Doctor directed to pay compensation (ケララでもＤｒの仕事は大変!?)

Doctor directed to pay compensation
Rs.1 lakh for failure to diagnose tubular pregnancy（卵管妊娠の見落としによる、１ラックの賠償金）

THIRUVANANTHAPURAM: The state Consumer Disputes Redressal Commission here has ordered a doctor to pay a compensation of Rs. 1 lakh to a person whose wife died due to the failure of the doctor to the diagnose and treat tubular or ectopic pregnancy (a dangerous condition when the foe-tus develops inside the fallopian tube instead of womb) on time.
The compliment, Thomas-kutty Sebastian of Nadakkal, Eerattupetta, said that in March 1996, his wife had become pregnant after undergoing infertility treatment. On April 11, he took his wife to the opposite party, Sunny Mathew of Pala, for consultation as his wife had experienced slight bleeding. A scan report was called for and after examining the report, the doctor said that there was some bulging of one of the fallopian tubes but it was a case of "incomplete abortion."
The patient was asked to rest for a week. The complainant said that he took his wife back to the doctor on April 15, 18 and 23 also as she was in pain but was told that the abortion had been "completed " and some medicines were prescribed.
She could not be saved:
On April 25, another scan was taken after which the doctor confirmed the diagnosis of tuber or ectopic pregnancy and advised a D&C. The next day, however, the woman was rushed to the opposite party in severe pain.
The doctor diagnosed that the fallopian tube had ruptured and advised an emergency operation. But the patient could not be saved. The complainant said that his wife was only 35 years at the time of her death.
The doctor denied that there was any negligence on his part. He said that on April 11, when the scan was taken, there was no conclusive diagnosis regarding tubular pregnancy and hence, the patient was advised bed rest. He said that on April 25, he had doubts whether it was a case of tubular pregnancy and advised the patient to undergo a D&C. He claimed that the inordinate delay on the part of the complainant in getting medical aid for the patient after the tube had ruptured had resulted in her death.
Expert witness:
The commission, however, took serious note of the deposition of the expert witness, Annie Thomas, the then Associate Professor of Obstetics and Gynaecology, Kottayam Medical College, that a laparoscopy or laparotomy should de done if at all tubular pregnancy is suspected.
She pointed out that advising a D&C when the doctor suspected ectopic pregnancy was not correct. The commission also noted that the opposite party, having suspected ectopic pregnancy, did not take any step to rule out the same.
With 9% interest :
Dr. Annie Thomas said in her statement that "on Aplil 11 itself, if laproscopy had been done, the diagosis could have been confirmed."
The opposite party himself admitted that more care and caution is taken by doctors in case of "precious pregnancy." In this case, the complainant's wife had undergone infertility treatment before she became pregnant and the doctor should have exercised more caution, the commission noted. The doctor was ordered to pay the compensation with 9 per cent interest from the date of the complaint.
The judgment in the case was delivered by commission members Valsala Sarangadharan and S. Chandramohan Nair. （４月１日２００９年。ＴＨＥ　ＨＩＮＤＵ より）

今日の一言
最 近、日本においても、医療事故、医療ミス責任、モンスタペーシェント等、医療現場の問題をよく耳にするが、世界の医療の現場においても、よく似た問題が起 こっている。　今回、ここトリバンで起こった事も、私自身の前職が医療現場で働いていた事もあり、とても考えさせられた。　結論的に、今回の問題はＤｒの 診察ミスにより、患者がなくなったと決着がついたが、この病気を調べれば調べるほど、その診療は難しいように思われる。　日本では産婦人科Ｄｒの人手が足 りない、余裕のある診断が出来ないことが、問題の一つでもあるが、ここインドでは、人手というよりも、その施設設備だと思われる。　今回の患者は、おそら く、中級以上の病院に入院したとは思えるが、その設備は日本に比べると低いと思われ、また、今回のような難しい症例を取り扱う施設が整っていたのか疑わし い。　
今回の記事では、不妊治療をしていた患者家族の気持ちを考えるととても切なくなるが・・・年を考えると、死を含むリスクを考える必要性がお 互いにあったのではないかと思える。・・おそらく、人間の技術が高まれば、高まるほど、出産という奇跡の事柄が薄れていき、テクノロジーが全てを救うかの ように思い込み、このような問題は増えると思う。　患者は問題をＤｒの責任にし、Ｄｒは医療オタクになって孤立していく。　余裕のある出産、余裕のある診 察、余裕のある生活が難しくなっていく現代・・・・お互いが自分の権利を守るために、モンスターになっていく・・・恥ずかしい事だが・・・仕方ないの かぁ!?　難しい。