"At the time of delivery, it's the Choice of the Anesthetist to decide whether to administer General Anesthesia or Spinal Anesthesia and he cannot be held negligent for his choice."..

"At the time of delivery, it's the Choice of the Anesthetist to decide whether to administer General Anesthesia or Spinal Anesthesia and he cannot be held negligent for his choice."

It's said that Anesthetists' job is thankless Job. Well, Medicos know the truth behind it. 
This judgement is kind of appreciation for Anaesthetists.

In an interesting case, the National Consumer Fora came to the rescue of Doctors and upheld the selection of treatment.
Case details : Dr. Vasantkumar Jog V/s. Shashikant Vichare & ors, R.P. No.3665/2013, decided on 28/10/2016, reported in I (2017) CPJ 82 (NC).

Facts in Short :.
1.The wife of the Complainant no.1 was pregnant after gap of 10 years from marriage. In one of her regular visits to doctors, after examination,   she was advised to go for immediate Caesarean on account of Foetal distress, to which she consented. Accordingly, she was administered Anesthesia & she delivered the baby.
2. On next day she had chest pain and it was found that it was due to accumulation of phlegm in the chest. She had to be operated again for removal of phlegm, but after 1 month she succumbed to death to ARDS (Acute Respiratory Distress Syndrome).
3. It was further alleged that the Petitioner -   Dr. administered general Anesthesia instead of spinal Anesthesia, when the patient had respiratory tract infection, to minimise the complications.
4. The Doctors denied all the allegations. The cesarean was performed due to emergency. Before administering Anesthesia, the patient was examined and her BP was also normal, nor she had any problems like diabetes, Asthma. The cesarean was also successful.
5. Both lower forums decided against the petitioner and hence the revision was filed.

Held :.
1. The National Commission observed that both the Lower forums committed error in holding the petitioner as Negligent.
2. The expert committee report was wrongly interpreted by the State Commission to question the education qualification of the Anesthetist !!
3. The National Commission held that it was not the job of an Anesthetist to investigate regarding complaints of cough and cold, but it was the duty of the doctor who performed cesarean.
4. The finding of expert committee that petitioner "choose" to administer General Anesthesia than Spinal itself indicates that it was his prerogative to decide the mode of Anesthesia and looking into situation of the case in hand, the Petitioner selected General Anesthesia.
5. It relied upon the celebrated judgment of Apex Court (AIR 2010 SC 1050) in the case of Kusum Sharma V/s. Batra Hospital, wherein it was observed by their Lordships that merely because of a Doctor chooses one course of action in preference to other available one and if the course of action selected by the Doctor was acceptable to medical Profession, he would not be liable !
6. Regarding his Degree, it was observed that the Petitioner Graduated as Ayurvedic Medicine in 1962 and underwent 3 months training Course in Anesthesia at GMC, Bombay  and cleared his MBBS in the year Oct-1976 and  thus it was held that the Petitioner prima-facie, was having sufficient knowledge, to administer anesthesia !

Important judgment, indeed. I think everyday no. of Deliveries must have been performed across the country and such kind of intricacies also must be arising quite often. What can be deduced from this judgment is you have to have proper informed consent and proper documentation. The last limb of the judgment regarding qualification may attract 2 opinions ! As in Pune case (Mr.Hanumant Mukinda Alkute & anr. V/s. Grant Medical Foundation Ruby Hall Clinic & ors , October 2016,) the Hospital was held by the State Commission guilty for engaging a MBBS Doctors, with 40 years of experience,  as Anesthetist..

Well present judgment is of a National Commission Judgment, binding upon Lower Forums, that's all I may say......

Thanks and Regards,

Adv. Rohit Erande
Pune. ©

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