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    Suggested precautions
   Facts of the case
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 Table of Contents    
 
Year : 2017  |  Volume : 10  |  Issue : 10  |  Page : 149
Extracts of medical books "weigh over leaflets and information obtained from internet," observes court - Information on internet is least reliable

 
   Suggested precautions 
  1. Every doctor is bound to follow the accepted medical practice while discharging his/her professional duties and the same can be deduced from the standard textbooks of medicine. Information available on the internet can also be referred but is the least reliable, especially in cases of medical negligence. In this case, the patient's relatives produced internet downloads to prove that inj. Serenace in alcoholic patient can cause cardiac arrest. The doctor (OP) on the other hand produced standard medical texts to disprove this allegation and this was accepted by the court. The court has very categorically observed that "the medical literature as filed by the opponents (doctor/hospital -OPs) consists of extracts of various medical books and hence weigh over the leaflets and information obtained from the internet."
  2. Be vigilant about patients indulging in self medication. Once you discover that a patient is a self-medicating one, record this fact specifically, and take appropriate precautions. (In this case, the patient's relatives produced certain information downloaded from the internet. The doctor (OP) was quick to point out that such information is "used as a reference only for person indulging in self medication and not for a doctor").
  3. Change of bed/ward/class of patient should be done with a reason. Such requests made by the patient/attendants must be taken in writing. (In this case, the allegation was that the patient was downgraded from an upper class to a general class and hence suffered cardiac arrest in the process. The defense was that the same was done at the request of the patient's relatives to reduce financial burden and this defense was accepted by the court).
  4. It is very important to take a proper medical history at the time of admission. At times, it proves to be a great defense in the court of law. (In this case, the allegation was that inj. Serenace was the reason for the cardiac arrest of the patient. But the history of use of the same drug in another hospital earlier on the same patient for the same problem without any complication proved to be a valuable defense).
  5. The dead body, death certificate, medical records, and such other documents cannot be withheld due to unpaid bills. Hospitals have to approach the civil courts to recover the same. (In this case, one of the allegations was that the "documents and case papers pertaining to the treatment of the patient were also not made available for want of payments of hospital bills").



   Facts of the case Top


The patient, a known alcoholic, with comorbidities, was admitted in the hospital (OP1) under the care of the doctor (OP2). The patient had consumed alcohol and was very violent. The patient was given inj. Serenace and subsequently inj. Phenergan to calm him down. The patient had a cardiac arrest after few hours, was revived, but remained unconscious. The patient expired after 1.5 years.


   Patent's allegation/s of medical negligence Top


  • It was alleged that the patient was intoxicated, and hence the patient should not have been given inj. serenace. Literature downloaded from the internet was produced before the court in support of this allegation.
  • It was alleged that the patient was downgraded from an upper class bed to a lower class bed without informing the relatives where the patient had a cardiac arrest.
  • It was alleged that the patients dead body was withheld because of unpaid bills and the patient's medical records were also not handed over.



   Doctor's defense Top


  • It was stated that the documents produced in court by the patient about contraindications of inj. Serenace bare internet downloads and can be at best used for self medication. It was pointed out that internet downloads cannot be a substitute for medical science for which standard textbooks of medicine should be referred to know the correct protocols. Textbooks were produced by the doctor (OP2) which clearly permitted use of inj. Serenace in violent alcoholic patients.
  • It was stated that giving inj. Serenace is not contraindicated to calm an intoxicated patient, and the same injection had been given to the patient during a previous hospitalization at another hospital but the patient had not encountered any problem at that point.
  • It was stated that downgrading of the patient from upper class to general class was at the request of the relatives to reduce the financial burden.



   Findings of the court Top


  • The court held that internet downloads cannot replace medical textbooks to find out medical science. The court observed that "the medical literature as filed by the opponents (doctor/hospital -OPs) consists of extracts of various medical books and hence weigh over the leaflets and information obtained from the internet."
  • The court observed that there was no evidence to prove that inj. Serenace given to the patient had been the cause of cardiac arrest as he had been given the same medication earlier at another hospital without facing any problems.
  • The court agreed with the defense that the patient's bed was downgraded to reduce financial burden in accordance with the request of the relatives as the patient was hospitalized for about 1.5 years.
  • Hence, the doctor and the hospital (OPs) were not held negligent.



 

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