#LegallySpeaking: Medico-legal tip of the week
Tip: "Standard Clinical Guidance should be followed while administering Anesthetic drug"
• Facts in nutshell:
~ A patient suffering from Jaundice was advised ERCP (Endoscopic Retrograde Cholangio Pancreatogrpahy) with CBD endoscopy.
~ During the ERCP procedure, doctors administered anesthesia, which resulted in fatal complications, and patient went to Coma, became brain dead and later succumbed to death.
~ Thereafter, hospital refused to treat and decided to discharge the patient.
• Doctor’s Defense:
~ The Doctors denied all the charges. They attributed the initial complications to sudden cardiac arrest during ERCP.
~ ERCP procedure was not followed by doctors as per standard guidelines, the Propofol was administered without monitoring and caution.
~ The cardiac arrest was not managed properly, therefore patient suffered coma. Thus, the hospital was fined compensation of Rs 47 lacs for Medical Negligence.
~ In the instant case, as opined by experts, this could have been avoided, had the doctors enquired with the patient and made an appropriate assessment as to whether the said drug can be administered or not.
~ Propofol sedation is ideally administered by dedicated and appropriately trained anaesthesia personnel, as per the guidelines by Royal College of Anaesthetists, London.
~ The hospital procedure required the monitoring and recording of a patient's vital signs before and during the procedure, such as blood pressure, oxygen saturation, and pulse rate. There were no records of that during the procedure.
We must learn what not to do than what to do, from the mistakes of others.