Critical Jaw Reconstruction Surgery at AIIMS Stalled for Over Two Months in Ayushman Bharat Administrative Deadlock
A life-altering jaw reconstruction surgery at the prestigious All India Institute of Medical Sciences (AIIMS) in Delhi has been paralyzed for more than sixty days due to an administrative impasse under the Ayushman Bharat health scheme. This bureaucratic gridlock has left a Haryana government beneficiary, Dolly Mandal from Faridabad, enduring excruciating pain and subsisting solely on a liquid diet, unable to consume solid food.
Patient's Condition and Urgent Medical Need
Dolly Mandal suffers from ameloblastoma of the right mandible, a rare yet aggressively destructive jaw tumor that erodes bone tissue. Medical experts warn that untreated, this condition can lead to severe infection, permanent facial deformity, and rapid health deterioration. Doctors at AIIMS have prescribed an extended total temporomandibular joint replacement on the right side, a complex procedure costing approximately Rs 2.5 lakh, which includes specialized implants. This surgery is deemed medically urgent to remove the diseased jaw portion and reconstruct it.
Administrative Bottleneck and State-Level Approval Hurdle
Despite the critical nature of the case, the procedure remains in limbo. Pre-authorization was initiated on December 6, 2025, with AIIMS actively following up via email and telephone with the Haryana State Health Agency. However, approval is still pending, contingent upon clearance by the state's standing medical committee.
"The authority to approve this procedure rests entirely with the state government and falls outside the jurisdiction of both AIIMS and the National Health Authority," explained Dr. V.K. Bansal from the Department of Surgery at AIIMS. He further noted that alternative financial assistance, such as through the Rashtriya Arogya Nidhi, the Health Minister's Discretionary Grant, or the Chief Minister's fund, could only be explored if the patient possesses a Below Poverty Line (BPL) ration card.
Worsening Health and Financial Strain
During this prolonged delay, Mandal's condition has significantly deteriorated. The tumor has begun discharging pus, exacerbating her pain and restricting her to a liquid-only diet. The situation has also imposed severe financial hardship on her family. Unable to work due to her condition, and with her husband—a daily-wage laborer—forced to remain in Delhi to care for her and navigate the approval process, the family's economic stability has been crippled.
Systemic Gaps and Legal Criticism
The surgery's delay stems from a procedural gap: the extended temporomandibular joint replacement is not listed under the Health Benefit Package 2022, requiring special clearance from the state health authority. This has led to administrative paralysis at the state level.
The case has attracted sharp legal criticism. Advocate Ashok Agarwal emphasized, "Why should a patient suffer because of paperwork? Administrative procedures cannot justify delaying essential treatment. The high court has already clarified that medical care must not be delayed under any circumstances."
Internal correspondence from AIIMS acknowledges the grievance but reiterates the hospital's inability to proceed without state approval. Repeated attempts to contact Haryana Health Secretary Sumita Misra for comments on the issue have gone unanswered.
Broader Implications and Systemic Fault Lines
As Dolly Mandal continues to wait in agony, despite being insured under a government health scheme, her plight exposes a critical systemic flaw: when life-saving treatment becomes entangled in bureaucratic red tape and committee approvals, accountability for patients left suffering remains unclear. This case raises urgent questions about the efficiency and patient-centricity of health scheme implementations in India.
