Can Apollo docs be booked in 304A when DMC says no negligence?

Six doctors of Apollo Hospital have been booked for causing death by negligence of a 70-year-old man in 2009 as per police.

According to the hospital, there is no medical negligence. The patient had multiple pre-existing co-morbid conditions including uncontrolled diabetes, heart and kidney disease. Appropriate care and treatment was provided by a competent multidisciplinary team but the patient, sadly, succumbed to his illness.

The Delhi Medical Council also ordered that the patient was duly treated as per established norms.

A case has been filed with police station on May 31 over an order of Saket court.

The patient, complainant’s father, was admitted to the hospital on March 6, 2009 with perianal abscess with diabetes and CAD. He was on blood thinners.

Allegations

·         After remaining in the hospital for 27 days, the patient died on April 1, 2009, due to gross, grave, reckless and culpable criminal negligence of the accused, who had vision, reasonable foresight and complete knowledge and awareness of the consequences of their acts, but showed thorough disregard and indifference.

·         There was unreasonable delay in conducting surgery for drainage of perianal abscess.

·         The surgery was performed after an unjustified delay of 20 hours from the time of admission.

·         Blood thinners were discontinued prior to surgery and were not restarted again. This contributed to a heart attack on March, 27, 2009 as per the allegation.

·         Anemia was not corrected on time.

·         Hyponatremia, very low albumin and plasma proteins and blood gases were not managed at all.

·         Had proper diagnosis been made in time the heart attack could have been prevented.

Charges: The hospital and the doctors now face charges under sections 304-A (causing death by negligence), 465 (forgery) and 471 (using forged document as genuine).

Defense

·         The patient was in sepsis at the time of admission. 

·         He had other co-morbidities which needed to be stabilized.

·         The patient was evaluated by the cardiologist, nephrologist and anesthetist.

·         After the patient had been pre-operatively evaluated, stabilized, he was taken up for surgery under high-risk consent.

·         Debridement was done everyday till debridement was necessary; hence, the blood thinners were not given for this period.

eMedinews Comments

·         Once the state medical council has cleared, the person can appeal the order in MCI. Till then, the police should not take any cognizance.

·         Difference of opinion, error of judgment is not negligence.

·         To be a criminal negligence, the act has to be willful, grossly negligent and reckless, which would have been observed by the state medical council if that was the case.

·         Stopping blood thinners is a normal practice for 5-7 days before any surgery.

·         Being on blood thinners does not guarantee that a person will not get a heart attack.

·         Death does not mean negligence or a criminal negligence.

·         If two experts differ, the benefit of doubt should go to the doctor and not the patient.

·         These types of case hurt doctors and make them practice defensive practice, which in long run is not in the interest of the patients.