12,000 ENT surgeons in India and 6,000 doctors are the members of the Association of Otolaryngologists of India. But only 30 odd surgeons do Cochlear implants in India,” said Rakesh Srivastava, an ENT surgeon based in Lucknow.