Simple laparoscopy took 5.30 hours! Court’s suspicion about what went wrong inside OT gets confirmed in absence of medical records

  • Posted on: February 01, 2024

Operation theatre could be a sensitive place, medically and legally speaking; especially if the outcome of surgery is not as per the expectations of patient / attendants.

What could doctors and hospitals do in order to avoid legal tangles arising out of such dissatisfaction?

Irrefutable Facts

The patient underwent laparoscopy hernia repair, performed by the surgeon under general anaesthesia administered by anaesthetist at the hospital. The surgery took about five and a half hours.

The patient remained unconscious for two hours post-surgery and was, therefore, shifted back to the OT and put on oxygen. He remained in coma for five days and was thereafter shifted to a higher centre for ventilatory support.

The patient remained hospitalized for five months and died after a year.

His family sued the hospital, surgeon and anaesthetist, alleging that a simple hernia surgery took a long time which pointed to negligence. It was further alleged that the patient suffered from an overdose of anaesthesia and yet the anaesthetist left the hospital without observing the patient.

The family claimed that the patient suffered from damage to the brain due to surgeon’s negligence during surgery. It was also claimed that the surgeon did not inform about patient’s condition, and visited him at the higher centre only once.

Doctor’s Plea

The hospital, surgeon and anaesthetist refused the allegations and claims. It was stated that the patient was suffering from obesity and the attendants were duly informed about his condition.

It was pointed out that while sleeping, the vein connecting to the brain and neck was pressurized (C.V. Junction), and the patient stopped breathing, resulting in damage to his brain.

Court’s Observations

The court referred to medical texts and observed that it does not take five hours to perform laparoscopy surgery. The court further observed that in the absence of medical records it was not clear after how much time was oxygen administered to the patient.

The court, therefore, concluded that the patient died due to a delay in administering oxygen.

The court also observed that medical records regarding the pre and post-operative treatment were incomplete, and drew an adverse inference against the hospital. Furthermore, the court suspected that the anaesthetist was not available for almost two hours, and in the absence of medical records refused to believe that he was called upon when the patient suffered complications.

The court held the hospital, surgeon and anaesthetist negligent.  

Prevention Is Better Than Cure

  1. In areas with restricted access like OT, ICU, labour rooms, etc. the only account of what was performed, what event/s occurred and what measures were taken to control / correct adverse incidents can be recounted and confirmed later only from well-written medical records. Documentation has immense therapeutic importance. Moreover, a well-written medical record is a good defence and a badly written or no medical record is no defence in cases of medical negligence. This case is an excellent example of the fact
  2. When an intervention is taking longer time than normal or if a complication occurs then it is necessary to keep the patient’s relatives / attendants in the loop. They should be informed about the reasons for the delay or if complications occur then measures taken to control / correct it. Document the fact that the attendants / relatives have been kept informed in the medical records also.

Source : Saurin Clinic & Ors. v/s Rekhaben Ishwarbhai Patel & Ors.

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