Taking consent-signatures on multiple pages saves doc from multiple problems

  • Posted on: June 08, 2023

The patient experienced severe headache and vision problems; therefore, he visited the hospital. The neurosurgeon diagnosed idiopathic intracranial hypertension and performed CSF manometry.

Patient’s vitals dropped drastically three days after the procedure. He was shifted to ICU but to no avail. Eventually the patient had to be referred to a higher centre. An emergency CT scan was performed, which revealed acute cerebral infracts with small bleed in tempo-occipital region.

Despite putting the patient on ventilator support and providing critical care treatment, the patient could not be saved. He died next day.

His family sued the first hospital and neurosurgeon. It was alleged that:

i. Proper and informed consent was not obtained before performing CSF manometry
ii. The neurosurgeon was indifferent, he neither checked the patient after performing the procedure, nor appointed competent doctors for his post-operative care

The State Consumer Commission did not accept these allegations, as it made following observations:

“Perusal of the document establishes that it is printed consent form for operation, anaesthesia, special treatment and for procedures. In the said form, signature of deceased patient and his relative appears. This prima facie proves that consent has been obtained. The question is whether it can be said informed consent or not? It is true that the form does not bear any information about type of surgery, name of doctor, name of anaesthetist, etc. From this form, it cannot be taken that doctor has informed patient and relatives about surgery and its complications. But at the same time, I cannot ignore a document, on the reverse side, there is hand written consent signed by two relatives of patient. Out of these two signatures, one is identical signature which is found on another page and it seems to have been signed by patient’s family member himself. This consent letter is exhaustive and everything is explained in detail. It also bears mobile numbers of signatory for identification. This clearly indicates that surgery was performed with informed consent”.

“Patient’s family member has complained that neurosurgeon refused to visit the patient since it was a Sunday, whereas the doctor says it is not correct. The complainant has not led any evidence to prove this fact. It is surprising that even in interrogatories put to doctor, there is no specific question in this regard. When it was asked about the number of visits he had made on each day, the doctor replied numbers of all days which includes this disputed visit on Sunday too. The doctor’s version gets support from indoor case papers”.

The case against hospital and neurosurgeon was dismissed. As it transpires, taking signature and mentioning mobile numbers also at multiple places in consent forms / documents goes a long way!

Source: Order pronounced by Gujarat State Consumer Disputes Redressal Commission on 24th April, 2023.