Early morning on February 3, Inder Kumar Gupta found his wife Manju on the bathroom floor. Her speech was slurred and her hand hurt. Realising that it was a medical emergency, Gupta took her to Bhagat Hospital in Janakpuri and then to Max Pitampura for a CT scan. The scan was done at 8.33am and the doctors began to treat her for stroke but chose not to administer tPA, a key drug which can limit and reverse the damage if given intravenously within 3-4 hours.
Manju is barely able to move now. “Sometimes, she says it is better to die than live like this. I cannot bear to see her agony,” says Gupta who has filed a complaint of negligence with the Delhi Medical Council (DMC).
According to Dr Girish Tyagi, member, DMC, such complaints have increased by 30%-40% over the past five years and each case takes at least a few years to be investigated. The punishment ranges from a strict warning to permanent cancellation of licence to practice, which has never happened. The maximum punishment awarded by DMC is barring a doctor from practicing for six months.
When is a doctor responsible?
Cases that constitute medical negligence if:
- There is damage to organs due to negligence
- A wrong course of treatment prescribed because of wrong diagnosis
- The treatment chosen that is not the accepted or established medical norm
- An instrument is left inside the body or a wrong part is removed
- A hospital it runs out of essential supplies, such as oxygen cylinders etc
- Allopathic treatment is provided by practitioners of alternate medicine
- Prescriptions, test reports, discharge summary or receipts are not provided
A doctor is not negligent when:
- Several methods of treatment are available and the doctor chooses one
- The disease is not cured
- There is an error in judgment (versus wrong diagnosis)
When to go to a consumer court?
- Indiaâ€™s Medical Council Act has provisions to take disciplinary action against erring doctors. Consumer courts provide an additional remedy for getting compensated under the Consumer Protection Act.
- If a doctor or hospital is not found to be negligent in a criminal case, it does not affect the case under Consumer Protection Act as gross negligence and intent to commit a crime is the parameter in criminal cases.
The DMC, which has the mandate to investigate cases of medical negligence, has been getting between 20 and 25 complaints of medical negligence each month. “Of these, five or six are accepted for review based on evidence,” Dr Tyagi said. In cases of negligence, the primary complaint is filed with the state medical council, consumer courts, state health department or the local police, but it is the state medical councils that have the mandate to screen the complaint to determine whether it needs investigation.
Less than 10% doctors charged are proven guilty after years of investigation, and those that are, get off lightly. Civil cases can win patients and their families compensation, as did Dr Kunal Saha in 2013, when he was awarded Rs 5.96 crore for the death of his wife Anuradha Saha at a Kolkata Hospital.
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While patients demand accountability, doctors demand trust and when either group is wanting, accusations of medical negligence occur. Though the DMC has accepted Gupta’s complaint, the hospital says standard protocols were followed in Manju’s case. “The exact time of stroke onset was uncertain as the patient woke up with symptoms of stroke. Therefore, the patient was not considered as an ideal candidate for thrombolysis as per established medical protocol and instead, was shifted to the medical ICU and provided conservative treatment. The patient was responding positively to the line of treatment given and her condition began to improve,” the hospital said.
Gupta says the doctors have now told him that Manju was not eligible for tPA. “But I have taken Manju’s case files to several specialists and who all say she should have been given tPA,” he says. Meanwhile, Manju can walk a bit but requires help for almost everything. Most part of her day is now spent being assisted to physiotherapy and acupuncture sessions.