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    Suggested precautions
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 Table of Contents    
 
Year : 2012  |  Volume : 5  |  Issue : 11  |  Page : 155
Importance of both the time taken to take a decision for transfer and to transfer

 
   Suggested precautions 
  1. A decision to transfer the patient to another facility should not be delayed when indicated and the actual transfer of the patient after taking such a decision also should not be delayed. (In this case, the patient's condition had deteriorated in the Operation Theater (OT) itself, but it took about three hours to take a decision to transfer the patient to another hospital and to inform the patient's husband accordingly, and even after the decision to transfer was taken, about two hours were taken to actually transfer the patient. The hospital (OP) was held negligent on account of both the said acts).
  2. In case of non-emergency procedures/surgeries, the same should be postponed if any shortcoming is noted, rather than proceeding with it on the scheduled time. (In this case, the patient had visited the hospital (OP) for a pregnancy test, and had also informed that she had taken a cup of tea, yet the procedure was performed on the same day. The court observed that the hospital (OP) ought to have postponed the procedure to the next day, with instructions to the patient not to eat or drink anything after the night meals and held the hospital (OP) negligent).



   Facts of the case Top


  • The patient underwent a pregnancy test at the hospital (OP1) and was found carrying a pregnancy of six weeks. The patient sought termination of pregnancy and it was decided to perform the procedure on the same day, although admittedly, the patient had disclosed that she had taken tea at around 8:00 a.m. in the morning The patient was asked to wait till 3:00 p.m. for the procedure and in the meanwhile not to eat or drink anything. The patient was taken into the O.T. at 3:00 p.m. The procedure was performed and at 3:30 p.m. she was shifted to the Recovery Room. At about 4:00 p.m. it was noticed that the patient was breathless. She was intubated, manually ventilated, repeatedly suctioned, and life-saving drugs were injected. By about 4.45 p.m., she started breathing, but at around 5.30 p.m., she started having myoclonic seizures, which could not be controlled. At 6:40 p.m. the patient's husband, a male nurse in the army, was advised to shift the patient to the military hospital, where a ventilator and Intensive Care Unit (ICU) would be available. The patient was actually shifted to the military hospital at around 8:45 p.m., where the patient was diagnosed as having hypoxic ischemic encephalopathy with pulmonary edema. The patient expired next day around 6.30 in the evening.
  • Postmortem reported that death took place due to shock as a result of MTP and that the endometrium of the uterus showed a raw surface and bleeding at places.

   Findings of the court Top


  • The court held the hospital (OP1) negligent as it took about three hours to decide that the patient should be shifted to a better hospital. The court found that although the patient was found to the breathless at about 4:00 p.m. her husband was informed and advised to shift her only at 6:45 p.m., about three hours later.
  • The hospital (OP1) was further held negligent because even after informing the husband to shift the patient at about 6:45 p.m. they actually shifted the patient at about 8:45 p.m., that is, about two hours later.
  • The court observed that it was common knowledge that a gap of 10 to 12 hours is required between the last food and drink, and anesthesia, otherwise it results in complications and the hospital (OP1) ought to have taken into consideration the fact that the patient had taken tea at 8:00 a.m. in the morning. The court further observed that the procedure ought to have been postponed to the next day, with instructions to the patient not to eat or drink anything after the night meals instead of performing the procedure on the same day, when the patient had taken tea in the morning.
  • Hence, the hospital (OP1) was held negligent.



 

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