Sunday, December 22

Held negligent for deficiency by the Anesthetist

New Delhi : The National Consumer Dispute Redressal Commission (NCDRC) has dismissed revision petitions to set aside order passed by Maharashtra State Consumer Dispute Redressal Commission holding Parel hospital & its Orthopedic surgeon negligent for the overdose of Ketamine by the Anesthetist before the surgery. The Anesthetist passed away during the hearing of the complaint. The Maharashtra SCDRC had held Parel hospital & its Orthopedic surgeon negligent and had directed them to pay Rs.1,68,049/- on account of the cost of the treatment and Rs.10 Lakhs towards compensation for loss of life, suffering by the family and mental agony. The Maharashtra SCDRC had further said that the bifurcation of the Rs.10 lakhs will be that Rs.8 lakhs will be paid by Parel hospital on account of vicarious liability and the remaining Rs. 2 lakhs will be paid by the orthopedic surgeon.

The facts of the case is that a 66 years old lady Kusum was brought to Parel hospital with a fracture of forearm. On the next day of admission, the orthopedic surgeon performed surgery to fix the fracture. Though the operation was conducted in the morning the patient did not gain consciousness due to  excessive anesthesia. Her condition worsened further and the patient was intubated and put on ventilator. After 25 days of the incidence, the Neurologist after doing CT-Scan & MRI diagnosed it as ‘hypoxic encephalopathy’. Thereafter the patient was shifted to another hospital but did not gain consciousness and died after 4 months.

The National Consumer forum after hearing the arguments from both the sides held the hospital and the orthopedic surgeon on two counts. Firstly the anesthetist did not perform pre-anesthetic test properly. He administered anesthesia by Ketamine along with Fortwin 25mg and Compose 10mg. It was pertinent to note that Ketamine was given as 5ml in Ringer Lactate and later on 3ml was administered. The Ketamine dose was excessive for a 66-year patient which led to hypoxic event which led to the death of the patient. The Consumer forum observed that the Anesthetist was negligent and failedon duty of care to the patient. Secondly though the expert committee gave the report that there was no medical negligence on the part of operating surgeon, one of the committee members was of the opinion that the Hb% of the patient was 7.4 gm% which was low and should have been built up before surgery. The NCDRC concluded that though the Orthopedic surgeon was not negligent the anesthetist was certainly negligent and overlooked many parameters and gave fitness for anesthesia but being the “Captain of the Ship” the orthopedic surgeon was supposed to be careful to ascertain proper pre-anesthesia checkup and fitness of the patient which was certainly lacking. Thus the hospital and the orthopedic surgeon were held negligent.

Legal PrescriptionThe orthopedic surgeon should ensure that proper pre-anesthesia checkup and fitness of the patient is carried out by the anesthetist The orthopedic surgeon is duty bound tocarry out preoperative medical assessment and should perform surgery only if the patient is medically fit for the surgery In case of a mishap during or after the surgery the orthopedic surgeon should ensure that the health issues of the patient are diagnosed and any delay on the part of diagnosis of the health issue caused during and after the surgery will be construed as negligence by the orthopedic surgeon    
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