Chandigarh: In a relief to the Director, concerned doctors, and nursing staff of Post of Medical Education and Research Graduate Institute (PGI Chandigarh), the State Consumer Redressal Commission, Chandigarh has absolved them from an allegations of medical negligence, in the case of a cancer patient. The court while passing the judgement observed that the patient was a smoker who was suffering form cancer, and the doctors at PGI had performed the duty that was expected from them
The case concerns a patient who was suffering from pain in lower jaw right side during the month of July, 2016. After the removal of his teeth, he developed a lump of gum muscle. He went to HP Govt. Dental College and Hospital, Shimla and after clinical tests, he was diagnosed “Chondroid Tumor” (a type of bone cancer on lower right side jaw region – also known as lower Mandible). Before removal, he was advised whole body pet scan for which he came to PGI Chandigarh
The patient visited PGIMER, Chandigarh on 03.11.2016 and after discussing the previous history, PET Scan was conducted on 11.11.2016 and after other clinical tests, it was diagnosed as “Chondrosarcoma-Mandible” (a type of cancer of spreading nature). It was further stated that the dental surgeon decided to conduct the surgery to remove the affected portion of lower jaw (right side) and in the meanwhile the case was also referred to plastic surgeon.
However before , the surgery was postponed as some abnormalities were detected and again advised to undergo whole body PET Scan test to determine whether the cancerous cells spread to other parts of the body or remained in the area where it was detected, due to its spreading nature.
After the second PET Scan, patient was cleared for the surgery by the dental and plastic surgery team. It was further stated that before the surgery, Pre-Anesthesia clearance from PAC Department was required, where, the kin was advised numerous tests, as one of the test was ECG for determining the condition of heart and the said test was conducted on 03.11.2016 and found abnormal. No further test was prescribed/advised. The said operation was conducted on 03.12.2016.
The complainants alleged before the court that after operation, the patient was shifted from the operation theatre to the plastic surgery ward at about 11.20 PM on 03.12.2016 without oxygen and breathing balloon and suffered a shock due to lack of oxygen, as his eyes were wide opened until he was put on oxygen in the ward. It was further stated that the kin regained consciousness on next morning on 04.12.2016 after the anesthesia effect started reducing but complained of chest pain, palpitation and sweating and continued to be so till early morning of 07.12.2016.
On the 7th, his condition deteriorated, and he was put on ventilator. The patient suffered massive heart attack in early hours on 07.12.2016 and could not be revived.
Several Allegations were made by the family of the deceased, major of which was that the main cause was not diagnosed earlier by the medical staff and due to sheer negligency of the attending doctors and nursing staff, besides the doctors of PAC Department, who cleared the operation/surgery despite having the abnormal ECG, the patient could have been advised first the treatment of heart ailment. Other allegations included
- Lack of care taken by attending doctor and nurse
- Blood transfusion was done but stopped after an hour. No sample of the blood was taken for matching before the blood transfusion whether it was fit for transfusion or not.
- No records of fever in treatment though the patient had fever. No record of removal of waste blood pipe from the neck, though the same was done
- After observing Acute Cardiac Event, the patient was put on ventilator by one Dr.Vipin but was suggested against putting on ventilator by ENT/Cardio team of doctors, as there might be chances of lungs and kidney failure after the heart attack as parameters were not normal and vital organs of the patient may not respond with sudden pressure on them to return to normal state. Cardiologist was called late
- No second opinion from the senior consultant of cardio was obtained.
- During the intervening period, Dr.Vipin also asked whether the patient was smoker. Dr. Vipin also informed the complainants on enquiry regarding the condition and said that there seems to be no supply of blood to lungs through pulmonary vein/nerve ; angiography is required to be done immediately to diagnose the clotting ; the patient after the operation should have been in ICU for special care and the lapse is on the part of one of the doctor for not doing so.
It was primarily alleged that the patient suffered a heart ailment and the same was not diagnosed earlier by the medical staff and due to sheer negligency of the attending doctors and nursing staff, besides the doctors of PAC Department, who cleared the operation/surgery despite having the abnormal ECG, the patient could have been advised first the treatment of heart ailment.
The court went Through the post mortem report that stated
“Final Autopsy Diagnosis – In this 41 year old with K/C/O Chondrosarcoma mandible grade II day 4 post operative demise final autopsy diagnosis are : “Billateral massive pulmonary thromboembolism-Saddle thrombus Bronchopneumonia, pleural effusion. *Double vessel CAD – (LAD & RCA : 70-80% occlusion)\ * Old healed myocardial infarction, Foci of Acute MI. * Meckel’s diverticulum * Terminal necrosis in pancreas and mucosa of small intestine” *
The Consumer forum after going through the cases came to the conclusion that the doctors had performed their duty, which was expected from them.
It is needless to say that the doctors had performed their duty, which was expected from them. The record shows that the kin was smoker. Smoking either active or passive, which is continuous or has been discontinued earlier has negative impact on the health of a person. The complainant has alleged that the operation was conducted without checking the condition of the heart of the person, whereas, there is clearance from the Department of Anesthesia during PAC for conducting the surgery. The complainant has alleged that the blood transfusion was not done properly and the waste blood pipe of neck out was not fully removed and bandaged, does not hold good because the doctors who were attending the patient have more knowledge and experience in conducting such like activities instead of common man. Prima facie it appears that such operation of removing the mandible is a very major surgery, which the complainant himself agreed that it went on for 13/14 hours and keeping in view already the frail ill health of the person, the post operative complications do occur in such serious cases.
It is not out of place to mention here that the said surgery undergone by the kin was of a very serious nature and had it not been conducted by PGIMER, Chandigarh, after clearance of the abnormality observed in his ECG report by PAC Department of PGI, which was in fact one month prior to the operation, there were ample chances of patient having died due to the spreading nature of cancer. Therefore, in our eyes, there was no negligence on the part of the doctors of PGIMER, Chandigarh.
The court then dismissed the complaint