Medical history – A ‘fish’bone of contention

For some unknown reasons patients don’t reveal their complete medical history. This lack of transparency could prove to be counterproductive and even fatal for them, as happened in this case.

A fish bone bruised patient’s tonsils. It started bleeding and hence, he was taken to a hospital. The ENT surgeon performed an X-ray which confirmed badly injured left tonsil. Tonsillectomy was performed after which the patient bled uncontrollably. He was referred to another hospital, received treatment there and was referred back to the ENT surgeon and first hospital.

The first hospital denied admission due to unavailability of Haematologists and referred the patient back to the second hospital. He was subsequently referred to another hospital where diagnosis of Haemophilia-A was made. Unfortunately, the patient developed Acute Respiratory Distress Syndrome (ARDS) and succumbed to it.

The family was taken aback. Perhaps they could not understand how a simple fishbone injury could have led to their beloved’s death. The ENT surgeon and first hospital were sued by them.

It was alleged that the negligence of ENT surgeon while performing Tonsillectomy caused complications, and that hospital’s refusal to admit the patient caused delay, attributing to his death.

The Commission rejected family’s allegations. From a bare perusal of medical records, it was clear that the patient was refused admission second time due to unavailability of Haematologists. The Commission further observed that the patient and his wife, both highly educated adults, were aware that patient was haemophilic, yet did not reveal this fact.

The ENT surgeon confirmed via X-ray that the fishbone was not stuck but the left tonsil continued to bleed. The Commission observed that he was duty bound to perform Tonsillectomy to ascertain the reason for bleeding. Neither the doctor nor the hospital could be held negligent for patient’s and his family’s non-disclosure of medical history, concluded the Commission and dismissed the complaint.