It is essential to have proper grouping and crossmatching of blood before going for blood transfusion. Failure to do so would tantamount to a clear case of medical negligence.
Case Study: Fifty five-year-old Madhuwala Chaudhary was admitted to Tata Memorial Hospital under Dr R C Mistry in the thoracic unit. She was examined and declared fit for transthorascopic total esophagectomy. Prior to her surgery her blood grouping was done and she was found to be B negative.
After the surgery Madhuwala was shifted to the intensive care unit (ICU). Between July 5 and July 12, 2005, she was transfused with 1400 ml. of B negative blood group. She was discharged on August 29, 2015 and proceeded to her native town in Jharkhand.
During followup for removal of the jejunostomy tube, it was found that her condition was deteriorating. She was admitted in critical condition on September 21, 2015. Sushma Singh, the technician in the transfusion department tore up and destroyed the original report recording Madhuwala's blood group as B negative, and substituted it with another one recording it as B positive. Madhuwala's family managed to retrieve the torn pieces of the original report from the waste paper basket and later pieced them together.
Meanwhile, going by the revised report, Madhuwala was given substantial transfusion of B positive blood. She expired after a few days. The cause of death was certified to be renal failure.
Madhuwala's husband, Barun Prasad Choudhary alleged that despite having spent over Rs10 lakhs, his wife died due to the medical negligence of administration of incompatible blood resulting in renal failure.
The complaint was filed before the Maharashtra State Commission against the hospital, its director Dr K A Dinshaw, medical superintendent Dr H K V Narayan, thoracic surgeon Dr R C Mistry, and Sushma Singh who was the technician in the transfusion department. All the opponents contested the complaint.
The Maharashtra State Commission noticed that the original report recording the blood group as B negative as well as the subsequent report recording it as B positive were signed by the same technician, Sushma Singh. It pointed out that proper grouping and cross matching is the foundation for blood transfusion. Hence this has to be done with proper care by a pathologist. The treating doctors as well as the hospital are required to take care to ensure that the right type of blood is transfused. Failure to do so could lead to various types of problems, including shock and renal failure. Also, a wrong method of transfusion could cause gangrene which might lead to amputation of a limb. So the patient has to be monitored carefully, and if any adverse reaction is noticed, the treating doctor must take immediate remedial action.
The Maharashtra State Commission held that wrong recording of the blood group and transfusing mismatched blood would be a clear case of negligence for which no further proof was required. For such negligence, the patient's husband would be entitled to reasonable compensation, but not an exorbitant amount of Rs 50 lakh as claimed by him.
The commission observed that even if the wrong transfusion had not been given, Madhuwala would not have lived a longer or a healthy, useful life.
Accordingly, the bench of Justice A P Bhangale and Narendra Kawde considered that Rs 5 lakhs would be reasonable. By its order of October 27, the bench held the hospital as well as the doctors and technician concerned to be guilty of negligence and ordered them to jointly and severally pay Rs5 lakhs as compensation and Rs 20,000 towards litigation costs.
Conclusion: When medical errors which are indefensible occur due to lack of simple care and caution, the hospital and doctors automatically become liable, and the consumer is not required to prove his case.