Delay in transferring the patient is negligence

  • Posted on: March 28, 2018

Shoda Devi had excruciating abdominal pain and was also suffering from menstrual problems, hence she approached Dr. Mittal who performed a USG and diagnosed fibroid and endometrial hyperplasia. The doctor advised a fractional curettage (D&C)and performed the same at Deen Dayal Upadhyay Hospital.

The doctor thought it’s a minor operation and hence it would be an uneventful one. But it turned out to be exactly the opposite. Neelam, a nurse working at the hospital administered injections before the surgery on the Shoda Devi’s right forearm after which she suffered continuous acute pain, even during the surgery. Her right hand had developed ischemia and she was transferred to another hospital where the right forearm was amputated due to spread of gangrene.

With the pain and shock of losing her right hand, Shoda Devi approached National Consumer Disputes Redressal Commission, New Delhi, alleging Dr. Mittal and the hospital of gross negligence. It was alleged that the injection was administered in the radial artery and neither Dr. Mittal nor anyone else from the hospital attended to her once she complained of unbearable and acute pain after injections were administered. It took them two hours to finally see that she was suffering from unbearable pain. It was further alleged that the doctors at the hospital didn’t use IV cannula and D&C was performed without anaesthesia and that only aggravated the situation.

It was also alleged that the patient was transferred in an inhumane manner. No ambulance was called even though it was raining heavily. Even some doctors at the hospital where the patient was transferred opined that an anaesthetist would have been in a better position to manage the problem. Moreover, as a common practice, IV cannula should be placed to avoid such problem before conducting any surgical procedure as it could also be helpful for giving brachial plexus block.

Shoda Devi concluded by stating that it was a case of Res IpsaLoquitor and hence the doctor and the hospital be punished for their negligence.

Believing in what they did was right, Dr. Mittal and the hospital presented a strong defence. It was stated that Neelam, the nurse, was a qualified and an experienced nurse to administer the injections. It was further stated that the patient was appropriately sedated with the injections and she didn’t complain of any pain during D & C which lasted not more than five minutes. The patient was attended immediately when the hospital doctors were first informed of pain in the right arm by her attendants. The doctors observed that the patient’s right arm was pale had feeble radial pulse, which was beginning of the ischemic process. A second opinion was taken immediately and the patient was referred to the other hospital for further management. We did all we could, concluded Dr. Mittal and hospital authorities.

The Commission had sufficient records to make its own observations and conclusions. Citing opinion of the registrar of Cardio Thoracic Vascular Surgery, the Commission observed that necessary steps were required to be undertaken immediately at Deen Dayal Upadhyay hospital, when the injection had been administered in the artery instead of vein. As per records, the patient complained of severe pain at around 2 PM but she was attended to at 4 PM. This delay aggravated the ischemic process. Moreover, the doctor who attended the patient was not competent to diagnose the problem.

The Commission further observed that the hospital didn’t provide ambulance despite of heavy rains. They could have called the ambulance from the other hospital and transferred the patient properly, stated the Commission.

Lastly, the Commission observed that it was not wrong on part of Deen Dayal Hospital for not using IV cannula; however, its use would’ve been helpful in avoiding such mishaps. The Commission agreed that the principle of Res IpsaLoquitor was applicable in this case and held Dr. Mittal and Deen Dayal Hospital guilty for medical negligence. They were ordered to compensate the patient almost five lakh rupees.

Source: Order pronounced by National Consumer Disputes Redressal Commission, New Delhi on 23rd February, 2018.