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5.       The OPs submitted that Dr. Amit Saha (OP-1) is a MBBS and passed M.D. in Preventive & Social Medicine in 1993. He has not made any false declaration or claimed himself as M.D. in General Medicine. The Complainants calling him as "a quack" was highly derogatory and defamatory. The OPs submitted that entire treatment was under the supervision of OP -1 to 5.  The OPs submitted the chronology of treatment that- the patient took treatment from 3 doctors before coming to OP-1. She was a known Asthmatic, and diagnosed it as  Broncho-Pneumonia-right side.. Initially, Dr. Rajdeep Chakraborty (OP-5) started treatment for Lower Respiratory Tract Infection (LRTI). The ABG report was informed by  OP-5  to the OP-1  who  advised moist Oxygen 2 ltr/min, Tab Clonazepam (0.5) stat, Syr. Macbery 10ml stat & TDS. Thereafter, the OP-1 visited the patient and noted the findings as Cough with blood tinged sputum, Temp 1020 F, Chest has occasional Rhonchi, Pulse-124/min, BP-110/70 mm Hg and  SPO₂-99% (2 L/min O2). For loose motion prescribed Tab Decolic-1 Tab TDAC and  stool exam with microscopy was advised. OP-5 later examined the patient and prescribed medication for cough and vomiting and advised lnj. Zofer 4mg 2 ampoules stat then 1 amp SOS and Alex Logenze SOS. At 9.30 pm OP-1 visited the patient and noted complaints of Cough, no dyspnea, high Tempt↑ 102°F, Chest was clear and advised lnj Pause (500 mg) IV TID and continued other medicines and Nebulization with Duolin & Budecort. The treatment continued under the supervision of OP-1 and OP-5. The patient was prescribed   symptomatic drugs like Levosulpiride and Paracetamol (Neumol) by OP-1. The Injection Neumol (Paracetamol) was prescribed 500 mg IV 4 times and patient became afebrile. It was not an overdose of Paracetamol.  There was no record of hypothermia. According to the literature the overdose of Injection if it was given more than 4000 mg / day.

iv) He further argued that OP No.1 holding MD degree in Social and Preventive Medicine but posing himself as a Specialist in General Medicine i.e. a Physician or a  Pulmonologist did not care for ABG Report (dated 28/10/15 at 11.03 AM) with Hb%  6.8 gm/dl. His pattern of writing Prescriptions and Clinical Notes itself indicate his deficiency and careless attitude towards the patient.

v)       He further argued that the doctors failed to carry investigations to arrive at correct diagnosis.  At the time of admission only ABG was performed but no other investigations like CBC, Widal, H1 N1 antigen and electrolytes performed. The MRI or CT scan and ECHO were not done though  available at next door.  The AR further argued that the medicines were wrongly given and not used judiciously. The patient was allergic to Sulpha drugs in spite of that patient was injected levosulpiride IV 3 times to daily. Its Chemical formula is -C₁₅H₂₃N₃O₄S[2]. This drug was used mainly in psychiatric disorders, may sometimes be used in gastro-esophageal reflux disorders and dyspepsia. The respiratory distress was due to adverse reaction of injection levosulpiride as it was contraindicated in asthma and in hypokalemia. The OP-1 unnecessarily gave  injection Neumol 500 mg (paracetamol) IV 4 times daily when the fever was 101.20F just a tablet Paracetamol would have been sufficient. Moreover the temperature came down to the normal on the next day after admission but the injection Neumol  500 mg 4 times daily were continued till the death of the patient. Injection pause 500 mg IV 3 times a day that is Cinnamic acid ordinary used to stop heavy bleeding during the menstrual cycle. It was used in this patient without asserting bleeding time (BT) and clotting time (CT) when the patient showed blood tinged sputum. The OP-1 prescribed antibiotics, without any proper indication or justification and with negative Sputum culture report. As per clinical findings noted by OP-1, the patient was improving with SABA (Short Acting Beta Agonist e.g. Levoline or Levosalbutamol 0.63mg) and ICS (Inhaled Cortico Steroids e.g.  Budicort or Budesonide 200 mg) and injection Cortico Steriod (inj. Hydrocortizone), which were already continuing. There was no justification of use of injection Aminophylline and drug Doxophylline.

19.     Secondly, on 31.10.2015 patient was prescribed injection Neumol (Paracetamol) 500 mg IV- QID (4 times a day). The patient became afebrile as a result of treatment only. It was continued to prevent rise of temperature which could lead to dehydration. As such patient did not suffer hypothermia. From the several medical literature, the overdose of Paracetamol is considered if it exceeds 4000 mg / day. Therefore, in our view the allegations of use of Levosulpiride and Neumol are not sustainable. It was an accepted reasonable practice.  Thirdly, blood pH 4.72 appears to be an inadvertent error in writing, and by any stretch of imagination such values never observed in practice of medicine.