Treating without proper diagnosis, an insult to injur

  • Posted on: September 02, 2021

Pintu, a young professional bodybuilder from rural Maharashtra, was admitted to the hospital with complain of pain in abdomen for ten days. The doctor performed ultrasonography, diagnosed liver cirrhosis and started treatment based on the diagnosis.

Unfortunately, Pintu died after about a month and half.

The patient’s family sued the doctor and alleged that patient’s condition was improving, but on the fatal day he was administered enema, and as a result he went into a shock and eventually died.

The doctor stated in defence that patient was a known alcoholic and clinical examinations performed indicated liver cirrhosis. A team of doctors was consulted at the hospital and they tried their best, but despite all effort the patient died due to gastrointestinal trout.

The Commission perused medical records and findings of medical experts and observed that the patient was actually a case of melena and abdominal tuberculosis (TB) which remained undiagnosed. There were other conclusions made in the expert committee’s report which seemed to have shocked the Commission as it stated the following:

“It is prima facie seen that the doctor’s diagnosis and method of treatment was incorrect. In addition to that, the things which were expected to perform were not performed at proper time. For example, it was important to examine black stool at proper time. It was also necessary to perform tests of oesophagus, stomach and small intestine at proper time which was essential to diagnose melena. The treatment given was based upon wrong diagnosis”.

“It shows that enema was given to the patient because the doctor diagnosed liver cirrhosis, notings in case papers however showed explicit infection which was neglected. Prior to giving enema the patient was examined and at that time his pulse rate, BP was proper. There was no blood vomiting or purgative. In such circumstances, the decision to give enema was wrong as it can lead to perforation of Intestine which can cause severe pain and kill the patient instantly”.

“On the second day of admission, patient had black colour stool which is a sign of upper gastrointestinal (GI) bleed for which endoscopy of upper GI track is mandatory for diagnosis and definitive treatment. This was not done and only intravenous fluids were given”.

“It is clearly observed that there is evidence of overwriting in many places in the IPD record, which could be manipulation. The patient was not properly examined and though the IPD clinical notes appear proper as per clinical diagnosis except abdominal TB and stress ulcer mentioned in the death certificate for which treatment was not given”.

“The liver biopsy was never done which is a must for diagnosis of liver cirrhosis. In the absence of history and clinical findings, it is difficult to understand as to how the doctor arrived at judgment of liver cirrhosis”.

Such serious mistake in arriving at a definitive diagnosis was obviously frowned upon by the Commission. The doctor was held negligent and ordered to pay more than eight lac rupees as compensation.

Source: Order pronounced by National Consumer Disputes Redressal Commission, New Delhi on 17th January, 2020.