There are instances when patients consult more than one doctor for treatment. While it is their right to do so, multiple treatment protocols could prove to be counterproductive – for patient and the doctor. Therefore, doctors would be well-advised to record such multiple consultations in treatment chart / medical records / discharge summary.
Irrefutable Facts
The patient, a known hypertensive / diabetic, was admitted to the hospital with pain in abdomen. The urologist performed investigation and diagnosed right pyonephrosis with chronic renal failure (CRF) and septicaemia. Nephrostogram revealed right uretero-vesical
(UV) blockage with no bladder spill. Percutaneous Nephrolithotomy (PCNL) was performed the next day, and a drain was put in her kidney.
UV blockage was cleared, the patient was prescribed antibiotics, and platelets were infused in view of low platelet count. She was discharged after three weeks ‘on request’ with drain. However, her platelet count remained low and she continued consulting at the hospital on a weekly basis.
Later, the patient consulted other hospitals, yet the problem persisted. After three months she was operated by the urologist; the drain was removed; a stent was implanted. After discharge, patient’s condition did not improve.
She consulted another hospital, where the x-ray reported a small synthetic tube in kidney.
The patient was again taken to the hospital; presence of a piece of the tube was confirmed. HOD of the Urology Department admitted the patient, the piece of tube and stent were removed; PCNL was performed again. However, she did not get relief.
Ultimately the urologist removed nephrostomy pipe from patient’s body. Thereafter she remained under the treatment at another hospital.
The patient sued the doctors and hospital, alleging that a piece of rubber tube was left in her body due to urologist’s negligence, either at the time when PCNL was done or at the time when the nephrostomy drain was removed and stenting was done.
Doctor’s Plea
The doctor and hospital authorities stated that life of the PCN tube is about three months and accordingly the patient was advised for its change, but she did not turn up.
It was pointed out that the patient had been visiting other hospitals; and that the PCN tube
was not removed at the hospital. It was admitted that pieces of the PCN tube were found in patient’s body, but where she got the PCN tube removed was not known.
Court’s Observations
The court after perusal of medical records found and observed that prior to admission to the hospital, the patient was “not only having infection within her body but also collection of pus in her kidney”.
The court further observed that admittedly post-discharge from the hospital, she was consulting various doctors and hospitals, and hence rejected the allegation that the PCN tube was changed / removed at the hospital.
Patient’s case against the doctors and hospital was dismissed.
Prevention Is Better Than Cure
Every patient has an unfettered right to take as many opinions as he / she deems fit and proper. But when the patient starts taking treatment or following the advice of more than one doctor, it becomes a cause of concern for both, the patient as well as the attending doctor. Recording the fact that the patient has consulted other doctors / hospitals is therefore necessary.
Source : Des Raj Singla & Ors. v/s Dayanand Medical College & Hospital & Ors.
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