The National Consumer Disputes Redressal Commission (NCDRC) has ruled that MD Medicine doctors are adequately equipped to treat ICU patients without the need for further intensive care training, while reviewing an appeal alleging medical negligence in treatment.

The Apex Consumer Court bench, led by Justice Ram Surat Maurya and Mr. Bharatkumar Pandya, declared that "every MD medicine is competent to treat patient in ICU" and dismissed the medical negligence allegation.

The complainant's wife was brought to Akshaya Hospital's Intensive Care Unit (ICU) ward in 2009 due to complaints of uneasiness, which is when the case started.

The patient was allegedly treated by a junior MBBS doctor and two homeopathy assistants, and no senior doctors assessed the patient, even though the hospital was a specialty hospital.

In addition, the complaint claimed that there were multiple irregularities, such as improper use of medications, inadequate monitoring, lack of informed consent, possible record-keeping manipulation, etc., and that the patient's death was allegedly caused by a sudden heart attack. The cause of death was listed as "Acute Coronary Syndrome, Cardiac Arrest, Cardiac Pulmonary Arrest" on the death certificate.

The complainant claimed that the diagnosis ran counter to the results of previous tests and the ECG. Thus, the complainant filed a complaint with the Madhya Pradesh State Commission, which denied the appeal, claiming negligence in medicine and inadequate care. They then made their way over to the NCDRC bench.

However, the hospital argued that Dr. Singh, a senior physician with an MD in medicine, was caring for the patient. After earning his MD from Gandhi Medical College in Bhopal in 2007, the doctor worked as a senior resident physician in the cardiology department of Hamidia Hospital in Bhopal.

The hospital also claimed that the patient had undergone all initial examinations. The hospital claimed that nitroglycerine (NTG) was given in addition to other medications, refuting the complainant's assertion. The hospital further asserted that all of its employees, including the doctors, were sufficiently involved and disputed the existence of a junior doctor.

Despite the fact that the medical team immediately began all resuscitation attempts, the hospital claimed, citing the patient's medical records, that a second ECG revealed the patient's condition had stabilized before she went into cardiac arrest. The woman experienced abrupt cardiac arrest, according to the hospital, since she had a history of uncontrolled hypertension and diabetes.

Rejecting the assertion that the patient never experienced heart attack symptoms, the hospital highlighted that the patient's sudden cardiac arrest was caused by a well-known side effect of Acute Coronary Syndrome, which encompasses a range of clinical presentations from those associated with ST-segment elevation myocardial infarction (Stemi) to those seen in unstable angina or non-ST-segment elevation myocardial infarction (NSTEMIN). According to the hospital, acute cerebral stroke (ACS) is nearly invariably linked to the rupture of an atherosclerotic plaque and partial or whole thrombosis of the infarct-related artery. They refuted all of the accusations of inadequate service, citing the medical records as evidence.

The top consumer court was deliberating over the matter when deciding if Dr. Singh, MD, was qualified to work in the hospital's intensive care unit.

On the State Commission's instructions, a Medical Board was established, including Drs. T.N. Dubey, B.S. Yadav, and Ajay Sharma. Under cross-examination, Medical Board Chairman Dr. Dubey declared that an MD should always be the treating doctor in the ICU.

Regarding the claims pertaining to NTG infusion, the Commission observed that NTG was administered through a PVC conduit (bottle & IV set) that absorbs NTG, resulting in a significantly lower effective NTG dose than what occurred with extra security attached, specifically Dial-O-Flow. This is standard procedure in the hospital for the infusion of NTG and other sensitive drugs.

"Last recorded BP of the patient at 2:00 hours on 01.04.2009 was 118/70. The patient was already on Betaloc and Betablockers, NGT could not be withdrawn suddenly as it may precipitate heart attack. Lomorin was not given to the patient. It was Lomorin-a low molecular weight heparin, a standard treatment for Acute Coronary Syndrome was given. The patient never went into hypotension. NTG cannot produce hypotension and death within a span of 10 minutes," noted the Commission.

As a result, the highest Consumer Court found that the hospital provided appropriate treatment and that there was no service deficit on its part.

(Input from various sources)

(Rehash/Priyanka Pandey/MSM)