In this atmosphere of distrust, how does a doctor prove that a key-hole surgery was performed? Court relies on detailed documentation, overlooks typo error

April 25, 2024

The trust deficit between the doctors and patients has reached a level where patients do not hesitate to level any sort of allegation against the doctors. This case is one of the best illustrations of the aforesaid.

Irrefutable Facts

The patient had a history of pain in the abdomen for a long time, repeated hospitalization and investigations, with no definitive diagnosis. He consulted the cardiologist with chest pain.

The cardiologist performed angiography and angioplasty at the hospital. The patient recovered and was discharged after a week.

The patient sued the doctor and hospital, alleging that although not required, angioplasty was performed to usurp money. Citing medical records, it was pointed out that while angiography was performed through the right femoral route, there was no sign of intervention at the right groin.

Doctor’s Plea

The doctor and hospital presented a combined defence, stating that the catheter was inserted through the radial route and therefore, there was no mark on the right groin.

There was a typographical error in mentioning that the angioplasty was performed through the femoral route in medical records.

Court’s Observations

The court perused medical records and observed that a ‘special blood thinner’ was prescribed post-PTCA; patient’s health status was noted as “Post PTCA Status”; and necessary tablets were prescribed to manage high blood pressure.

The court, therefore, concluded that angioplasty was indeed performed and accepted the defence of typographical error.

Prevention Is Better Than Cure

Complete details of the intervention performed should be recorded in medical records.

Furthermore, it should be checked and cross-checked for any mistakes.

In cases of medical negligence, these medical records are scrutinised very closely by the courts and provide a complete defence.

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Source : Source: Raman S. Darji & Ors. v/s Dr. Bharat Barad & Anr.