Healthcare establishments, such as hospitals, must invest in a robust IT infrastructure. This would not only enhance procedural aspects of patient care, but also could prove to be crucial in a medical negligence court case.
Irrefutable Facts
The patient with myocardial infarction (MI) was referred to the cardiologist. The cardiologist
advised hospital admission and requested another cardiologist to manage the patient till his arrival at the hospital.
Angiography was performed and it revealed an acute anterior wall myocardial infarct (AMI). Both cardiologists jointly performed angioplasty of the left anterior descending (LAD) artery.
The patient’s condition did not improve hence, angioplasty of the right coronary artery (RCA) was also performed. The patient was shifted to the intensive cardiac care unit (ICCU) after stabilisation.
The patient went into hypotension in the ICCU and was therefore taken back to the cath lab for a check angiography. The angiography revealed a patent LAD and RCA stent and the presence of thrombus in the mid and proximal portion of the RCA due to an ulcerated plaque.
With the help of intra aortic balloon pump (IABP), the BP was stabilised and two more stents were placed. An intra coronary anti-thrombotic injection was administered; patient was shifted to the ICCU.
While being shifted to the ICCU, the patient suffered a massive MI and died in spite of cardiopulmonary resuscitation (CPR).
Patient’s family sued the hospital and both cardiologists, alleging that the first cardiologist was present in the hospital when the patient was admitted and had telephonically advised treatment to the other cardiologist.
It was further alleged that although it was not required, the cardiologists performed angioplasty of RCA and a stent was put in its PDA branch which led to a complete cut-off of the blood supply to the RV branch, ultimately leading to patient’s death.
Patient’s family pointed out that the medical records were fabricated, and the hospital did not provide complete medical records including death summary and CDs of the procedure.
Doctor’s Plea
It was pointed out that the second cardiologist stayed at the hospital campus, therefore he was asked to attend the cardiac emergency immediately, and to start with angiography to avoid delay, and by the time angiography was started the first cardiologist had reached the hospital.
It was stated that at the time of admission, the patient showed signs of AMI; examination and investigations revealed the need for angiography and angioplasty. These aspects were duly informed to patient’s brother who was a doctor himself.
Court’s Observations
The court perused expert opinion and concluded that patient’s ECGs clearly showed MI and that both the cardiologists performed angiography and angioplasty procedures as per standard guidelines.
The court also perused medical literature, and further observed that angioplasty is less invasive and carries few risks and that the patient died of cardiac arrest despite CPR.
The court, after perusal of medical records, concluded that the attendants were provided with the medical records and CDs and the hospital had their acknowledgement for the same.
Prevention Is Better Than Cure
Computers are now an unavoidable part of every human activity, medicine being no exception. Proper care and caution have to be taken in respect of both hardware and software, especially storage and data privacy.
In this case, where a patient who had suffered MI died post-angioplasty, one of the allegations was that the CD of the procedure was not given to the relatives. In defence, the hospital stated that the memory (storage capacity) of their computer’s hard disc had been exhausted and therefore, the images of patient’s procedure were automatically deleted.
The Metropolitan Magistrate referred this aspect of the case to CFSL and another independent expert, who confirmed the hospital’s stand.
Source : Neera Arya & Ors. v/s Batra Hospital & Medical Research Centre & Ors.
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