Case Study – One should disclose relevant truth and facts to the Doctor
“if the patient willfully chooses to
withhold information from the physician, the physician cannot be liable for a
medical negligence”
By Mohit Popli
Manju Anil Chawla
& Ors. Versus Jivandhara Hospital & Ors.
Decided On 20th December , 2013
CONSUMER COMPLAINT NO. 45 OF 2002
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
Brief facts of the
Complaint :
The complainant Smt.
Manju’s husband, late Mr. Anil Chawla,(hereinafter, “
a patient” consulted the, Dr. at his clinic for his long standing and recurrent cold problem since 10 years and he was taking anti-cold medicines
for many years but often he had inability to breathe from
the right nostril, snoring at night and bitter taste in throat during nasal
infection with running nose . The Dr examined him and diagnosed as the
cartilaginous nasal septum was grossly deviated to right side and blocking the nose on the right nostril. After
X-ray and Endoscopy investigations the Dr advised the patient to undergo a
surgery.
Doctor’s Submissions
The Dr conducted
operation of Septoplasty with
functional endoscopic sinus surgery with left maxillary clearance using Caldwell Luc Approach under General
Anesthesia on the patient. Dr. Rajesh Kolte was an anesthetist. It was clear
that, after proper radiological (x-ray) and blood
investigations it was confirmed that the patient had
gross deviation of the cartilaginous nasal septum. Surgery performed by Dr on
the patient was a non-invasive surgery,
which has no surgical complications.
Patient suffered Cardio Respiratory Arrest
The Dr. Amit Chadha submitted that, the
attendant of the patient called him at 11.25 PM there was sudden cessation of
respiration. The Dr examined the patient whose Pulse and BP were not
recordable. Therefore, all emergency measures were carried out by Dr and the
Anesthetist Dr. Kolte. Immediately cardiac massage was one, patient’s throat
was checked for secretions, blood, gauze, which were absent, then the patient was intubated immediately with endo-tracheal
tube by the anesthetist. Intermittent positive pressure ventilation was given
with 100% oxygen started by the anesthetist through the tube with the help of
portable Boyle’s Machine apparatus. Cardiac massage continued, IV adrenaline,
atropine, soda bicarb and I/C adrenaline were given but the patient did not respond. The Dr called the physician, Dr.
Vinay Bhomia, who came at about
11.30 p.m. and in a couple of minutes he revived the
patient with the help of DC shock and Intra Cardiac adrenaline. There was no secretions/blood, in the oro-pharyngeal
tract. The patient was thereafter shifted to ICCU of Navneet Memorial Hospital
and was put on to ventilator with I.P.P.R. mode. The patient was attended by
Dr. Guha, the doctor in-charge of the ICCU, at that time. Also opinion of Dr.
Parindra Desai, Neuro-Physician was also taken. The patient was diagnosed to have suffered a cardio-respiratory-arrest.
Observations/Finding:
The Dr further, contended that, the Complainants have concealed the material facts about the true
condition/ diseases suffered in pasts. In past the patient was admitted and
took treatment for his Cardiac and
Urinary /Renal problems at various hospitals in year 1997. There upon the
Hon’ble National Commission found that, the patient late Anil Chawla suffered from Cardiac as well as Kidney
problems in the year 1997.
Medical Text Ref:
The Hon’ble National Commission have referred medical text books and
literature on ENT surgeries and searched for the complications of “Septoplasty
with Functional Endoscopic Sinus Surgery”. There are no reports of
fatal complications due to such surgery. It is well known that, there are
risks and complications for all surgeries; those for deviated septum and
Septoplasty surgeries
are very infrequent, but it includes nasal obstruction, bleeding, chronic nasal
drainage ,eye damage, numbness of facial structures, septal perforation,
alteration of sense of smell or taste, and failure to resolve any associated
nasal or sinus problem.
Decision:
In this case, it is apparent to be a
“Contributory Negligence”, that there was a mistake on the part of patient as
well as the complainant who did not disclose about the previous medical
treatment and disease to the treating Doctors. Sometimes the unexpected results may not be only due to
negligence of the doctor but also due to negligence of patients or relatives. “If anybody undergoes any medical treatment, or
is about to undergo a medical surgical procedure, one should take care to
disclose relevant truth and facts to the doctor.” Thus, if the patient
willfully chooses to withhold information from the physician, the physician
cannot be liable for a medical negligence.
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