Signs of appendicitis absent on operating table! What do doctors do to convince relatives about imperfection of medical science?

October 12, 2023

Human body is far too complex for a definitive diagnosis in many cases - if not most. Medically and legally, this is an accepted fact. Therefore, doctor-patient/relatives communication skills play a vital role in explaining surprises and unfavourable anomalies in order to avoid untoward incidents 

Irrefutable Facts

Patient suffered abdominal pain for 6 - 7 months, and consulted the local physician. USG revealed signs of acute appendicitis. Therefore, the patient was admitted, a general surgeon performed appendicectomy.

The appendix was absent when the patient was opened; hence the surgery was abandoned and he was discharged.

The patient sued general surgeon, alleging that he performed surgery even in absence if appendix.

Doctors’ Plea

The doctor stated that X-ray was normal, but the patient suffered from abdominal pain for a long time. Hence, he was clinically diagnosed with appendicitis and the decision to operate was taken in patient’s best interest.

The doctor also pointed out that diagnoses are matter of chance, and one cannot give 100% correct findings.

Court’s Observations

The State Consumer perused medical records and accepted that “doctor is the best judge to decide whether to perform the surgery on the spot or not”. However, in view of normal USG report, the Commission concluded that there was no urgency need to perform the surgery.

Prevention Is Better Than Cure

  1. Medicine is an imperfect science and the human body is too complex. Initial diagnosis and the final diagnosis need not be always correct. In surgeries, the springing of surprises after opening the patient is fairly common. Courts are aware of these vagaries of medicine and a doctor will not be held negligent in such cases. But explaining these anomalies and surprises to the patient needs extraordinary efforts and skills of the doctor or else it may lead to dissatisfaction.   
  2. In medicine, there is a philosophy of masterly inactivity according to which when the clinician is not able to arrive at a diagnosis, he / she waits for the picture to get clearer to arrive at a diagnosis. Greater care, caution and contemplation is required in resorting to this doctrine.

Click here for annual subscription of Medical Law Case – For Doctors

Source : 15MLCD (j83) Dr. Bhargav D. Patel v/s Baldevbhai Bababhai & Ors.