Discharging critically ill patients, a dereliction of duty

  • Posted on: August 26, 2020

Extra caution must be exercised before discharging critically ill patients. If the patients choose Discharge Against Medical Advise (DAMA), the same should be noted in medical records. In this case however, the doctor was held negligent for discharging the patient even though she had severe jaundice and had not opted for DAMA.

The patient visited the doctor at hospital with complain of ulcerous growth on the lower part of her left leg. The doctor cleansed and dressed the wound, prescribed medicines, advised blood tests and discharged her after four or five days with an advise to come for follow-up.

What transpired later was shocking for the patient’s family. The patient was taken to another hospital where she was diagnosed with septicaemia and encephalopathy with suspicion of malaria. She was referred to a higher centre but unfortunately died the next day!

The patient’s husband sued the doctor and alleged negligence on his part which eventually lead to patient’s death. The doctor denied any wrongdoing.

The Commission rejected doctor’s stand and stated the following:

“It is clear from the above prescriptions that the patient had ulcer on her leg with jaundice and skin rash”.

“At the time of discharge, the patient was suffering with severe jaundice. The liver function test done at the hospital showed very high values of enzymes and patient was severally jaundiced. In our view, discharging patient in such condition was not justified. ”.

“It is pertinent to note that the doctor in defence stated that on 25th August, the patient left the hospital to attend the court case and returned in the evening. However, as per medical records from same days’ notes the patient was given IV fluids at 11 AM at the hospital. After discharge, the patient developed further complications. She was taken to another hospital and thereafter to a higher centre”.

“In our view, the doctor at initial stage failed to take proper care of the patient”.

Source: Order pronounced by National Consumer Disputes Redressal Commission, New Delhi on 2nd March, 2020.