Doctors to now tread cautiously

Hyderabad: Advocating basic patient safety across small and big hospitals in the city is the new mantra of the Association of Health Care Providers (India), given the increasing number of medical negligence cases being registered against hospitals in consumer forums.

The new initiative has been taken up after a recent study pointed out that 5.2 million deaths in the country are due to medical errors and adverse effects of medication. To ensure that these errors are minimised, the AHPI will be creating a platform to train paramedical staff and doctors on the best methods that can be used to handle critical patients.

It will also insist that along with an anesthetist, during a surgical intervention, other specialists like neurologists and cardiologists are close at hand so that they can be called in during complications.

These protocols are going to be set even for hospitals with 100 beds to ensure that the right standards are in place to save a patient’s life and in case of an eventuality to deal with an adverse legal case.

Currently, as a proactive measure, every counselling in a critical stage has the signature of the patient’s relatives on the case sheet. A few small hospitals have also started video-recording the doctor’s counselling and the relative’s consent so that they have proof in case of a legal battle.

Senior Dr S. Vijay Mohan of Care Hospital said, “The admission of a high-risk patient has become a matter of concern for hospitals. Despite clearly stating to the relatives that it is a high-risk case and chances of survival are minimum, most of them come back and blame the doctors for a death. This kind of behaviour by the patient’s relatives is very demeaning. When there is an unidentified complication during a surgery or a simple procedure being wrongly done, then the errors account for negligence. Not all cases.”

The problem, feel doctors, is that these simple errors occur because most of the newly passed-out students are not interested in practicing medicine. A senior professor of Osmania Medical College explained, “The problem with the new breed of doctors is that they are not practicing medicine zealously.

The focus now is only on getting a job in a corporate hospital and not working hard to learn how to handle an emergency. It is here that we are going wrong. In a recent case of by-pass surgery, a junior doctor forgot to prescribe a medicine instructed by his senior.

As that medication was not prescribed, the lungs of the patient filled with water. This is negligence as the patient underwent trauma both mentally and physically for a span of three months as water intake had to be reduced to five glasses a day.”

Cases of these errors are cropping up on a regular basis in hospitals, alarming senior doctors who have to be on the alert. General secretary of AHPI said, “Our coming together is because we have to work at all levels and identify the new problems which are emerging in the fraternity. If on the one hand, there is a major question of safe and affordable care, on the flip side, we have to deal with the fear of heavy compensation packages in case of negligence. To balance it out is our task.”

Next: Demand for docs on legal panel

Demand for docs on legal panel

Hyderabad: The Indian Medical Association wants an amendment to the Consumer Protection Act that would mandate that a doctor be part of the consumer court, that deals with cases of medical negligence. It has also demanded a separate tribunal to ensure that cases of medical negligence are scrutinised before the doctor is prosecuted.

Dr Ramesh Reddy, member of the Indian Medical Council and senior paediatrician at Niloufer Hospital, said, “We are insisting on a doctor in the forum as what comes across as medical negligence to a common man is a complication to a medical person. When there is criminal negligence, action must be taken but not for unwarranted cases. The problem before the doctor now is whether to treat a complicated case or face a court battle later.”

Adds IMA state secretary Dr Yadgiri Rao, “The fine distinction between complication, emergency and criminal negligence is not understood by people. If there has been a wanton act of negligence, then action must be taken. But if it is a complication during a surgical procedure, what can the doctor do?”

High Court advocate Suresh Kumar says that having a doctor on the panel would help to clarify technical clauses, but adds that “a medical negligence case is also about the adequate care that was taken to not allow a complication to arise.

This is a crucial aspect which the legal fraternity has to prove and which is the patient’s right.” It is also important that that a doctor on the panel be unbiased and not protect the medical fraternity from genuine allegations of negligence.

Next: Case filed against Omni in HIV case

Case filed against Omni in HIV case

Hyderabad: Late M. Pradeep Reddy’s family has moved the district consumer forum in Ranga Reddy district alleging that the Omni Hospitals at Kothapet had wrongly claimed that he was an HIV-positive patient, causing social ostracisation of the family.

It also claimed that Pradeep’s severe head injury due to an accident was not treated properly by the hospital authorities. Pradeep had met with an accident at the Nagarjunasagar road on February 3, 2013, and had suffered nasal injuries, a blunt chest injury as well as severe head injuries due to which blood supply to his brain had stopped. The first aid treatment and initial suturing was done elsewhere after which he was shifted to Omni Hospital. The hospital authorities had put him on ventilator as his condition was critical, but he had died after four days.

Dr M. Gautham Reddy, director of Omni Hospitals, said, “The patient came in a very critical condition and only medical management could be done. In a severe case like this, surgery is not possible. This counselling has been recorded on video by our staff. As HIV tests are mandatory under government rules, it was carried out and it was positive.”

Confusion had arisen following a typing error in the discharge sheet from the hospital which mark-ed him HIV-negative. At the same time, when the status was disclosed to the relatives, the doctors had not been careful, alleged Reddy’s wife M. Srilatha.

“We wanted to shift him to a corporate hospital for better treatment but the doctors didn’t agree to discharge my husband. They counselled that they were doing their best. On top of it, every staff in the hospital knew that he was an HIV-positive patient and that put me and my children under tremendous social stress,” she said.

Dr Gautham Reddy says they had received a notice from an advocate in June 2013 and had accordingly replied. “We have not got any other papers from the court and have all the details of the counselling,” he added.