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DMC/DC/F.14/Comp.2676/2/2019/ 24th October, 2019

O R D E R

The Delhi Medical Council through its Executive Committee examined a representation from DCP Central District Darya Ganj, Delhi, seeking medical opinion on a complaint of Shri Satyajit Bora r/o- Flat No.2D, Rohini Apartment, G.N.B Road Chandmari, Guwahati, Assam-781003, alleging medical negligence on the part of doctors of Sir Ganga Ram Hospital in the treatment administered to complainant’s mother Smt. Tagar Bora, resulting in her death on 28.06.2018.

The Order of the Executive Committee dated 22nd August, 2019 is reproduced herein-below:-

“The Executive Committee of the Delhi Medical Council examined a representation from DCP Central District Darya Ganj, Delhi, seeking medical opinion on a complaint of Shri Satyajit Bora r/o- Flat No.2D, Rohini Apartment, G.N.B Road Chandmari, Guwahati, Assam-781003, alleging medical negligence on the part of doctors of Sir Ganga Ram Hospital in the treatment administered to complainant’s mother Smt. Tagar Bora, resulting in her death on 28.06.2018.

The Executive Committee perused the representation from the Dy. Commissioner of Police, written statement of Dr. (Brig) Satendra Katoch, Addl. Director Medical, Sir Ganga Ram Hospital enclosing therewith written statement of Dr. Nipun Rana, Dr. O.N. Nagi, copy of medical records of Sir Ganga Ram Hospital and other documents submitted therewith.

The Executive Committee noted that the patient Smt Tagar Bora was a 77 year old lady who was diagnosed as a case of bilateral Avascular necrosis (AVN) of the hip joints, and complained of pain in her right hip with inability to walk for 4 months. She also had bilateral osteoarthritis of her knee joints and had an osteoporotic fracture of her spine.

She was admitted for hip replacement on 26th June, 2018 by Dr.O.N.Nagi at Sir Ganga Ram Hospital, New Delhi, who wrote on the paper. ‘To be admitted in Semi Pvt for building her up for surgery.’ After admission, she underwent various investigations and was clinically examined by an endocrinologist nephrologist and a cardiologist, as advised by the anaesthesiologist, for fitness of her surgery.

The cardiologist and endocrinologist noted the following medical comorbidities in addition to her orthopaedic problems :

1. She was a previously diagnosed case of polymyositis and was on steroids from 1996 to 2006.

2. She had diabetes mellitus (DM-II) with hypertension (HT) with atrial fibrillation (AF) with CVR LAD (Controlled ventricular rate LAD-Left axis deviation).

3. Her CHAD S2VASC score was 5 suggestive of a high risk for stroke.

4. Among the abnormal investigation reports, her sodium was 122 and Potassium was 5.6, her urine Na was 91. Her hemogram, urea, S. Creatinine, S.alb, PT/INR,APTT was WNL(PAC),

The endocrinologist had given clearance for surgery. She was on Inj Insulin and Inj Apidra.

The cardiologist had given clearance for surgery with the advice of DVT (deep vein thrombosis) prophylaxis and advise of anticoagulants after surgery. Patient was on Tablet Dytor Plus, Tab Concor 2.5, Tab Valext 40 and the nephrologist had advised to withhold Tab.Valent/Dytor Plus and to get urine spot sodium. Nephrologist advised that patient can be taken up for surgery under spinal anaesthesia with moderate risk and advise of fluid restriction 3 litre/day.

She was given potassium binding sachets on 27th June. After correction of serum electrolyte she was taken up for surgery after due high risk consent.

Exercises for DVT prophylaxis and prevention of pulmonary embolism, as well as standard essential exercises for all bed ridden patients were initiated after admission.

During surgery conducted on 28.06.2018 patient had an episode of cardiac arrest. She was resuscitated and shifted to ICU, where she had multiple cardiac arrest form where she could not be revived ultimately.

From the case records, it is evident that the 77 year old patient with multiple medical and orthopaedic co-morbidities had been thoroughly investigated and appropriately optimized by a team of endocrinologist, cardiologist and anaesthesiologist and taken up for surgery after obtaining high risk consent. It is observed that the patient required surgery for which she was taken up after high risk consent, unfortunately she had bradycardia and repeated cardiac arrests during and after surgery because of her advanced age and other co-morbidities. She was resuscitated (CPR done) as per guidelines. Inspite of efforts she could not be revived and succumbed at 02.45 pm on 28.06.2018.

In view of the observations as per the records, the decision of the Executive Committee that the Smt. Tagar Bora was treated as per accepted professional practices in such cases by doctors of Sir Ganga Ram Hospital and primafacie no case of medical negligence is made out on the part of doctors of Sir Ganga Ram Hospital.

Complaint stands disposed.”

Sd/: Sd/: Sd/:

(Dr. Arun Kumar Gupta) (Dr. Vinay Aggarwal) (Dr. Ajay Gambhir)

Chairman, Member, Member,

Executive Committee Executive Committee Executive Committee

Sd/: Sd/: Sd/:

(Dr. Satendra Singh) (Dr. Vishnu Datt) (Dr. Richa Dewan) Member Expert Member Expert Member

Executive Committee Executive Committee Executive Committee

Sd/:

(Dr. Sumit Sural)

Expert Member

Executive Committee

The Order of the Executive Committee dated 22nd August, 2019 was confirmed by the Delhi Medical Council in its meeting held on 30th September, 2019.

By the Order & in the name of Delhi Medical Council

(Dr. Girish Tyagi)

Secretary

Copy to :-

1) Shri Satyajit Bora r/o- Flat No.2D, Rohini Apartment, G.N.B Road Chandmari, Guwahati, Assam-781003.

2) Dr. O.N. Nagi, through Medical Superintendent, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi-110060.

3) Dr.Nipun Rana, through Medical Superintendent, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi-110060.

4) Medical Superintendent, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi-110060.

5) ACP/PG Cell for Dy. Commissioner of Police, Central District, Daryaganj, Delhi-110002.(w.r.t. No. 9745/Complt.(C-II/KB)C dated 19.12.2018)-for information.

(Dr. Girish Tyagi)

Secretary

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