Document Fragment View

Matching Fragments

 

2. Practically, all the material facts of the case are undisputed. Raj Karan was a patient of chronic renal failure (CRF) and he also suffered from dilated cardiomyopathy DCM (a condition in which the heart becomes weakened and enlarged, and cannot pump blood efficiently; the decreased heart function can affect the lungs, liver and other body systems). On consultation with OP 1 at his personal clinic, Raj Karan was advised to undergo maintenance haemodialysis (HD) twice a week regularly, in addition to some medication. He underwent nearly 120 such sessions of HD at the OP 2 hospital where OP 1 was the Professor of Nephrology and Head of the Nephrology Unit. The blood group of Raj Karan was B, Rh-Negative. During previous sessions of HD, he was all along transfused with blood of the same group and Rh type. However, in his scheduled HD on 17.09.1999, he was given blood of B group, Rh-Positive. He died of cardiac arrest on 19.09.1999.

3. The complainants case before the State Commission was that her son died prematurely because of the negligence on the part of the OPs in transfusing blood of the wrong Rh type during the HD session of 17.09.1999. Raj Karans blood group was B, Rh-Negative and all through the previous sessions of HD, at OP 2 hospital, he was given blood transfusion of the same group and Rh type. There was, thus, no reason to transfuse B, Rh-Positive blood during HD on 17.09.1999, without checking for cross-matching compatibility. This was what led to his sudden death on 19.09.1999.

 

4. The OPs contested the complainants allegations on alll grounds including, inter alia, that (i) Raj Karan was a patient of not only CRF but also DCM, (ii) patients undergoing maintenance HD for CRF have a cardiovascular mortality rate approximately 3 times higher than that of age-matched control subjects, (iii) patients suffering from DCM have a much higher mortality rate than that of the general population, with about 25% dying within 1 year and nearly 50% within 5 years and (iv) not all Rh-Negative persons have anti-Rh (D) antibodies in fact, only a few do so that not all cross-matches of Rh-Negative recipients (of blood) from Rh-Positive donors or vice versa would be incompatible, as a result of which transfusion of Rh-Positive blood may be perfectly safe. In support of these contentions, the OPs produced extracts of relevant medical texts and published articles in journals. On 17.09.1999, the Blood Bank of OP 2 supplied one unit blood of B group, Rh-Positive. This was transfused during the HD session of 17.09.1999, without any complication during the process of HD. In support of their claim, the OPs relied on the medical notes of the process of HD on 17.09.1999, which showed that it went off without any complication. They also referred to the document (cross-matching report of the Blood Bank of OP 2) produced by the complainant herself showing that, contrary to the allegation, the blood used for transfusion was cross-matched with the blood of the patient and there was no reaction of incompatibility. Had the transfused blood been incompatible, there would have been immediate reaction, in the course of the HD itself. According to the OPs, transfusion of Rh-Positive blood quite safe for a first such transfusion, as was the case here. In their appeal, they further contended that the State Commission erred in not taking cognisance of the authoritative medical literature produced by them, when nothing to the contrary had been adduced as evidence by the complainant.

Before transfusing the blood, the Opposite Parties should have done cross-matching of the blood instead of straightaway opting to transfuse the blood. No doubt, the deceased was suffering from serious ailment relating to the kidneys but he died not due to his long ailment but due to cardiac arrest, which has a direct concern with the transfusion of the wrong blood. The Opposite Parties cannot wriggle out of their responsibility by simply taking the plea that the deceased was suffering from Chronic Renal Failure with dilated cardiomyopathy and that Rh-negative recipients can be transfused blood Rh-positive by cross-matching in some cases.