Medical Malpractice!

(Medical negligence)

Medical malpractice is an act of negligence committed by a medical practitioner.
One can define it as doing something a medical provider of ordinary skill would not have done or failing to do that which a medical provider of ordinary skill would have done.

Medical negligence is the third most common cause of death after cancer and heart disease.
In the USA, more than 2,50,000 people succumb to medical malpractice every year.
At least Americans are frank enough to admit it; the rest of the world is always in denial mode.
Reasons?
1-Wrong diagnosis- Outdoors as well as indoors.
One out of twenty patients with OPD gets a wrong diagnosis, which may be because of loss of focus, incompetence, or lack of the right tools.
2-Wrong medications- Wrong prescription by a doctor, wrong doses or wrong medicines given by nurses, miscommunications between doctors or nurses, Drug interactions,
3-Deaths related to births- 6–8 out of 1000 deliveries are born with defects because of medical mistakes.
Why do doctors get away with murders?
There are usually two reasons:
1. The patients never learn that the doctors committed a mistake. They never realize that their complication or injury was from medical errors.
2.The time limit to file a lawsuit seeking compensation expires. In India, it is three years from the date of the incidence.
Clinicians, specialists, nurses, pharmacists, and laboratory technicians own the responsibility for carrying out the duties of their particular discipline and sharing everything with the team.
An incorrect diagnosis will almost inevitably lead to wrong treatment.
Coordinated activity, open communication, and empowerment to voice concerns are all part of the process that needs to drive such cases so patients will get the best possible outcomes.
A-Wrong diagnosis-
A young man in his thirties approached a hospital for breathlessness
and weakness. He was being treated for bronchial asthma for the last six months. His CT scan revealed diffused pneumonitis. As he didn’t respond to the antibiotics his bronchoscopy was done. The final diagnosis was made as histoplasmosis, a kind of fungal infection. A detailed history revealed that he had a couple of pigeons as pets. Had this history been taken properly in the initial stages, the patient could have saved a lot of inconvenience.
The fault doesn’t always lie with the treating physician. Even patients hold on to some critical information because of various reasons. The history of sexually transmitted diseases is still taboo.
B- Wrong medicines-
Miscommunication is a sure-shot recipe for the wrong medicines being prescribed.
An honorary physician on his routine indoor round prescribed Tab. Diamol, an anti-flatulent, to a patient. The doctor finished his round and was resting for a while when he received an emergency call from the ward that the patient he had seen 15 minutes before suddenly became unconscious.
“Yes, Staff, what’s the problem?”
“ Sir, I just gave him a tab. Daonil and in 15 minutes he became unconscious.”
Diamol became Daonil. Daonil is a sulfonylurea, an oral anti-diabetic, which has the propensity to cause hypoglycemia (Fall in blood sugar) even in non-diabetics.
There were instances where the patients were wrongly given Inj Morphin, an opioid given for pain. After realizing the mistake the doctor asked for intra-nasal Naloxone, an antidote to Morphin. Some patients went into respiratory depression, and their blood pressure had a sudden fall. At times it is difficult to revive the patient.
Wrong doses are another culprit. Paracetamol or Acetaminophen is a medicine that is normally given for fever. Up to 50–60 mg per kg body weight per day is a safe dose for Paracetamol. Make it 120 mg per kg body weight, and you might have severe liver toxicity at hand.
India has become a hub of pharmaceuticals. So many companies are producing limited drugs with a plethora of brand names. Many times the spelling is so similar one can hardly make out one medicine from another. Hand-written prescriptions are the main culprits, especially when doctors don’t harbor a very good reputation for legibility.
Allegra gets substituted for Viagra. Imagine, a hypertensive patient on amlodipine getting Viagra; one might have a sure-shot case of death on the cards.
Most of the time, the patients are not briefed about the possible diagnosis, the required investigations, medicine options, the side effects of the drugs, and the prognosis.
Every hospital should employ a junior resident doctor to explain all these to the patients.
The only thing that is followed religiously is to take written consent before surgery. Even there, most of the patients do not know what they are signing for.
An overload of patients is always offered as an excuse, but no excuse is justified if the patient’s life is at stake.
The self-proclaimed demigod status makes the doctors take the patients for granted, and this belief could be the genesis of medical negligence.

Nandkishor Shingne

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