#LegallySpeaking: Symptomatic treatment vis-à-vis investigat
#LegallySpeaking: Symptomatic treatment vis-à-vis investigations
Postponing investigations and treating a patient symptomatically, especially in the initial phase of treatment, is not negligence.

Background:

A neurosurgeon conducted surgery on the patient after which, the patient was seen to be recovering well. But after a few days, the patient complained of pain and uneasiness in the abdomen. The duty doctor instructed the nurse to apply 'muccaine gel' after which, the patient went to sleep. A few days later, a second surgery was done after which, the patient was kept in the SICU. On the following morning, the patient complained of pain in the abdomen. After examining the patient, the neurosurgeon requisitioned an X-ray and a scan. The patient's father was informed that the problem could not be identified by X-ray and hence, the patient was taken to another hospital for treatment. The patient died the next day.

Allegation:

It was alleged that the patient's death was due to a failure on the part of the hospital and the neurosurgeon to accurately diagnose the ailment. It was contended that before applying muccaine gel, the neurosurgeon ought to have conducted necessary investigations to rule out 'pancreatitis'.

Doctor's defense:

In defense, the neurosurgeon explained that it was natural to suspect the problem as gastritis while prescribing muccaine gel, and hence, the treatment given was symptomatic and there was no reason for suspecting pancreatitis. It was further pointed out that pancreatitis did not have anything to do with the surgery done by the OPs.

Findings of the court:

The court observed that abdominal pain is generally attributed to acidity and the doctor does not normally suspect pancreatitis initially, unless abdominal pain is associated with other symptoms or complications. The court further observed that that in the instant case, once the patient got relief from muccaine gel, there was no reason to resort to any other investigatory process, and as the condition of the patient deteriorated quickly thereafter, there was no time to give any other treatment for suspected pancreatitis. The court therefore held that there was nothing wrong in the neurosurgeon having treated symptomatically instead of suggesting that the patient go for expensive and invasive tests.


Suggested precautions:

- In a fit and proper case, postponing investigations and treating a patient symptomatically, especially in the initial phase of treatment, is not negligence
- Proper protocols must be developed and followed by hospitals and nursing homes, whereby investigations when advised by consultants must be done at the earliest in emergencies, efforts must be made to procure reports quickly, the consultants must be informed about the results of the investigation at once on receiving such reports, and any direction(s) given by consultants must be carried out forthwith

Source: MLCD (https://pxmd.co/oqD4D)

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.
Dr. S●●●●●●h H●●●●●a and 12 others like this5 shares
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