MD In Medicine Qualified To Treat ICU Patients Without Additional Intensive Care Training: NCDRC

Brief Facts of the Case

The complainant's wife was admitted to Akshaya Hospital's ICU after complaining of uneasiness. Despite the hospital's claim as a specialty heart center, no senior doctors examined her, leaving her care to junior staff and homeopathy assistants. The complainant alleged numerous irregularities, including inadequate monitoring, inappropriate medication use, lack of informed consent, and potential manipulation of medical records. The patient unexpectedly passed away, with the cause listed as cardiac-related issues. However, the complainant argued that the diagnosis contradicted earlier test results and ECG readings. The complainant argued that the hospital's failure to provide appropriate care, including the absence of senior doctor examinations, improper use of medication, and inadequate monitoring, may have contributed to the patient's death. The complainant filed a complaint before the State Commission of Madhya Pradesh, which dismissed the complaint. Consequently, they filed an appeal before the National Commission.

Contentions of the Hospital

The hospital argued that contrary to the complainant's claims, nitroglycerine (NTG) was administered along with other medications and that senior doctors were not required due to the presence of the attending doctor. The hospital denied the existence of a junior doctor and claimed all staff, including doctors, were adequately involved. A second ECG showed the patient's condition had stabilized before she experienced cardiac arrest, despite immediate resuscitation efforts by the medical team. The hospital argued that the patient had a history of uncontrolled diabetes and hypertension, contributing to the sudden cardiac arrest. It was emphasized that acute coronary syndrome (ACS) typically involves complications like those experienced by the patient. It refuted allegations of improper treatment, explained the administration of NTG and other drugs, and detailed the patient's medical condition at admission. The hospital concluded that there was no deficiency in service, and the complaint should be dismissed.

Observations by the National Commission

The National Commission examined whether the doctor was competent for ICU duty, concluding that an MD in Medicine was qualified to treat ICU patients without additional intensive care training. Regarding the complaint, the commission found that the patient's medical history was properly recorded upon admission. The complainant's allegations about the risky infusion of NTG and lack of informed consent were addressed by the hospital, which explained the standard procedures followed. The commission found that the patient's vital signs were monitored at intervals and that there was no evidence of negligence or excessive NTG dosage. Furthermore, the patient's BP and other vitals were within acceptable ranges during treatment. The commission ultimately determined that the hospital provided appropriate care and did not find any deficiency in service.

The National Commission upheld the State Commission's order and dismissed the appeal.

Case Title: V.C. Rawat Vs. Akshaya Hospital

Case Number: F.A. No. 587/2023