Reports indicate severe mismanagement in the 108 Arogya Kavacha ambulance services, with drivers claiming that their contractor, EMRI Green Health Services, is endangering lives by transferring critical patients between multiple ambulances. On July 19, patient Syed Iftikhar, who suffered a heart attack and stroke in Chitradurga, was transported in six ambulances over six hours, traveling from Chitradurga to Jayadeva Hospital in Bengaluru. His brother, Syed Mumtaz, reported significant delays and distress, alleging that Iftikhar was moved in four vehicles from Chitradurga to Tumakuru before being transferred twice more.
Drivers have criticized the practice of “double dispatch” or multiple transfers, which is intended to expedite patient care but is alleged to be part of a scam to inflate trip numbers and increase government billing. This practice, with a maximum of three transfers permitted, has led to additional complaints, including an incident on August 5 where a pregnant woman lost her baby after being shifted between three ambulances.
Health Minister Dinesh Gundu Rao acknowledged the issue and promised a review and new tenders to improve accountability. Health Commissioner D Randeep has called for an audit of the company’s reports to address the problem.
Rejoinder received from EMRI GREEN HEALTH SERVICES, Published as received
Subject: Allegations of mismanagement and scam in ambulance operations
This has reference to your report published on 19-08-2024 in your daily Newspaper News Karnataka wherein it was Allegations of mismanagement and scam in ambulance operations in this regard EMRI Green Health Services, under the Public-Private Partnership, has made substantial progress over the last 17+ years in providing Emergency Response Services across the country. We currently operate over 15,000 state-of-the-art ambulances in 16 States, 2 Union Territories, and 2 provinces of Sri Lanka. The service handles close to 50,000 emergencies daily with a fleet of over 15,400 ambulances, supported by 42 emergency call centers and a team of more than 60,000 associates. Additionally, we operate other services such as the 181 Women Helpline, Dial 100 in association with the Police Department, the 104 Health Helpline, the 102 Drop-back Ambulance under JSSK, Mobile Medical Units, Mother and Child Tracking Centers, and the 1962 Animal Care Ambulances.
The 108-Arogya Kavacha ambulance services have been provided under a MoU agreement between the Government of Karnataka and EMRI Green Health Services since 2008. The agreement concluded in 2018; however, the Government of Karnataka requested that EMRI Green Health Services continue providing the service until a new service provider is finalized. EMRI Green Health Services is not charging any fees to the Government of Karnataka or to the public for offering its expertise.
By performing double dispatches, EMRI Green Health Services will not gain any financial benefit, as expenditures are reimbursed on an actual basis rather than being paid based on the number of cases or kilometers covered, even with the delay in government funding, the EMRI Green Health Services Head Office has supported smooth operations by providing necessary funds.
Usually, critical patients are not given Double Dispatch. However, in 4% to 5% of cases, requests are made to transfer patients to district or major hospitals with better facilities, which are often located at a considerable distance. Double Dispatch is provided in these instances to ensure that a local ambulance remains available at its base location for other urgent emergencies within the golden hour. This has been adhered since 2008 with the constant support of the department to help people in emergency situations.
Additionally, if a patient requires an ALS (Advanced Life Support) ambulance but only a BLS (Basic Life Support) ambulance is available in a remote area, services cannot be refused. In such cases, providing a higher-level ambulance becomes necessary.
Table 1: Month wise Double Dispatches case details, 108 service ,EMRI-GHS, Karnataka,Jan’24 to July’24
| Months | Availed cases for Month | Double Dispatches for Month | % Of Double Dispatches | Double Dispatches Avg.cytime | Double Dispatches Avg. distance |
| Jan-24 | 54,578 | 1,782 | 3.3% | 2:33:57 | 81 |
| Feb-24 | 54,531 | 2,432 | 4.5% | 2:25:11 | 79 |
| Mar-24 | 61,835 | 4,037 | 6.5% | 2:03:54 | 77 |
| Apr-24 | 58,046 | 2,604 | 4.5% | 2:14:03 | 80 |
| May-24 | 57,768 | 2,238 | 3.9% | 2:19:46 | 80 |
| Jun-24 | 54,521 | 2,048 | 3.8% | 2:16:59 | 78 |
| Jul-24 | 65,122 | 4,068 | 6.2% | 2:10:07 | 76 |
| Total | 406,401 | 19,209 | 4.7% | 2:17:42 | 79 |
We would like to bring to your attention the facts regarding an incident that occurred on 19/07/2024 at 12:04 AM. We received a call requesting an ambulance to transfer a patient from Chitradurga District Hospital to Bangalore, a distance of approximately 227 km. Due to the patient’s attendant being unwell and unable to make alternative arrangements, they sought assistance from the 108 emergency service to transfer the patient for further treatment, as it was an OPD case from Chitradurga DH. However, our 108 emergency staff informed the attendant that such a transfer was not permitted due to the distance exceeding 200+ km, as per emergency protocols which stipulate that patients must be transferred to the nearest hospital.
On humanitarian grounds, and considering the poor condition of the patient and their attendants, we decided to assist them during this challenging time. We informed the attendant that, since the patient was non-critical and stable, we would help with transferring the patient to Bangalore with 3 to 4 interim dispatches, while maintaining other aspects of clinical assistance. This plan was agreed upon by the attendant, and with their verbal consent, our 108 Emergency staff transported the patient from Chitradurga District Hospital to Bangalore.
Once again, we would like to bring to your kind notice that our intention in shifting non-critical cases to other nearby ambulances was to ensure that the local ambulance remains available at its base location to respond to other unforeseen emergencies and assist those in need during the critical golden hour.
It would be greatly appreciated if the newspaper could convey the actual facts in its news bulletin, thereby redirecting the audience’s attention. For any clarifications, please feel free to contact the undersigned.
Regards,
Hanumanth R G
EMRI GREEN HEALTH SERVICES
STDC Housing Board Colony, Basaweswarnagar Entrance,
Opp. to Govt. Unani Medical College, GMS Compound,
Magadi Road, BANGALORE – 560079.
M: +91 7829500108 W: www.emri.in
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