Medicolegal case

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PSYCHIATRY

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Allegation of medical negligence against a psychiatrist while performing Electroconvulsive therapy resulting in death of the patient

Summary

This is a case of a 23-year old male paent who was admied with the complaints of stress and was further diagnosed with schizophrenia. Unfortunately, the paent passed away due to sudden cardio-respiratory arrest while being treated for schizophrenia. The complainant, paent’s mother alleged that her son passed away due to the negligence of the respondent, Dr. X. Complainant claimed that the respondent had administered the paent, electric shock at three different dates without her consent and had also prescribed 12 tablets per day. At some me, she tried to feed water to her son but he did not consume the same. Hence, she called the respondent who declared him dead. According to the complainant the paent was alive at that me. She further stated that she herself was given two injecons aer this.

Respondent resisted to the complaints filed against him. The paent was presented to him and on careful examinaon he found him to be a case of schizophrenia and iniated treatment of ECT (Electro Convulsive Therapy) and anpsychocs aer obtaining prior consent from paent’s father and then shied the paent in a special room. In the next morning, paent felt unconscious. Thereaer the respondent was called and aer certain aempts he declared the paent to be dead due to sudden cardio respiratory arrest. Following this, the complainant started crying and weeping and was administered Digrocam 10 mg for her hypertension.

The complainant had no evidence to prove that the diagnosis and treatment given by the respondent was wrong. Complainant filed an affidavit of an expert, Dr. Y, who alleged that post-mortem should have been carried out since schizophrenia is not a cause of sudden death. However, in his affidavit, he did not menon anywhere that the treatment given by the respondent was wrong or that high doses of anpsychocs and ECT given by the respondent was the cause of death.

Case of the complainant

Ÿ The complainant Mrs. I had admied her 23-year old son in the respondent`s hospital on 13.2.1986 for treatment of stress.

Ÿ The respondent Dr. X gave him electric shock treatment without her consent.

Ÿ The complainant further stated that her son was facing breathing problem, and when she asked the respondent about it, respondent ignored her requests to intervene.

Ÿ She later tried to feed him water but the paent did not respond. When the respondent was called to intervene, he declared the paent dead. The complainant stated that the paent was alive at that me.

Ÿ She requested respondent to call some other doctors, but he repeatedly ignored her requests.

Ÿ She further stated that she was mistreated by the respondent’s staff and given two injecons.

Ÿ It was contended that the paent died at 3.00 A.M. on 21.2.1996. The anesthest arrived an hour aer the paent was already dead.

Ÿ The complainant approached State Consumer Dispute Redressal Commission demanding compensaon of Rs.15 lakhs.

Case of the respondent

Ÿ Respondent No. 1 appeared before the commission and resisted the complaint by filing his wrien statement.

Ÿ He stated that he was praccing as a psychiatrist since January 1978 and had treated numerous cases of schizophrenia.

Ÿ The complainant brought her son on 13.2.1996 at 10.30 A.M., to him.

Ÿ He examined him and found that it was a case of schizophrenia.

Ÿ He examined him thoroughly and found that he had no other disease.

Ÿ He decided to give treatment of ECT (Electro Convulsive Therapy) and anpsychocs.

Ÿ The respondent stated that he had given detailed informaon about electric shock and had obtained wrien consent for administering ECT from the paent’s father.

Ÿ The respondent started anpsychoc therapy from 13.2.1996.

Ÿ The respondent used to examine the paent every day at 5.00 p.m. and used to

take decision about the treatment.

Ÿ The respondent administered ECT again on 15.2.1996 and 19.2.1996 under general anesthesia.

Ÿ The respondent observed that the paent spiked a fever on 16.2.1996 and also had sour throat for which he was prescribed with syfrodec 500 mg.

Ÿ It was contended that his condion was normal up to 20.2.1996. On the same day, the staff tried to awaken him but he did not respond for which the respondent was called.

Ÿ He immediately rushed to him and found that paent was unconscious. His B.P. was not recordable; pulse not felt, no heart sound, respiraon absent.

Ÿ He started cardio respiratory resuscitaon up to 5:50 A.M. but his efforts were in vain. Thus he declared the paent dead at 5:50 A.M.

Ÿ The cause of death was stated to be sudden cardio respiratory arrest.

Ÿ The anesthest also tried respiratory resuscitaon on the paent, but the paent

could not be revived.

Ÿ The paent had schizophrenia. The paent’s father had given consent for administering ECT. The respondent had prescribed him anpsychoc drugs and there was no negligence on his part.

Findings and Discussion

Ÿ The complainant did not present any sort of evidence in the shape of expert to prove diagnosis arrived by respondent and treatment given by him was wrong and he had given high dose of medicine.

Ÿ There was nothing to establish the connecon between cause of death and treatment given by respondent.

Ÿ The evidence on record did not show that the death is aributable to any act of respondent.

Ÿ No literature, documentary evidence or

otherwise was brought before the Commission

by the complainant, to prove negligence on the part of respondent.

Ÿ No expert`s evidence was led by complainant.

Ÿ It appears that doctor exercised proper skill and bestowed his best of his aenon

and care for treatment.

Judgment

Ÿ The judgment of the court will be published in the next issue.

Points for determinaon

Ÿ Do you think this case incontestably amounted to medical mistreatment?