Relief to Anesthetist after 25 years: NCDRC holds Death of Patient post surgery not conclusive proof of negligence

Written by Barsha Misra Published On 2022-07-10T18:53:44+05:30 | Updated On 10 July 2022 6:53 PM IST

Relief to Anesthetist after 25 years: NCDRC holds Death of Patient post surgery not conclusive proof of negligence

New Delhi: Holding that simply the death of a patient is not a conclusive proof of medical negligence, the National Consumer Disputes Redressal Commission (NCDRC) bench recently exonerated Rajasthan Hospital and its Anesthetist from charges of negligence after around 25 years.

Although the Complainant had claimed that the patient, who had been operated for intestinal obstruction, had suffered cardiac arrest because of the overdose of anesthesia by Dr Gauri Punjabi, the top consumer court clarified, "Simply because the patient died after a surgery is not a conclusive proof of alleged negligence."

"The operative notes clearly show that there was no complication during the surgery. The CPR was performed as per the standard protocol. Therefore, the allegation of medical negligence against the Opposite Parties is not sustainable," it further added.

The matter goes back to 1997 when the patient got admitted to Rajasthan Hospital after suffering from some digestive problems. Various tests including blood test, x-ray, electrocardiograph (ECG) had been conducted and the patient was discharged after a couple of days. However, the patient had to come back again and he had been operated for intestinal obstruction on 05.01.1998.

Also Read: Lack of care, mere accident not evidence of Medical Negligence: NCDRC exonerates ENT Surgeon, Hospital after 22 years

After the operation, while transferring the patient suffered a sudden cardio-respiratory arrest at around 4.10 p.m. and he suffered the second arrest at around 7.45 p.m. and around 30 minutes later, the patient had been declared dead.

It was the contention of the complainant that the patient was young, around 32 years old at that time. He had god general condition and he had been declared to be fit for surgery as per normal ECG and other reports. Therefore, the complainant alleged that his death during the operation was due to negligence and carelessness or overdose of anesthesia. Being aggrieved, the wife of the patient and other legal heirs filed the Consumer Complaint and prayed for Rs 10 lakh as compensation.

On the other hand, the Hospital and its doctor denied any negligence during the treatment. They submitted that while the operation was uneventful, the patient had suffered cardiac arrest while being transferred from the operation theatre.

After taking note of the submissions and arguments, the State Consumer Court had dismissed the complaint as it had opined that the complainant had failed to prove negligence.

Therefore, challenging the State Commission's order, the complainants approached the NCDRC bench. The counsel for the Complainants argued that the State Commission had dismissed the complaint without considering the evidence on record. He further argued that even though the patient was normal, he had suffered three cardiac arrests due to negligence during surgery and by anesthetist.

It was further claimed that the hospital did not take any precautionary measures and the dead body had been brought out of the operation theatre. With this argument, the complainants' counsel contended it to be a clear case of "Res Ipsa Loquitor". He also pointed out that post mortem was necessary in the case of unnatural death but it had not been performed.

The counsel for the complainants also argued that the State Commission had grossly erred to consider an expert report of Forensic Medicine Department of B.J. Medical College which speaks about negligence of the hospital. Further, they claimed that the deposition of expert in examination in chief and cross examination was not considered properly by the State Consumer Court.

However, the doctor and the hospital argued that there was no medical negligence during operation. They also submitted that the patient had suffered Cardio-respiratory arrests twice and the same had been treated as per standard resuscitative protocol.

Apart from considering the arguments, the top consumer court bench also perused the medical record and noted that the patient had been admitted in the hospital on 02.01.1998 with the complaint of recurrent pain in the abdomen since 15 days, acute pain for 7 days and vomiting, which was clinically suggestive of obstruction.

Following this, the barium meal test confirmed obstruction in small intestine at multiple sites. Therefore, the doctor had carried out the intestinal resection anastomosis operation without any complications. The NCDRC bench also noted that the operation had been carried out with the surgical team work under vital monitors and there was no excess blood loss during the operation. After the patient suffered cardiac arrest, immediately cardiopulmonary resuscitation (CPR) was started and all the necessary treatment had been given to the patient including endotracheal intubation and cardiac massage.

The top consumer court also noted that the patient had been treated by a team of expert doctors belonging to the Hospital including a Senior Anaesthetist Dr. S. T. Multani, Dr. Rupalben and Dr. Punjabi. Although the patient had responded to the treatment initially, he started having a cardiac arrest and ultimately died.

It was further noted by the NCDRC bench that the complainant had filed a criminal complaint u/s 304 A. Consequently, the Investigating officer had referred the case to Forensic Medical Department of B.J. Medical College, Ahmedabad along with the application and the whole treatment case papers, including the death certificate.

Following this, Assistant Professor Dr. Ganesh Govekar and Dr. V. R. Patil, Tutor in Forensic Medicine B.J. Medical College jointly opined "Death, in this case, is an un-natural death and can be due to surgical operation and/or anesthesia because all analysis report done before operation was normal."

Taking note of this, the NCDRC bench referred to the Supreme Court's order in Jacob Mathew's case, where the Supreme Court had laid down certain guidelines to govern the future prosecution of doctors for medical negligence allegations. Referring to this, the top court bench noted,

"Simply because the patient died after a surgery is not a conclusive proof of alleged negligence. In our considered view the Opposite Parties had taken all necessary precautions before performing the surgery. The operative notes clearly show that there was no complication during the surgery. The CPR was performed as per the standard protocol. Therefore, the allegation of medical negligence against the Opposite Parties is not sustainable."

Therefore, exonerating the doctor and the Hospital from the charges of medical negligence, the top consumer court ordered, "Based on the discussion above, we find neither negligence nor deficiency in service of the treating doctors or hospital in the instant case. Accordingly, the First Appeal stands dismissed. There shall be no orders as to costs."

To read the NCDRC order, click on the link below.

https://medicaldialogues.in/pdf_upload/ncdrc-no-medical-negligence-179063.pdf

Also Read: NCDRC holds Ophthalmologist negligent during cataract surgery, slaps Rs 2 lakh compensation

intestinal obstructionCardiac arrestECGrajasthan hospitaloverdose of anesthesiaanesthetistbarium meal testanaesthesia overdose

Barsha Misra

Barsha completed her Master's in English from the University of Burdwan, West Bengal in 2018. Having a knack for Journalism she joined Medical Dialogues back in 2020. She mainly covers news about medico legal cases, NMC/DCI updates, medical education issues including the latest updates about medical and dental colleges in India. She can be contacted at editorial@medicaldialogues.in.