Lack of Preoperative ECG: NCDRC directs 3 doctors to pay Rs 2.7 lakh

New Delhi: Lack of ECG and assessment of the cardiac condition of the patient before the operation as well as lack of proper documentation in CPR notes costed three medical practitioners, when they were held guilty by the National Consumer Disputes Redressal Commission held them guilty of medical negligence and mismanagement leading to the death of a 25-year-old patient.

The apex consumer forum directed three doctors to pay Rs 2.7 lakh for "gross negligence" and "mismanagement" that led to the death of a woman after she suffered a cardiac arrest during an operation and slipped into a coma and never recovered from it.

The National Consumer Disputes Redressal Commission (NCDRC) said that it was a "serious lapse" on the part of the doctors to not assess the woman's cardiac condition before the operation.

A bench of presiding member Anup K Thakur and member C Vishwanath upheld the district consumer forum's order asking Doctors Desai, Shah and Jigneshbhai Shah of Ahmedabad, Gujarat, to pay Rs 2.7 lakh to Mustafabhai Ibrahimbhai Salar for the death of his wife, Memunaben Salar.

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According to the complaint, Salar (Age 25 years at that time) was admitted to Ahmedabad's Samved hospital on October 20, 2004. She suffered a cardiac arrest during the surgery the next day. She was shifted to another hospital where she remained in a coma till her death on November 18, 2005.

The tribunal overturned the state consumer commission's order and said that once cardiac arrest takes place, its management is an important aspect in reviving the patient and the operation notes speak of cardiac massage being given but there was no mention of the time taken to get the heartbeat back, a delay in which could lead to hypoxic damage as it happened in this case.

"The respondent (doctors) ought to have mentioned the duration of cardiac arrest, especially when the condition could not be revived neurologically. All this indicates that the complainant's wife went into subsequent conditions because of gross negligence and mismanagement on the part of the respondents," the bench said.

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It also said that the doctors, knowing that cardiac arrest was a known complication of spinal anaesthesia, should have taken an ECG to conduct a thorough pre-operative check-up of the patient and her heart.

"As seen from the record, last ECG was conducted way back on May 25, 2004. The present operation is an elective operation and was not done on an emergency basis. The respondents had all the time to do thorough investigations before taking the patient to the operation theatre. They should have taken another ECG after her admission in the hospital and on assessing her cardiac status proceeded with the operation.

"Failure on the part of the respondents in not assessing the cardiac condition of the patient before the operation is certainly a serious lapse on their part, knowing full well that cardiac arrest is a known complication in spinal anaesthesia," the bench said.