2008 June - Note 5

Law and precautions on dealing with organs / cysts / tumours / aspirated fluids removed from a patient’s body

Smt. Saroj Chandhoke v/s Sir Ganga Ram Hospital (a79; j247) is an important case decided by the National Consumer Commission in July 2007. The patient had alleged that her healthy kidneys were removed and the same were not shown to either the patient or her relatives after removal. Hence, an inference that the hospital indulges in illegal organ trade must be drawn by the court against the hospital. The National Commission chose not to comment on this aspect.

In the case of Neeru & Parvinder Kaur v/s Dr. Shashi Gupta & Anr (a78; j243), which was decided by Punjab State Consumer Commission in December 2007, the same issue once again cropped up. The patient alleged that although she demanded the cystic ovary, which was removed from her body, the same was not given by the doctor. The doctor in her defense stated that the cystic ovary was sent to a modern computerized laboratory for its histopathology test. The State Commission rejected the patient’s contention. The law on this aspect of medicine was formulated by the State Commission thus:
“When a major surgery was performed by her on the person of the complainant (patient), it was the duty of respondent No.1 (doctor) to get tested the material taken out of the body of the complainant to assess its nature and its effect and to inform her about its consequences or possible effect on her body.”(j246)

Thus, there is an authoritative judicial pronouncement from a higher court very clearly stating that the operating surgeon is duty bound to send the organs removed from a patient’s body for histopathological examination and should not hand over the same to the patient even if the same is demanded.

The possibility that in future similar arguments may be advanced on behalf of the patients against doctors cannot be overruled. It is, therefore, necessary that whenever an organ/cyst/tumor/aspirated fluids is removed during a surgery/procedure, it must be duly preserved, labeled, and dispatched for histopathological examination. Before dispatching, it is advisable (although not mandatory) that the removed organ/cyst/tumor/aspirated fluid is shown to the patient/relatives/friends/attendants and their acknowledgment must be taken and preserved in the medical records. The pathologist who receives the specimen must take note of the gross appearance and then proceed to take sections for microscopic examinations of the organ/cyst/tumor. The report received from the pathologist must be duly recorded as well as preserved in the medical records of the patient.

It is advisable that this protocol is assiduously followed irrespective of whether the tissue/organ removed is diseased or healthy.

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