Death of Orthopedician during Knee Surgery Workshop case: NCDRC absolves surgeon, hospital

Published On 2021-01-06 12:53 GMT   |   Update On 2021-01-06 12:53 GMT
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New Delhi: The National Consumer Dispute Redressal Commission (NCDRC) has dismissed a case of medical negligence against a private hospital and its doctors who were about to perform knee surgery on an orthopedic surgeon who volunteered to undergo the operation during a medical workshop. The surgeon had died in the OT before surgery due to cardiac arrest post administration of anesthesia.

The case is related to a patient who himself was an Orthopaedic Surgeon and Professor & HOD of Orthopaedics. He attended the Continuation of medical Education (CME) arranged by the Karnataka Orthopaedic Association at a Hospital, Belgaum. During the CME, he was about to get operated on his left knee by the hands of Orthopaedic surgeons expert in Arthroscopy doctors at a Hospital. The complainant's (father of the patient) second son, a practicing Gynaecologist at Belapur also joined the patient during the proposed operation.

As per the complainant, the patient was taken inside the Operation Theatre for the left knee operation and the orthopedic surgeon was neither available there nor contactable. Meanwhile, the patient's doctor brother was made to see the live demo of the surgery after 15-20 minutes. Later, the brother approached the OT but he was not allowed to enter there as the patient was serious. On enquiry, the doctor informed that the heart of patient had suddenly stopped and at that time the necessary lifesaving equipment and the presence of a Cardiologist was not there, therefore the patient was to be shifted to KLE Hospital. There was no ambulance facility; hence ill-equipped ordinary ambulance was called by the treating doctor. In the ambulance, the doctors were pressing the patient's chest. However, by the time ambulance reached KLE Hospital, the patient was declared dead.

A few days later, the Anaesthetist who administered anesthesia to the patient had committed suicide which made the complainant suspect that the death of his son was not natural but was caused due to the negligence of the doctors at the hospital.

The Complainant filed an FIR and alleged that Pre anesthesia fitness of the patient was not obtained from any doctor and they had not taken any pains to discuss with relatives present in the hospital even though there was a danger to give general anesthesia. No advice was taken from any other doctor regarding General anaesthesia though it was initially decided to give spinal anaesthesia. Moreover, the qualification of the anesthetist was not confirmed. The operation theatre was neither well equipped nor had a sufficient number of specialist doctors. It was also alleged that no Post-Mortem was done mostly to hide their mistakes. The doctors who were supposed to be present at the time of emergency were not even in the Operation theatre. It was further alleged that the owner and Managing Director of the Hospital is Homeopath, but he falsely prints his title as M.D. 

The respondent hospital and doctors denied the allegations stating that the present case was not maintainable under the Act, 1986 as it was not a 'service' under section 2(o) the Act, 1986. The surgery/procedure was a part of a live demonstration during the CME Workshop and completely free wherein even the consumables were not charged. The doctors further submitted that the Hospital is well equipped and has all facilities including specialized surgery and ICU etc. The doctors are also qualified Orthopedic surgeons, the Anesthesiologist was also a qualified medical professional. The hospital confirmed that the sudden death of the patient was due to massive cardiac arrest after the administration of anesthesia. It was not due to negligence from the hospital or the doctors, they submitted.

After considering the submissions, the apex commission observed that as far as the hospital facilities are concerned, the information sheet revealed all facilities were available including ICU, Lab, Radiology Department and Operation Theatres for Neurosurgery, laparoscopic surgery and plastic surgery."
The commission also observed that " it is evident from the medical record, that the necessary pre-operative investigations viz laboratory reports and ECG were done by the patient on a day prior at his working place. All the reports were within normal limits and fitness for the operation was obtained from his Physician and the same was mentioned in the clinical notes. Those reports were again checked by the Anesthesiologist on 07.06.2009 before the Arthroscopic procedure."
The commission noted that the patient's colleague was called by the patient himself to administer anesthesia during the procedure and after Spinal anesthesia was administered to the patient, suddenly the patient developed a respiratory problem and Cardiac arrest. Immediately, doctors started Cardiac resuscitation, the patient was intubated and administered Atropine and Adrenaline. The ventilation with 100% oxygen started. The court added,
 the doctors present in the OT were competent and have performed cardiac resuscitation as per standard protocol. The unexpected cardiac arrest during spinal anesthesia is rarely seen.
While acknowledging that the Anesthesiologist who administered anesthesia to the deceased had committed suicide under depression at his home town, the court stated,
" it is apparent that after the administration of anesthesia patient suffered massive cardiac arrest; it was before the commencement of the surgical procedure. Therefore in my view the team of Orthopedic Surgeons (Opposite parties) cannot be attributed with negligence as their role did not commence at all. In this context, I do not find any deviation from standard of practice from the doctors in the OT who immediately initiated cardiac resuscitation and despite all efforts patient could not survive. "
Stating that it is important that the Complainant has to establish on a balance of probabilities that the defendant's tortious act was a necessary cause of alleged injuries, the court further added,
In the present case, it was an unfortunate and unexpected death of the Patient even before the surgeons putting a knife for surgery. For me the 'causation' of medical negligence is not visible....... . I do not find any failure of duty of care from the doctors or there was any evidence to indicate any unexplained deviation from the standard protocol in the Operation Theatre.
The commission added that the case by itself cannot be a cause for awarding damages for the passing away of his son. Finally, the commission ordered
In obtaining the facts and the evidence adduced, in the instant case it is not feasible to determine medical negligence or deficiency in service on the part of doctors and hospital. Resultantly the Consumer Complaint fails. It is dismissed.
To view the full judgement, click on the following link:
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