#LegallySpeaking: Medico-Legal Tip
The consent form must be filled by one doctor/nurse, in one sitting, if possible without changing the pen.
The patient (85 years old) was diagnosed to be suffering from prostatic enlargement and was advised surgery. During the course of the next few days, general health check-up and pre-operative investigations were undertaken, which included blood test for fasting blood sugar, blood grouping, blood urea etc. The patient was finally admitted on 30.6.1998 to be operated on the next day as the first case.
Operating team of doctors first adopted the Trans Urethral Resection of Prostate (for short TURP) method also known as the pinhole method but subsequently switched over to trans-vesicle route (open surgical method) due to technical reasons.
The operation was over in about two hours, thereafter, the patient was shifted to the recovery room. In the evening, however, the condition of the patient started deteriorating. He had to be given oxygen at 7.45 p.m. which, however, did not help improve his condition and the patient finally expired at 9.10. p.m.
The main grouse of the complainant against the doctor is that wrong method of surgery i.e. TURP was adopted which had to be later changed to Trans-vesicle (open) method and that there was excessive bleeding which could not be controlled as CTBT test was not done.
The complainant, who is a doctor himself, argued that he signed a blank consent form which was manipulated to add the method TURP.
The court stated,
- "...To the contrary un-rebutted Annex.A2 which was prepared long before the operation clearly states TURP/open indicating, as has been explained by the learned counsel for OP No.2 that the decision to go either for TURP or open trans-vesicle method was open to the best judgement of the operating doctor. In this back drop, it is difficult for us to believe that the word TURP was inserted by OP No.2 on the blank consent form signed by him. Being a doctor himself, he cannot be permitted to take the plea that he signed the blank consent form believing in good faith that trans-vesicle method would be followed..."
- "...The word TURP as it appears does not appear to have been manipulated or written by a different hand. Besides, when there was no compulsion for the educated doctor to sign on a blank form nor was there any emergency on the previous day, the least expected of the complainant was to have filled up the column properly, if as alleged it was blank..."
This contention of having signed on a blank consent form, therefore, has to be rejected outright.
The consent form here was filled without a pen-change and by one person so when the court found that it was not manipulated, they rejected the argument presented by the complainant.
Note: The objective of the #LegallySpeaking initiative is to spread awareness about the medicolegal implications of commonly encountered scenarios in a clinician's daily practice.