A cardiologist underwent spinal surgery. Complications followed. Allegations came next. But the court focused not on professional status or expectations — only on clinical judgment, documented risk, and continuity of care.
Irrefutable Facts
The patient, a cardiologist, consulted the neurosurgeon at the hospital for severe lumbar spondylosis. He underwent spinal decompression and fusion with screws and rods.
After the surgery, the patient experienced excruciating pain radiating up to the leg, followed by two heart attacks. He was shifted to the Heart Institute, where he was stabilized. The following day, he was shifted to a higher center and underwent coronary artery bypass grafting.
The patient was discharged with follow up advice for 3 months of bed rest, medications, exercise regime and other precautions.
He sued the hospital and neurosurgeon. It was alleged that no consultant visited the until the day of surgery. Further, on the day of surgery, the he was made to wait on the stretcher for 7 hours without being informed of the postponement of surgery.
It was also alleged that the neurosurgeon performed the surgery without assessing the cardiac condition, and later, he immediately left for Haridwar.
It was further alleged despite two cardiac arrests; a cardiologist was not consulted. Only when the neurosurgeon returned, he was shifted to the Heart Institute.
Hospital & Doctor’s Plea
It was stated in defence that the doctors at the hospital treated all patients alike and that the patient’ s ego was hurt because he expected VIP treatment as he was a cardiologist.
It was further stated that the patient, a practising cardiologist, appeared in good health during his pre-anaesthetic check-up and denied any history of cardiac problems. The ECG did not indicate any signs of infarction, so he was considered fit for surgery.
Court’s Observations
The court noted from the defense that the patient showed no clinical cardiac signs / predictors for perioperative cardiac morbidity. The court found from the medical records that he had no history of other systemic illnesses and had undergone major surgeries earlier without cardiac events.
Referring to medical literature, the court acknowledged a residual 0.4% risk of major perioperative cardiac events, according to Lee’s modified cardiac risk index, despite the patient’ s overall good clinical condition. The court, therefore, held that there were no lapses on the part of the neurosurgeon in managing the patient.
The court further observed that “most of patients, after spinal surgery, suffer backache for 1st postoperative day and get relief by pain killer medication”. Further, the neurosurgeon had gone to Haridwar due to some personal exigency; however, the patient was constantly under the observation of other doctors from neurosurgeon’s team.
The court appreciated that post-surgery, when the patient suffered cardiac complications, he was stabilized and then shifted to the Heart Institute.
Hence, patient’s case against the neurosurgeon and hospital was dismissed.
Prevention Is Better Than Cure
- As per MCI guidelines, doctors owe a duty of care towards their patients and respect towards their peers. A doctor consulting as a patient should be managed with due respect. However, such a doctor-patient expecting VIP treatment is legally and ethically unacceptable. All patients must be respected without any discrimination.
- As a human, a doctor might have some emergency needs or other commitments which may require him / her to leave the patient and travel. This is acceptable to a court of law. However, a doctor is also responsible for patients, especially those hospitalized under the doctor’s care. In such circumstances, the doctor should hand over the patient to another equally competent doctor, ensure continuity of care, inform the patient / attendants about the change, and document in the medical records.
Source : Dr. J. C. Mudgal v/s Dr. A. K. Singh & Ors.
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