Share the information or dole out compensation

  • Posted on: May 30, 2018

Following standard protocol such as informing the patient and relatives about known complications of an intervention, ensuring availability of equipment to manage the complications and to provide pre and post-operative care is a must for healthcare providers. Deviating from such protocols often draws the ire of courts, as this case demonstrates.

Suffering from dysphagia, Santi had approached the hospital where Dr. Baruah performed endoscopy. After the procedure the patient’s condition deteriorated as she developed intense pain in right side lower chest and right side upper abdomen. She was referred to ILS Hospital where endoscopy was performed again during which it was found that there was a perforation in the esophagus. The patient’s family immediately shifted her to Apollo Gleneagles where she was diagnosed with hydropneumothorax, septicaemia and mediastinitis.

Once she recuperated from her ailment which took a long time, Santi approached State Consumer Disputes Redressal Commission, Tripura and made several allegations. At the outset, it was alleged that Dr. Baruah neither disclosed nor counselled the patient about the possibility and risk of muscle spasm during endoscopy. The hospital didn’t even arrange for pre and post-operative care, it was further alleged. Why wasn’t she referred earlier even though the hospital authorities knew that they didn’t have facilities to treat mediastinitis, questioned the patient.

It seemed the doctor and the hospital neither had questions nor a strong defence. Dr. Baruah stated that the patient had a history of dysphagia and could not gulp solid food for a year. It was further stated that the patient’s oesophagus was thinner than normal and she had chronic rheumatoid arthritis. The injury to the oesophagus was not due to endoscopy performed by her, claimed Dr. Baruah.

The Commission was not impressed by statements made by the doctor and hospital. Having carefully observed medical records and charts, the court stated the following: “Dr. Baruah did not inform the patient or her relatives regarding the known risks of endoscopy and also did not abstain from introducing the scope when there was muscle spasm. Had there been perforation in the oesophagus before the endoscopy, then that could have been found by Dr. Baruah herself, but fact remains that she did not inform regarding the perforation of oesophagus when the patient was in the hospital, rather she was referred to ILS Hospital where the patient was informed that there was perforation in the oesophagus which happened due to earlier endoscopy. Moreover so, the hospital should have made arrangements for pre and post-operative care, but admittedly there was absence of the required facilities.There is no doubt that the decision of taking intermediate oesophagoscope may not be medical negligence, but having considered the patient’s condition, the risk factors of doing endoscopy should have been informed. So, there is carelessness to the some extent and also deficiency of service”.

Dr. Baruah and the hospital were held negligent and were ordered to pay seven and half lakh!

Source: Order pronounced by State Consumer Disputes Redressal Commission, Tripura on 4th April, 2018