Anesthetist and Surgeon absolved from damages of Rs19 lakhs and Criminal Prosecution...

The Case was based on the PM Report that suggested the cause of death as Inj. Thiopental, but the Doctor who made the report was  not an Anesthetist.. Finally Doctors were saved from Criminal as well as Civil charges.

Case Details :

DR. VIJAYA NIRMALA V/s. UDHIYA @ UDHIYAKUMARI & 4 ORS, PONDICHERRY

REVISION PETITION NO. 1015 OF 2016, Date of Decision : 16 Oct 2017

Link to the Judgment :

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FRP%2F1015%2F2016&dtofhearing=2017-10-16

Facts in Short :

1. The case is of 2002. The deceased patient Mr. Kanniakumar had complaints of Penile Pain and Dysuria and after various tests, was diagnosed with VUJ-calculus of 3X2 mm and two large stones in Gall Bladder and he was advised to undergo a surgery.

2. At about 1.20 pm, The patient was administered  General Anesthesia (GA) with 250 mg. of Thiopental and 100 mg. of Scoline and at the time of 2nd attempt of intubation, Scoline 75 mg, Thiopental 100 mg. and Atropine 0.6 mg were administered.. However, as 2 attempts of Intubation  failed due to large leafy epiglottis and anteriorly placed Larynx, the Surgery was postponed. 

3. The patient’s vitals were examined  and to maintain ventilation, laryngeal mask airway introduced.  At 3.30, after recovering from Anesthesia, he was shifted to Post-OP-Ward, but at about 4 pm  the patient developed profound pulmonary edema. It was tried to to be controlled through Tracheostomy. But the patient developed ST depression, his BP went down. A Cardiologist was called and the patient was resuscitated. The relatives were also called and explained the situation. However, unfortunately the patient died at about 6.15 pm. 

4. The post mortem was conducted. The biopsy report revealed extensive pulmonary edema with focal area of Broncopneumonia.  The Chemical examination of viscera revealed 14.5 mcg of Thiopental in the blood.  The final post mortem report of Forensic Medicine that the cause of death of the patient was due to Injection of Thiopental. Hence the Widow of the deceased with her 2 minor children filed the case for getting Rs.19 lakhs as damages. At the same time the Complainant-Widow field a criminal  case against the Doctor, but the Hon. High Court acquitted the Doctor-Petitioner herein. On revision made by the Complainant-Widow, the High Court called for the expert opinion of Dr. T. Venkatachalam, Professor, Dept. Of Anesthesia, Madras Medical College & Hospital, Chennai.  He also deposed that the doses of administration of medicine was correct as per medical norm.  Thus, the High Court upheld the acquittal in revision too.. The District Forum dismissed the Complaint. But the state commission partly allowed the Complaint to the tune of Rs.15 lakhs.

HELD :

1. The Hon. High Court as well as relying upon the expert evidence held that the dose of Thiopental was as per medical norms and it was not excessive.

2. The main question was whether Thiopental was the cause of death as the consumer complaint was filed on the basis of final report, which has suggested the cause of death as Inj. Thiopental..

3.The cross examination of the doctor, who issued the report categorically admitted that Thiopental is most widely used drug since 1940.  He had given the opinion based on the findings of post mortem report.  He himself was not an anesthetist

4. Even the chemical examination report indicates the Thiopental level of 14.5 mcg was within the normal limit.  The intubation process was duly monitored and failed intubation did not make pulmonary edema when the patient was fully recovered 14.00 p.m.

It's a very important case indeed, though its of 2002. After 15 years, there must have been tremendous development in Technology. However as the case is decided on the facts of each case, benefit of development in Medical Science as on the date of judgment cannot be given to such cases. The Surgeon who performed the initial operation was also dragged in the matter. Nevertheless, its an important lesson for other Anesthetists too.. Isn't it ?

One more aspect it was the Doctor only who gave PM report, that became the basis of the Compliant.. Expert Evidence is very important aspect in Medical Negligence cases.. No doubt the family of the deceased must have experienced unfathomable ordeal, still the Doctors who worked as per Medical Protocols cannot be held guilty.. 

Thanks and Regards

Adv. Rohit Erande

Pune  ©