Case Study: Doctor! There’s a Bug In My Scan!

Dr Vispi Mehta, senior gynaecologist of Orient Hospital, was on the phone with Tara. “Tara? All well?” “Mostly,” said Tara, more out of utter exhaustion. “My patient Saiba Williams has come back without her scan images, dikra! Soo thaiyoo? This is unlike you! Saiba needs that surgery done by this week, we need the images to save the baby trauma!”

Dr Tara: Dr Mehta, I have been having the worst time of my life.....

And Tara narrated her woes to Dr Mehta, her mentor during her post-graduation studies.

Dr Mehta: This is very unfortunate! Whatever Company A is up to dikra, you cannot afford to jeopardise your work! Would you like to talk to Company B? I know Vatsal Parikh, MD of Company B and he will have his boys set up their BS-232 at your clinic in no time! We cannot have downtime, dear girl!

Dr Tara: No, Dr Mehta. There should not be need for that. The service people at A have promised to set things right.

Dr Mehta: We are doctors and we cannot hang on ceremony and pointless detail like brand loyalty. Every scan not done could put a life in danger.

Tara and her husband Shiv had been up all night with the service team of Company A. Awasthi, the regional sales head, and Aman Yadav, the service engineer, had arrived at 5.30 p.m. on Sunday evening (her weekly holiday), to reinstal the software, a major exercise lasting over seven hours. But not without theatrics and drama.

A quick recap: Company A had sold to Tara their older AA-SW13, which after much hardship continued to work even if whimsically while Awasthi had simply said that ‘it will settle with time’. A year into the SW13, Company A proposed that Tara upgrade to the SW15 (which would set her back by another Rs 25 lakh) with a buyback on the SW13. Tara upgraded only to enter a new phase of frustration. The SW15’s touchscreen failed to work, the printers malfunctioned and the machine hung right during a patient scan.

Tara’s nightmare had begun a year ago with the purchase of A’s SW13, a Rs 63-lakh ultrasound machine. But like most people used to shoddy service, Tara too expected that the reputed SW13 would be smarter and hardier than its handlers and will quietly fall in line and start working. That did not happen. And Tara continued her calls to Awasthi and he continued to dodge her. One day, he suggested that she upgrade to the SW15 offering her good price offs on the SW15. An unsuspecting Tara, poorer by another Rs 25 lakh, discovered within minutes of the shoddy installation that the SW15 too had serious problems: the images froze or disappeared, the printers went unresponsive, and above all, the machine took to restarting right in the middle of a scan!

Tara had called Awasthi several times but the man had pretended to be busy. Why was Awasthi dodging?

Tara was a repeat customer and her problems with the machine were uncannily repeating and, most gallingly, Company A’s behaviour was also repeating! Worse, Tara had repeatedly reported the problems since the SW15 had begun to give trouble. But Awasthi had simply rolled over and played dead.

Was Company A simply revealing its mental construct or was it hiding something? This was Shiv’s question.
So, this Saturday — her busiest day — when the machine hung even as a patient was being scanned,Tara realised the road had ended. That was when she had no recourse but to stop work and wait all day for Awasthi to return her call.

Matters had reached such a state not because Tara had not complained in time. She had logged in each and every problem as it occurred. She had recorded all her complaints on the toll-free number. She had then escalated her complaints to the regional service head, Yadunandan Bisht, and even spoken with the regional head, Sameer Sequeira, who had originally sold her the machine. But nothing got fixed. Finally, Tara moved all appointments to Sunday, and called Awasthi and Aman in turns, but to no avail. That was when Shiv left a menacing message for Awasthi promising to put up the SW15 on Pinterest with this caveat: Don’t trust this machine.

Within minutes the duo arrived and spent all Saturday evening until midnight reloading the printer drivers, test running and checking. The change was not significant, but did print some reports. A relieved Awasthi left, promising to bring in more help early next morning (Sunday).

Tara arrived at her clinic on Sunday morning, soon after that chat with Dr Mehta. She waited. And waited. Saturday’s patients who returned on Sunday had to be sent back yet again. Finally, at 3 p.m, Shiv who had had enough, called Awasthi, “How much longer do we have to wait?”

Awasthi: Sir, we have a case to attend before your’s today; as soon as we finish that we will come to you.
Shiv: But you were supposed to come in first thing this morning; our complaint has been lying unaddressed since yesterday morning! How does your ‘other call’ today take priority over us?

Awasthi: No, sir, it’s not like that, we are just finishing and will come. Just one more hour, I promise you.
Shiv: You know what, I don’t trust you anymore. Can you give me your India Customer Service Head’s contact numbers and e-mail IDs? And before you think of lying to me, understand I know how to get it off LinkedIn.

Awasthi: Ok, ok, I will get Mr Tambe’s number....

Shiv took all of ten minutes to write to Prashant Tambe the all-India customer service director. Describing in bullet points the three problems the machine had, right from the week of installation of the new AB-SW15 machine, he underscored feeling let down and abandoned by a brand they trusted. Also that they had been logging in their complaints and didn’t know why there had been no redressal so far. All this for a machine that was brand new, top-of-the-line, expensive, and within warranty. Finally that the clinic work had stopped since two days and they had no idea when they could restart. Shiv copied Aman, Awasthi, and Bisht, the regional service head on the mail as all of them had been aware of the situation at Tara’s clinic.

Seven minutes later Shiv got a one liner back from Tambe’s BlackBerry, “We have received your mail, requesting national service head Sunil Chelaram (copied here) to look into your matter.”

Half an hour later, Chelaram called from Bangalore and said he would ask Bisht to get personally involved. Then, Bisht called. Rather hot under the collar, he said mournfully to Tara, “Madam, if you had such a problem, what was the need to go anywhere else – we would have certainly helped you.”

Tara: (putting her phone on speaker) I think that is why I called your teams seven times in the past four weeks, that my problems were not being attended to. There are more than a dozen of my service requests pending. Maybe we could take a look at the complaints log together?

Bisht: No problem Ma’am, I will come and see you tomorrow, Monday morning at 9 a.m.

Shiv: Tomorrow, Mr Bisht? Your team has kept us up all night,...

Read Analysis: Vineet Kapoor and Debabrata Mukherjee
 

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Tara: My patients have been coming back and forth since Friday. ‘Patients’ means they are in need of medical assistance. They know no Sunday or holiday. I did think Mr Chelaram intended for us to get the help we need, today. But if your best is tomorrow, then...

In 30 minutes, Aman and Awasthi arrived and after some checks declared they would have to reinstall the entire machine core software.

Shiv and Tara were intrigued. Why core software? But Aman gave an estimate of 3-4 hours for the job, in reply! The next thing he did was plug in his headphones and call someone in headquarters who spoke with him for almost an hour while he made notes. For the whole hour, he understood what he had to do and how. It was after that that he actually got started. As he worked, he kept speaking to his HQ and it was clear he was doing this for the first time. Shiv was amazed by the irresponsibility — Company A’s service engineer was here to reinstall the core software, learning on the job! Wow, the blinding power of an MNC brand! Around 2 a.m. on Monday, Aman finished the software reinstallation and restarted the machine.

Bleary eyed and tired, Aman showed Tara that the machine was starting and the printers were receiving inputs. On the touchscreen issue, he said he would discuss with Bisht in the morning.

When Bisht arrived at 9 a.m. Tara had to explain everything one step at a time — the problems as if ‘surprised’ him. It was as if he had never seen the call logs, never spoken with Tara about these. Aman had nothing to say. Shiv chose to be present, having taken a half day’s leave from work.

One would have thought at this stage, Company A — if it honestly believed that the SW15 was as amazing as they had made it out to be — should have been fair, taken back the faulty machine and supplied a new one, thus saving face and importantly patients’ time. But the story goes on...

Bisht, uniquely, suggested that Tara should ‘observe the machine’ to see if it hung again. Tara choked in disbelief. Next, Bisht also blamed the Dustin Dempa printers for the patchy printing. But Tara said, “Many other Ultrasonologists use exactly this printer brand and model.”

He had no answer, but even suggested she use a different photo paper, “Maybe this brand is the problem, who knows?”

Shiv groaned audibly and deliberately, “No, not that again, please. We have already tried three brands of photopaper, including the most premium brand. We have also bought a new brand of printers as suggested by Aman. What else may we change, let’s think, the clinic?”

So that was the end of that line of reasoning from Bisht.

Something was not adding up. Increasingly Tara and Shiv both felt the problem was different. Even fundamental.
Glad that the machine was responding, the printers printing, an exhausted Tara bid Bisht goodbye and set about printing Saturday’s backlog.

That was also when Chelaram called to check status. Tara told him that the touchscreen issue had not been addressed even by Bisht. Chelaram promised to get that fixed immediately .

Shiv was also scathing in his comments about Aman and Bisht. “There is a lot of shooting in the dark. Neither has a logic to his suggestions. Only diversions. Very disappointing, really! ended Shiv.

Three days later Company A sent a new touchscreen, with another service engineer, Brijender, who replaced the old errant one. Now the SW15 began working perfectly. Tara had a moment of déjà vu. “This is exactly like the faulty keyboard on the old machine and how Paul Anand waved his magic wand. Looks like this organisation’s customer support is completely personality-led, and complaint logs, etc., have no meaning for them. I don’t think they use the logs to study trends and understand...”

Brijender was different. The machine hung twice in that week, but he was quicker to reach than Aman.

Until, the machine hung twice on one day. Tara was devastated. “What is going on?!” she lamented.

Read Analysis: Vineet Kapoor and Debabrata Mukherjee

Why was the machine software still hanging? This time, Brijender painstakingly collected the data and keystroke logs just preceding each hanging incident (which was recorded in the machine’s memory). He sent it to the HQ, and in two days, he came back and said something that shook the ground under Shiv and Tara’s feet.

Brijender: See, the version of the machine software on the SW15 is due for change.... some bugs are being fixed... so, you may as well wait for the new version?

Shiv was sure he heard wrong. “What do you mean?”  he asked.

Brijender: Aisa hai, you know that the SW15 has a new software and a faster processor? Now, the software that was reloaded on your machine on Sunday night was the recently debugged and documented new version. The global tech team has been working on it since six months. The difficulties that you and some others have been facing were fed to the global tech team in Virginia where the software is being debugged and a new version is being developed. The new version will solve the machine’s hanging problem, which has also now got documented for implementing the fix.... It will be available in two weeks...You will have to wait, ok?”

Shiv felt an unusual sense of anger. “So, was this some kind of experimental software,” he asked.

Brijender: I won’t say that....

Shiv pressed on keenly, “In computer parlance, this is called a Beta version. Was this what we were subjected to so far?”

Brijender’s silence was both eloquent and embarrassed as it was evasive.

Tara picked up Shiv’s phone and found the call from Tambe in Bangalore and dialled it. Introducing herself she said, “This SW15? It is a life saving equipment, Mr Tambe, but your organisation sold it to me like it was a juicer. Do you realise these are equipment that determine life decisions for ill patients? And all this nonsense about debugging and version change, etc., you do not think is downright unethical, worse when you wilfully conceal it from me the doctor ? You Mr Tambe knew all along that you were using me as a guinea pig to test your software. You put my patients’ lives at risk?

This is breach of customer faith, Mr Tambe! This is breach of your fiduciary relationship with me because I trusted you to know what healthcare is about. I am hopping mad now Tambe. You have betrayed unsuspecting patients!” 

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(This story was published in BW | Businessworld Issue Dated 16-06-2014)