#LegallySpeaking: Medicolegal Tip
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#LegallySpeaking: Medicolegal Tip
Tip: "If a Surgeon or a Doctor opt for one of the two accepted procedures, it cannot be said that he is guilty of negligence”

• Facts of the Case:

~ The Patient was advised by the Cardiologist for CMV (Closed Mitral Valvotomy) to be performed as this procedure would be more effective and less expensive.
~ However, instead of carrying out CMV, the cardio specialist of the hospital resorted to open-heart surgery.

• Patient's Allegation:

~ When the patient again developed some problems, she was advised 2nd heart surgery, which was beyond her monetary means.
~ Closed mitral valvotomy instead of open mitral valvotomy should have been performed upon her. Hence the Complaint about Negligence.

• Doctor's Defense:

~ The mitral valve was competent and did not require any repair, however, the tricuspid valve required repair which was done.
~ When the patient again came to the hospital, it was diagnosed with mitral incompetence & was advised for valve replacement.
~ Mitral incompetence was not because of any negligence in the operation performed but was a manifestation of a known risk of said operation, which was also recorded in operative notes.
~ Open valvotomy had to be resorted to since the tricuspid valve needed to be repaired.

• National Commission Held:

~ There was no deficiency in conducting the first surgery.
~ As long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available.

Source: http://www.doctorsdirectoryindia.com/assets/medicolegal/If-Surgeon-or-Doctor-opt-for-one-of-the-two-accepted-procedures.pdf
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Dr. V●●●●●●j D●●●i
Dr. V●●●●●●j D●●●i Legal Medicine
It is always better to inform the patient of the various available surgical & other options, with a rider that the procedure can be selected out of the various options, in the best interest of the patient, according to the intraop findings (actually seen on the operation table). This informed consent obviously has to taken before the procedure is actually started and preferably before the patient is taken to the OT, so that the patient doesn' t have to give his say in haste in the OT just before the procedure (ie he gets enough time to consult his well wishers, and to take a second opinion, if he wishes). This practice is better than only the doctor himself deciding. Only the doctor deciding also is not culpable, as long as reasonable care is taken; however involving the patient in choosing the option, is the best methodology, more so looking from the perspective of avoiding litigation in consumer courts.... Read more
Jul 5, 2020Like1