Difference in case papers and typed report – an attempt to save the doctor?

  • Posted on: February 09, 2023

The patient suffered from TB and thyroid and was subsequently diagnosed with typhoid. She was taken to a hospital.

The doctor at this hospital performed ascitic fluid test to rule out cancer, although admittedly by obtaining oral consent only. Subsequently, the doctor undertook laparoscopy procedure for performing omental biopsy.

The patient developed severe complications due to anaesthesia and was shifted to another hospital where she succumbed after two days.

Her husband was furious at the doctor. He sued him and alleged that no consent was obtained before performing ascitic fluid test. He further alleged that even though there was no need to perform biopsy, the doctor simply went ahead with it.

CT biopsy, a less invasive and safer option was available but it was ignored. The doctor must pay for his folly, pleaded patient’s husband.

The doctor denied the allegations and stated that ascitic fluid test was performed after explaining every risk and benefit, and an oral consent was obtained from patient’s husband. Moreover, several other tests led to suspicion of cancer which then necessitated ascitic fluid test.

The patient was referred to a haematologist who, after going through the tests, advised biopsy to rule out ovarian cancer.

Citing medical literature, the doctor finally submitted that CT guided biopsy was disadvantageous for the patient as it may not have been able to remove enough tissues for the analysis.

The Commission perused medical records, and at the outset observed that the doctor was negligent for not obtaining a proper, informed and written consent from patient or her husband.

The Commission found glaring lapses on part of the doctor in treatment record, and observed:

“In brevity, the patient was suffering from Koch’s abdomen which was a chronic condition and above that she suffered from acute typhoid fever which caused small bowel perforation which was sealed in third week of illness. That is why there was plenty of slough and small bowel adhesions which required urgent exploratory laparotomy for peritoneal lavage searching perforation and adhesiolysis. It was omitted by the doctor which was negligence on his part”.

“Further it is noted that the anaesthesia related complications escalated the situation and patient had to be transferred to the other hospital. Post-operative investigation showed positive CRP, positive procalcitonin which were not done pre-operatively. Case papers of the second hospital shows that there was intra peritoneal haematoma and typed report says there was no peritoneal hematoma. It arouses doubt about the authenticity of report. That may be an attempt to save the doctor. It shows that the case papers are fabricated following the complication of surgery”.

The doctor and his team were held negligent for these lapses. They were ordered to collectively pay eight and a half lakh rupees as compensation.

Source:Order pronounced by Gujarat State Consumer Disputes Redressal Commission on 7 th September, 2022.