A patient’s treatment moves forward — then pauses, then shifts direction. What begins as a defined course gradually turns into delay, indecision, and eventual change in approach.
The case examines how time, continuity, and clinical clarity play a decisive role when managing serious conditions.
Irrefutable Facts
The patient initially noticed a pea-shaped abnormal growth in his mouth and consulted the doctor at the hospital. He was subsequently referred to the ENT department, where he was advised Fine Needle Aspiration Cytology (FNAC).
Thereafter, a biopsy was performed, and a sample tissue was collected from his mouth.
After a month, he was diagnosed with “Squamous Cell Carcinoma (Oral Cavity Caner) in the left side of his mouth.”
The doctors planned a surgery. The patient was advised for a pre-anesthetic check-up (PAC) test and was found to be fit for surgery. After that, the patient was made to wait for 2 weeks.
Further, the patient was advised urgent dental extraction and to arrange for 2 units of blood. The patient followed the advice.
The surgery was further postponed after 3 days and was later kept on hold for another 25 days. Ultimately, when the patient consulted the doctors with a problem of purulent discharge from the oral cavity, he was referred to another hospital for radiotherapy.
The patient was managed at the other hospital but died after 2 years.
His family sued the doctors and the hospital, alleging that they considerably delayed diagnosing the patient despite the fact that he was under their care.
It was pointed out that the surgery was postponed several times and the patient was kept waiting. Ultimately, he was referred to another hospital without performing the surgery, leading to the death of the patient.
Doctors’ & Hospital’s Plea
It was stated in defence that the patient was reluctant to undergo surgery and didn’t take his treatment plan seriously. It was further stated that the patient needed radiotherapy treatment, which was not available with the hospital, necessitating his referral to the higher center for further management.
Court’s Observations
The court observed from the medical records that the patient was fit for surgery. However, the surgery was repeatedly and unreasonably delayed and the patient was eventually referred to another hospital for a completely different modality of treatment i.e. radiotherapy.
The court held such conduct of the doctors as an “apathetic approach towards the gravity of the ailment”.
The court went on to observe that during this course of more than 2 months, the size of the tumor grew from 1 to 3 sq.cm, indicating that the patient did not receive any cancer-specific treatment despite the doctors being fully aware that cancer is progressive in nature.
Even the prescriptions reveal that no cancer-specific medicines were administered to the patient. Hence, the court held the hospital and doctors negligent for failing to choose the right course of action in time.
Prevention Is Better Than Cure
- The decision to perform surgery / intervention should be made after due contemplation and in accordance with the accepted standards. Moreover, after taking the decision to perform, any postponement / cancellation or change in the course of treatment must only be for a justified medical reason.
- A stitch in time saves nine. Time is a crucial factor in managing patients, especially those with life-threatening diseases. Early detection and treatment increase the possibility of favourable outcomes. Ensure that there are no delays.
Source : GTB Hospital & Ors. v/s Ramo Devi & Ors.
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