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Dr. Majumdar submitted that he is a surgeon and not a specialist physician cardiologist. He, however, immediately sought the opinion of Dr. Khurana and physician cardiologist Dr. P.K. Babbar. After examining of patients condition by Dr. Khurana and Dr. P.K. Babbar, it was found that the heart sounds of Smt. Jasbir Kaur were feeble and muffled. The ECG was also examined by them and they opined that it was highly risky to shift the patient at that stage for CT scan and, therefore, the attendants were explained in details about it.
It is also worth high lighting here that a cardiologist namely Dr. Vinay K. Jindal had also been summoned immediately. As far as the question of giving D.C. Shock (Electric shock) is concerned, in the medical science it is considered safe that such a shock be administered by a cardiologist. Again, this is an established fact recognized by medical fraternity that a patient suffering from cardiac arrest goes into coma and there was therefore nothing unusual in Smt. Jasbir Kuar going into coma. It is admitted that Dr. Avdesh Bansal had been summoned on the request of the relatives of Smt. Jasbir Kaur on 19.12.96. He after examining Smt. Jasbir Kaur at 10.30 a.m. had explained to her attendants the details regarding prognosis and had also advised C.T. scan.

Issue No. 7. Whether a team of Cardiologists, available in the hospital reached in time to revive the patient who had suffered cardio respiratory arrest soon after administering of anaesthesia by the Anaesthesiologist?

Ans:

Analysis of the treatment sheet:
 
Date 16.12.96 Progress   I/V line with 18 no canula established.

Premedication Inj. Atropine 1 amp + Inj. Forturn 15 mg I/V given at 9.45 am. Induced the patient with 2.5% thiopentone sodium 10 ml followed by 2cc scoline. IPPV done with 100% O2 intubator with 7.5 mm Coffed Tube. Coff inflated Suddenly Pulse became feeble and cardiorespiratory arrest was notice. N2O switched off and IPPV with 100% O2 started and cardiac massage started Inj. Adreline Inj. Cardiac given Inj. Eflorlin 2 AMP given, in the meantime physicians Dr. V.K. Jindal was summoned. Later Dr. P.K. Babbar and Dr. Bhowmik were also summoned. Patient was reviewed to sinus Rhythem as displayed by cardiac monitor. Pulse palpable, feeble Dopamine drip started and BP recordable after Dopamine drip 100/70. Pupils were dilated, non reacting patient unconscious. Pt. Shifted to CCU at 1.45 pm and put on life support system in Bipay system of machine at 8 pm. Till then Pt. Was given CR manually   Medicine   Inj. Efcorlin I/V total (800 mg) in OT Inj. Decadron I/V 60 mg Inj. Sodabicarbnonate 40cc I/V Inj. Atropine 2 amp I/V By Anaesthesia Machine with 100% O2 3 pm     BP 100/70, G.C. same Pulse rate 132/mm Temp. 98F   O2 = Oxygen N2O = Nitrous Oxide CR + Cardio Pulmonary Resuscitation           From 9.45 am to 1.45 pm (four hours) for these crucial four hours who did what is not mentioned. When the patient suffered cardiac arrest and at what point of time the cardiologist/team of cardiologists came? What was the time gap? Who made Cardio Pulmonary Resuscitation (CPR) efforts and for how long? At what point of time the patient went into coma. No time chart is made available by the hospital. Why a neurosurgeon or Neurologist was not summoned? Why automatic ventilator was not kept as a stand by. It is mentioned that only Dr. Khurana handled the Boyles machine for 8-10 hours. Is it humanly possible?

 

The hospital neither had public announcement system nor paging system, therefore, the treating surgeon, Dr. Mazumdar himself had to come out of the operation theatre at the critical time when the patient suffered cardio respiratory arrest to summon a Cardiologist. Though a team of Cardiologists had arrived at the scene, it is clear that they did not arrive in time.

 

Issue No. 8. Whether the report of the enquiry conducted by the Additional Deputy Commissioner can be taken into consideration for deciding the case of medical negligence?