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NCDRC finds Sitaram Bhartia Hospital guilty for not taking consent, fines Rs 7 lakh

NCDRC finds Sitaram Bhartia Hospital guilty for not taking consent, fines Rs 7 lakh

New Delhi: Doctors MUST take consent of patient/family members before undertaking an invasive procedure during treatment, a bench of Justice Ajit Bharihoke and Anup K Thakur of the National Consumer Disputes Redressal Forum were seen reiterating while pronouncing the judgement in a case of medical negligence.

The consumer court was responding to a case filed against Sitaram Bhartia Institute of Science and Research, New Delhi, where the patient had alleged that the doctors had not taken consent of family members before inserting a catheter for central venous line procedure adding that due to their  alleged negligence, the jugular artery was ruptured resulting in profuse bleeding and he had to be shifted shift to another hospital for treatment.

The hospital responded that the procedure of insertion of CVL in the patient’s neck was a routine procedure like giving injection and consent was not required as it was not a surgical or invasive procedure.

The court however, not finding any merit in the hospital’s justification stated that putting CVL in the body of a patient could not be equated with ordinary procedure

A central venous catheter (CVC) also known as central venous line or central venous access catheter, is a procedure in which catheter is placed into a large vein. A catheter can be placed in veins in the neck, chest, groin or through veins in the arm. It is used to administer medication or fluids that are unable to be taken by the mouth. From the record it transpires that in the instant case, the CVC was tried to be placed by the team of doctors in the internal jugular vein, which went wrong resulting in injury to the vein and excessive bleeding. The aforesaid procedure obviously is an invasive procedure which admittedly carries the risk

 The court specified that the provision of taking consent could be overlooked only if urgent intervention was required to save the life of a patient. However, it added that there was not such urgency in the current case.
Unless the procedure is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay the procedure until the patient regains consciousness and takes a decision, a doctor cannot perform such procedure without consent of the patient. In the instant case, the insertion of catheter by Central Venous Line procedure being an invasive procedure carrying certain risk of complication, including injury to the jugular vein or bursting of the blood cells, the team of doctors was legally required to obtain consent of the patient.
Holding the hospital guilty of negligence, the apex consumer court asked it to pay a compensation of Rs 7 lakh to the patient, reports TOI. The Hospital, responding to the daily’s queries stated that while it had not receieved the order, yet, it may challenge the same in the Supreme Court.

“We haven’t received the copy of the order yet. After seeing the order, if order is adverse we will approach the Supreme Court,” said Dr Shubhra Verma, General Manager (Operations), Sitaram Bhartia hospital told TOI.

Source: with inputs
15 comment(s) on NCDRC finds Sitaram Bhartia Hospital guilty for not taking consent, fines Rs 7 lakh

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  1. In such circumtances if patients refuge should we leave the patient to die.bullshit.ima should prevail

  2. user
    vijay kumar kadam May 13, 2017, 8:22 pm

    We should document CVL as life saving procedure in such cases.

  3. There is no excuse 4 an informed consent. There r detailed guidelines on this issue and one sud acquaint themselves with them b4 undertaking any invasive procedures including even endoscopies on GI Tract. In difficult situations, one should hold a board of responsible hospital officers to document it since solo witness shall b clouded under vested unitarian autocratic decision and liable 4 prosecution and controversial. In coming times, \”Informed Consent\” in India shall make very important part of surgical practice.

  4. I think the lame group of people sitting at the top in MCI or the IMA are suffering from a lot inferiority complex or mental disease.
    The are more interested in torturing their own people and just ignoring such stupid judgements.
    I feel very helpless and most vulnerable as a young doctor in this stupid country. Here action should against the till now jobless judges of ncrd whi pass such foolish judgements.

  5. What is being overlooked is that if such a consent had been sought, would the patient have refused? Every treating doctor advises procedures which are expected to be the need for the patient and it is very unlikely that a needless procedure would be advised. In the instant case, one assumes that insertion of the CVC was considered necessary. Every procedure carries a risk – even an injection can cause problems to some people and we dont resort to test doses every time unless we have reason to believe that the specific medication could cause adverse reactions. If Doctors start running scared to undertake any invasive procedure and have to explain all details first to the patient, the number of patients that will get treated will drop. Also, in how many instances are patients knowledgeable enough to say that they do not want to undergo such procedures? And, what is the implication for treatment if patients indiscriminately refuse to give consent? And, who will be held liable if the treatment is withheld and results in complications? Will the court charge the doctors with not explaining the gravity of the situation while seeking consent? I think we are walking a dangerous path where everyone stands to lose. A better option is to trust the doctors and not suspect them of intention to cause harm unless there are obvious reasons to suspect the intent. Mere absence of paper work should not become the excuse to run to courts

  6. user
    Vikram Shah Batra May 13, 2017, 1:12 pm

    Very well said sir.i completely agree. In the end it is the patient who is the loser.

  7. Sir,I didn\’t read the statement of the hospital.They say that the consent was not required,thereby meaning that they didn\’t even bothered to explain the rationale of putting the cup,leave aside the implications of this procedure.What if the relative didn\’t have money to get it repaired by a vascular surgeon.He would have died .That is why the courts decision to held the hospital guilty.

  8. There are definite known possible complications of central venous cannulations, of which some can be life threatening to the patient . As after all [despite the greatest expertise] these are blind procedures .Therefore taking written consent for such procedures is mandatory but this job should be the work of the paramedical staff. Why doctors be held responsible for such paper work . Paramedical staff also gets salary . This should be their working area in total .Doctors may maximum sound them verbally but paper work should be the job of nurses and rest of the paramedical staff including the staff who is keen look after the billing by the patients and attendants .

  9. Paramedics can take signature I agree,but it\’s your duty to explain the implications of the procedure,because patient is entrusting you his life ,and not the nurse.It is as simple as this my friend.

  10. Nursing staff and even other staff people can do the significant explaining but writing , typing should be the job of the assisting paramedical staff .

  11. user
    Dr Krishnamoorthy May 13, 2017, 8:51 am

    it is also difficult to keep track which is routine and which is not. There can be divided opinion. For an intensivist, central line could be routine, as he does it day in and day out

  12. Its routine that doesn\’t mean that you can play with the life of the patient.Its insensitiveness towards your patient.What would you if the patient is your relative.Being doing it day in and day out doesn\’t mean that the procedure become safe .