Misreading Myocardial Infarction ECG as Normal: Max Hospital told to pay Rs 24 lakh

New Delhi: On account of its doctors misreading an ECG highly suggestive of Myocardial Infarction, which finally led to a patient’s death, the Delhi State Consumer Disputes Redressal Commission has directed Max Hospital, Pitampura to compensate an amount Rs 24 lakh to the deceased patient’s family.

The concerned case goes back to the year 2006, when the 48-year-old patient, GK Jaggi was rushed to the hospital, following the complaints of sudden onset of pain in both of his legs radiating into his lower abdominal region.

According to the observation made at the emergency block, the patient had a history of Hypertension but no medication, a development of burning sensation in the chest along with pain. At that time, the patient’s had BP 150/80 and blood sugar 181 high.

Thereafter, he was administered injections of Voveron [Diclofinac- Anti-inflammatory and analgesic] as also Pantocid [Pantoprazole Sodium- Proton Pump Inhibitor works on the Gasto-intestinal Tract] as also the oral administration of syrup Mucaine Gel [Oxethazaine+Aluminium Hydroxide+Magnesium Hydroxide in oral suspension- used to treat acidity].

Moreover, ECG was ordered to rule out any Cardiological threat to the patient. At 8.30 am, the ECG found T wave inversion in leads I and aVL, which is highly suggestive of Myocardial Ischemia as also Myocardial Infarction. However, Dr Nitin Khanna misread this ECG as ‘Normal’ and did not ask for further Cardiological examination

At 9.05 am, the Cardiac Monitor in respect of the patient reported a straight line. Accordingly, CODE BLUE was announced and thereof the team of doctors commenced CPR, however, unfortunately the patient could not be saved and was declared dead at 9:38 am.

Alleging that the err made by the doctor during the ECG observation, led her husband’s death, the complainant in the case, Suman moved the consumer forum. She complained to the commission that the doctor did not ask for further Cardiological consult and the patient was virtually unattended for the crucial 40 minutes.

The grounds taken by the family in support of their complaint are that “as per Standard Medical Textbook literature this etiology of unspecified symptoms pointed towards deeper seated malady/condition which required immediate investigation for a Myocardial Infarction/Heart Attack, which should have been suspected by the doctor at the very outset without wasting precious time which is the essence of such management.”

It was averred before the court that the doctor, instead of understanding the etiology of symptoms, holistically and seeking the most basic of investigations to rule out the occurrence of a Myocardial Infarction being suffered by the patient, got a solitary ECG conducted and misread the same to be Normal and thereinafter decided to treat the patient symptomatically only.

In response to the allegations made against them, the hospital and the doctor stated that the complaint is founded on false and frivolous grounds. They contended that the family, themselves are responsible for the result since the patient was not brought to the Hospital for treatment in time.

Meanwhile, the expert committee comprising Dr Sanjay Tyagi, HOD (Cardiology), GB Pant Hospital, Dr Munisha Agarwal, Prof Aneasthesia, MAMC and Dr Sandeep Garg, Assoc Prof (Medicine) MAMC, received from the Govt. of NCT of Delhi, Maulana Azad Medical College (Coordination Branch) noted,

“The ECG provided in the documents shown T wave inversion in leads I and aVL while it was reported as normal sinus tachycardia. Further in view of the ECG changes cardiology opinion should have been sought. The records shows that the proper resuscitation process was adopted by the code blue team, however no records of the reports of the sample sent by the code blue team are available.”

Accepting the observations of the Expert Committee, the court noted

The court then quoted various judgements of courts relating to medical negligence. Finally, hearing all the contentions made by both the parties, the bench of honourable Judicial Member, OP Gupta and Member Anil Srivastava, observed,

“Shorn of superfenties, we note that the OPs by being casual after the ECG report at 08.25 a.m. and waiting till worsening of the situation at 09.05 a.m. were surely and certainly negligent particularly when they were fed by the complainants that the patient since deceased was suffering from hypertension in which case the OPs were expected to be extra cautions even otherwise. They were supposed to examine the report succinctly and not in the usual and casual manner.”

Ultimately, keeping in view the report of the committee, the court held that the hospital and the doctor were negligent while treating the patient and directed the hospital to pay Rs 24 Lakh to the deceased patient’s family for the suffering, mental pain and agony caused as well as an additional Rs 2 lakh towards litigation expenses.