Better care expected from tertiary care hospitals

  • Posted on: May 11, 2023

A dental surgeon was severely injured in a car crash. He was rushed to a hospital where knee operation was performed.

Three days after the surgery, he complained of headache and had several bouts of vomiting. CT scan of the head was performed which reported haemorrhage in left temporal lobe with minimal edema.

Yet another CT scan was performed after a week, Subarachnoid haemorrhage (SAH) was suspected. The patient was shifted to a reputed tertiary care hospital for better management.

The neurologists at this hospital adopted conservative line of treatment – they prescribed analgesics and anti-edema medicines. The patient was discharged after two days; he was taken to his home town.

A fortnight later, the patient experienced excruciating headache and intense shivering and seizures. He was rushed to a local hospital. But it was too late. The internal head injuries suffered during accident were serious. The patient became comatose. His family shifted him to the tertiary care hospital as he needed urgent brain angiography and ventilator support.

CT cerebral angiogram was performed. It confirmed everyone’s worst fears - progressive bleeding and large hematoma in the brain. Cranial surgery was performed but the patient suffered two cardiac arrests. He was resuscitated the first time, but succumbed after the second one.

His family sued the hospital and alleged that the patient was discharged in two days despite complaining of headache. They should have performed CT angiogram or MRI to rule out internal bleeding.

The hospital and neurologists defended their act by stating that patient’s vitals, including neurological systems, were normal. It was further stated that the CT scan done at the first hospital showed minor bleeding and he was responding well to the conservative line of treatment.

The Commission did not accept this defence and held the hospital and neurologists negligent, observing that:

“It is pertinent to note that hospital’s discharge summary is silent about the finding of SAH. The CT scan done earlier reported hyper dense collection in right quadrigeminal cistern and anterior interhemispheric fissure. It was suggestive of SAH. The doctors treated the patient symptomatically, but failed to do proper clinical assessment and crucial investigations”.

“The patient himself was a doctor and brought all the way from his home town to the hospital, with a hope of better tertiary care. The expected duty of care at tertiary care hospital is more. It was the duty of treating doctors to rule out the cause of SAH due to aneurysm. But in the instant case, the patient was discharged within short period of two days, it was a failure of duty of care. The CT angiography of brain, if done, could have detected the cause of SAH or any aneurysm. Thus, the surgical intervention like clipping / coiling of aneurysm could have prevented from complications and saved patient’s life”.

The hospital and neurologists were ordered to pay twenty-five lakh rupees compensation for their failure in duty of care!

Source: Order pronounced by National Consumer Disputes Redressal Commission on 19th December, 2022.