Different ailments, similar symptoms – What to do?

  • Posted on: November 09, 2019

Can a doctor be held negligent if a diagnosed and under-treatment ailment shows symptoms of another ailment? No. Not unless the other ailment is diagnosed and treated on time, as this case demonstrates.

The patient suffered severe pain in the right side of the abdomen and visited Dr. Kanoongo who performed Ultrasonography (USG) that reported swelling in the right iliac fossa. The doctor suspected appendicitis as the cause of pain and decided to perform exploratory laparotomy during which tubercles were discovered in intestine – the patient had tuberculosis (TB)!

Dr. Kanoongo sent two tubercles for histopathology examination (HPE) which reported that patient had TB.

The doctor performed laparotomy within a few days during which two perforations were found and excised. To be absolutely sure, the doctor sent the intestinal sample biopsy which reported a burst in the intestine due to TB.

The patient was discharged after a few days in a stable condition and she even showed improvement in the subsequent period. But it seems fate had other plans for her. She died after a month!

The distraught husband blamed Dr. Kanoongo for the unfortunate death and sued him. One of the main allegation was that there was no need to operate the patient in the first place since she had TB.

The doctor in defense stated that symptoms of appendicitis and TB are common, and anti-Tubercular Treatment (ATT) was started immediately when the patient was diagnosed with TB. The doctor further stated that the patient had an infection in her eye and she had visited a specialist who prescribed her medicine Wysolone which flared up her condition.

The Commission referred to medical literature and accepted doctor’s defence that patients who have abdominal tuberculosis may present with signs and symptoms similar to acute appendicitis which makes arriving at accurate diagnosis difficult. The Commission further observed that the doctor followed due diligence and confirmed presence of TB and changed the course of treatment immediately.

The Commission held that Dr. Kanoongo was not guilty as he followed standard protocol and the complaint was dismissed.

Source: Order pronounced by Madhya Pradesh State Consumer Disputes Redressal Commission, Bhopal on 8th July, 2019.