Doc does everything right, but pays for not taking consent

  • Posted on: July 09, 2018

Is it not unfair that a doctor is punished even after taking proper care of his or her patient? Such an incident had recently occurred whereby the doctor was held negligent despite providing care as per standard of protocol. The reason? He did not take a proper consent from the patient!

Suffering from intense abdominal pain, Suman approached Dr. Midha at Harmu Hospital & Research Center. The doctor performed a USG which reported distended gall bladder with a stone in its neck. A laparoscopic cholecystectomy was performed by the doctor during which he discovered that there was accumulation of pus around the gall bladder and its anatomy was distorted. Like any expert doctor should, Dr. Midha performed particle cholecystectomy and left the large stump at the cystic duct.

The patient was discharged in a couple of days, but the pain in her abdomen returned quickly. She visited Dr. Midha again who hospitalized her, administered antibiotics and discharged her after a couple of days with an advice to undergo another laparoscopic surgery in four to six weeks, or earlier if the pain recurred. Unfortunately for Suman, the pain returned sooner than expected. Suman’s trust in Dr. Midha had dwindled and she was fed up of the trauma, hence, she visited another doctor who performed cholelythiasis and cholecystitis, removed the cystic duct along with the stone. And voila! The pain was gone.

As soon as the pain disappeared, Suman appeared in front of the National Consumer Disputes Redressal Commission, New Delhi, alleging that Dr. Midha did nothing when he first performed laparoscopic cholecystectomy. She further alleged that he did not even take an informed consent for same. This last allegation proved to be damning for the good doctor.

While the Commission concurred to most of what Dr. Midha presented in his defence, it also made some crucial observations. At the outset, the Commission observed that Dr. Midha had indeed treated the patient correctly. Since the gall bladder was engulfed with pus, he rightly chose to ligate the cystic duct and inserted the drain. The stone could not be removed at that instance. When the patient visited again with complain of pain, the doctor diagnosed cystic duct stump with the stone and rightly managed the patient conservatively by administering antibiotics and advised for another laparoscopic surgery in four to six weeks, the Commission further observed. The Commission however, did not accept the doctor’s submission that the patient submitted herself for the procedure while she was fully conscious and that implies consent.

For this one and only,but a crucial error, Dr. Midha was held partly negligent and ordered to compensate the patient. Perhaps he would not err on such procedural protocols henceforth.

Source: Order pronounced by National Consumer Disputes Redressal Commission, New Delhion 15th November, 2017.

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