Choosing alternate mode of surgery on the operating table is
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Choosing alternate mode of surgery on the operating table is not negligence
- A surgeon has the indisputable right to abandon or change the surgery/procedure midway after opening the patient. The reason/s for doing so must be acceptable to medical science and should be in the patient's interest
- Law of consent stipulates that an adult, conscious, and oriented patient alone has the right to give consent. However, whenever there is any doubt on the patient's capacity to provide consent, it is advisable that signature of a near relative of the patient must also be taken on the consent.
- Hospitals must have the required infrastructure and equipment necessary to perform a particular type of surgery.
- In case of an on-table complication or change of the agreed course of action during surgery, the surgeon/doctor must himself/herself inform the relatives and not communicate through a team member, anaesthetist, nurse or any other person

Case facts
The patient, a known case of AS, had undergone total hip replacement (THR) previously but the pain reoccurred and a doctor diagnosed that the cup of prosthesis had loosened and advised revision surgery for replacement of the acetabular cup.The surgery was postponed once and performed a week thereafter. During the surgery, the orthopedic surgeon decided against the revision surgery and performed an alternate surgery, girdlestone arthroplasty. Three months after the alternate surgery, the patient developed complications and underwent another surgery.

Findings of the court
The court observed that the patient was suffering from AS, which is not completely curable and only corrective surgeries are helpful for mobility. Therefore, the alternative mode of surgery, the only recognized alternative mode of surgery when THR is not possible, adopted by the orthopedic surgeon was not negligence and hence, the hospital and the orthopedic surgeon were not held guilty of negligence



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