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Patient’s ‘restless nature’ reason for IV displacement says hospital – Doctors’ / Nursing staff’s duty to “take special care” observes court

September 05, 2024

Prudence must be exercised by doctors, medical and para-medical staff while providing medical treatment to patients that are restless by nature. While this matter is neither a part of medical science or medical law, it can be a sensitive aspect in enhancing patient care.

Irrefutable Facts

The patient was admitted to hospital under the care of a gynaecologist. She delivered a child through LSCS. After a few hours, the patient developed acute swelling and pain in her right hand around the cannula.

The gynaecologist immediately attended the patient, removed cannula from her right hand and placed it on left hand. An anaesthetist and orthopaedic surgeon were consulted for a second opinion. The patient was diagnosed with compartment syndrome and was managed conservatively until discharge and even thereafter.

Patient sued the hospital and gynaecologist, alleging that a staff nurse administered injections intramuscularly instead of intravenously. This resulted in swelling and pain in her hand, leading to disability of the right hand.

Doctor’s Plea

Refuting the allegation, the healthcare providers stated that the patient was managed with regular dressing and medication even after her discharge, but she followed up regularly only for 5-6 days and stopped visiting thereafter.

Court’s Observations

The court perused medical records and observed that the patient was managed with due care and was treated as per accepted standards for her post-operative complications. The court observed that “the swelling in right hand was due to accidental displacement of intravenous cannula and extravasations of intravenous fluids, which is known to be a post-surgical complication.”

The court also observed that there was no evidence or a disability certificate from a competent hospital certifying disability of patient’s right hand.

Hence, the court dismissed patient’s case against the hospital and gynaecologist.

Prevention Is Better Than Cure

  1. Some patients need higher care. Failure to provide these patients greater care and / or to take some special precautions could be construed as negligence or deficiency in service. Patients who are of restless nature belong to this category. 
  2. Law accepts that complications, known as well as unknown, are unavoidable in medicine. Law merely expects the doctor to follow the accepted standards in identifying and managing the complications.

Source : Dr. R. Singh & Anr. v/s Shabana

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