#LegallySpeaking: ENT Surgeon Absolved Of Medical Negligence
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The National Consumer Disputes Redressal Commission (NCDRC) dismissed a case of medical negligence against an ENT surgeon who performed a Tonsillectomy on the patient who shortly died after the procedure.

• Background of the case:

~ Patient was taken to the hospital 1 with the complaint of pain in the throat with blood in the saliva while spitting. X-ray was done which showed a fishbone piercing in the left tonsil.

~ The patient was advised for Tonsillectomy, which was performed. After operation when patient suffered uncontrolled bleeding he was referred to Hospital 2 wherein the diagnosis of Hemophilia-A was made. However, during treatment, the patient succumbed due to ARDS.

• Complainant/Patient's allegation:

~ Patient's wife approached the state medical council alleging medical negligence on part of the doctor for not diagnosing the bleeding disorder before tonsillectomy surgery performed on the patient which ultimately led to the death of the patient.

• Doctor's Defense:

~ On examination, there was left tonsillar fossa bleeding but no infection. All necessary blood investigation including Bleeding Time (BT), Clotting Time (CT) and Platelet Count were done.

~The bleeding was completely stopped till the evening of next day of operation. But the bleeding started and became profuse due to the Haemophilia A. It was then suspected that patient might be suffering from a congenital bleeding disorder.

~ Since, the conservative method to stop the bleeding failed, tonsillectomy and cauterization of the left tonsillar fossa was done. Two days after the surgery, the patient developed bleeding from the left tonsillar fossa, thus suspected some bleeding disorder.

~ The patient and his wife concealed the family history of bleeding tendency. If the history of bleeding disorder in the family would have been disclosed, treatment would have taken a different mode. Thus diagnosis was not a negligent diagnosis.

• State Commission held that:

~ The state commission clarified that there is contributory negligence on the part of the patient as well as on the part of the bystanders including the complainant and held the doctor guilty of negligence and stated that the complainant will be entitled to receiving almost Rs 350000 as compensation.

• Being aggravated by the order, the doctor approached NCDRC and the court observed:

~ Non-disclosure of past history of bleeding disorder by an educated aware patient before tonsillectomy surgery, cannot be held to construe negligence on the part of the doctor. Also, doctor diligently referred the patient to a higher centre after suspecting bleeding disorder. Thus, the doctor treated the patient as per the standard medical practice.

~ The court dismissed the case of medical negligence against the doctor and held that " in our opinion, the state commission erred in holding negligence on part of doctor, hospital."

Source:
http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0/0/FA/193/2012&dtofhearing=2020-12-11
R●●U Y●●●V and 23 others like this16 shares
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Dr. R●●●t P●●●●●n
Dr. R●●●t P●●●●●n Dentistry
How bt and ct was normal in investigation for haemophilic pt.?
Jan 4, 2021Like4
A●●●●●n C●●●●●●●●●y
A●●●●●n C●●●●●●●●●y General Medicine
Same question as Dr. Rajat. How did the coagulation work up came up unremarkable?
Jan 5, 2021Like
Dr. M●●●●●v D●●●i
Dr. M●●●●●v D●●●i Internal Medicine
Bleeding time, clotting tine and platelet counts may be in normal range in hemophilia with mild factor VIII deficiency. Activated Partial Thromboplastin Time (aPTT) will identify defect in intrinsic cascade pathway of coagulation, where factor VIII is required. If one wants to screen for bleeding and coagulation disorder, stop ordering BT and CT, and order aPTT, PT(Prothrombin Time) and Platelet counts.... Read more
Jan 6, 2021Like4