Whether Decision to put a patient on Ventilator, problem of Bed Sores and failure to provide copies of Medical Records, can be grounds of Medical Negligence ?
The case of MANMOHAN SINGH & 2 ORS. V/s. FORTIS HOSPITAL
You may see the link.
http://cms.nic.in/ncdrcusersWeb/GetJudgement.do…
The Brief Facts :
The deceased was 96 years lady, who was admitted in Fortis Hospital, Mohali for the compliant of dehydration. She was put on and of in ICU. The sons of the deceased filed a Medical negligence case against the Hospital and Doctors for the compensation of Rs.60 laks plus and the bone of contention was that the Doctors intentionally put the patient on ventilator, at several occasions, without any reason and the consent of the Complainants or the family members, as per regulation 7.16 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 were not taken. The Complainants were denied for the access to the patient as per hospital protocol, the nurses and junior doctors were not attentive. The facilities were inadequate; no cleanliness, there was a fecal contamination on body, blood secretions in mouth also.The bed sores, which were not there at the time of admission, were due to negligence of the hospital and the nursing staff. The patient suffered hospital acquired infection and subsequently sores sepsis and ultimately was discharged with Bed Sores. The doctors did not provide medical records on demand and therefore all these reasons Doctors are liable for deficiency in service.
After going through the entire medical record it was observed by the National Commission that the team of doctors at hospital acted as per the protocol of treatment, the decision to put on ventilator was purely decision of doctor, in the interest of patient and seeing her bad condition. the patient was suffering from Psuedomona UTI at first admission and for 2nd time she was suffering from Urosepsis, bacteria in the blood. The medical records clearly go to show that two hourly change of position, care of pressure points by massaging, the sores kept upon and dressing at different time was done. Alpha mattresses, extra pillows & water gloves were used and therefore charges about treatment of bed sores were struck down. Time to time consent was taken and information was also given to patients relatives!! The physical restraints were given as per the protocol as the patient was agitated, tried to remove the tubes, ventilation assistance, CVP on their own, which may have fatal consequences. only thing for which the Hospitals were held liable for deficiency in Service on the failure to provide medical records to the complainant.
The Court dismissed the contention of the Complainants that for the terminally ill patient/ their mother, the Doctors unnecessarily gave Ventilation support. The Court said Right to live does not include right to die, even though end-of-life issues are becoming major ethical considerations, in the modern-day medical science, in India.
Fortunately in this case, too proper record and documentation saved Doctors !! Now a days if a patient or relatives, demand in writing about records, it should be made available as its their right..
Adv. Rohit Erande
Pune.
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