The patient consulted doctors at a hospital as he had rapidly lost eight kilos without any explainable reasons. CT scan of chest was performed, leading to suspicion of cancer or TB.
The pulmonologist and surgeon advised diagnostic laparoscopy with peritoneal biopsy to confirm diagnosis. Their suspicion of TB was proven, ATT drugs were started.
A re-look laparotomy was performed after few days to take biopsy sample from the bowel to rule of any other complications. The patient developed complications immediately. He suffered multi-organ failure due to sepsis and DIC.
Despite best efforts, the patient could not be saved.
His family sued the doctors and hospital, alleging that they failed in their duty of care leading to complications during diagnostic procedure. It was also alleged that the there were no TB experts in the hospital, hence the patient should have been referred to a higher centre.
The surgeon stated in defence that the patient should have been brought back immediately to hospital after discharge, but he came after ten days, which worsened his condition. It was further stated that it was difficult to take biopsy through the small opening therefore, laparotomy was performed to get mesenteric node biopsy.
The Commission observed that the pulmonologist was qualified to manage and treat TB, hence the allegation of non-availability of TB expert was dismissed.
Perusing medical records, the Commission observed that the surgeon made an error while performing laparotomy.
“It is evident that short segment of bowel was resected at the time of biopsy. In the instant case, admittedly, the surgeon noted frozen abdomen and the friable tissue during procedure. However, while taking the biopsy of mesenteric lymph node, he resected a piece of intestine”.
“In our view, when the abdomen was frozen, resection of intestine was not advisable and also it was not a standard of reasonable practice. We further note due to friability of the tissue, stitches could not be put and therefore, enterostomy was performed. It further led to peritonitis and septicaemia leading to multi-organ failure and death of the patient”.
The doctor and hospital were ordered to pay forty lakh rupees in compensation. Apparently, failure in duty of care is not taken lightly by courts.
Source : Order pronounced by National Consumer Disputes Redressal Commission on 9th February, 2023.