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The death of a 48-year-old Kollam native, who had been referred to the Government Medical College Hospital (MCH), Thiruvananthapuram, with chest pain for emergency care and follow-up treatment, triggered major protests in the hospital and outside on Thursday, with the patient’s family alleging that lack of proper treatment and care had led to the patient’s death. The patient, Venu, had died on Wednesday night. The allegation of medical negligence gained more traction through the day after a voice recording sent by the patient to one of his friends, claiming that he was not being cared for and that angiogram test was not performed on him even though he had been admitted with chest pain, went viral. However, medical college authorities denied the allegations of medical negligence and said the the patient was treated, initially by the General Medicine and then the Cardiology department. Angiogram was not performed on him because the patient had several risk factors like diabetes, hypertension, previous history of stroke and transient ischemic attack and elevated creatinine levels at the time of admission, which made angiogram a risky proposition, C.G. Jayachandran, Superintendent of the medical college, told The Hindu. “The patient was seen by the doctors at the chest pain clinic when he was admitted here on Saturday night, by which time he had been experiencing pain for over 24 hours. As performing an angiogram would have put the patient (whose creatinine levels were seriously elevated) at a higher risk, medical management was advised and he was started on heparin (blood thinner). On Monday, Cardiology department took over the treatment. In between, when the patient’s wife came and met me, I had personally made enquiries with treating doctors about the case” Dr. Jayachandran said. On Wednesday night, the patient’s condition took a turn for the worse and he was admitted in the ICU and put on the ventilator. But he went into cardiac arrest later. The patient’s family complained that an angiogram was not performed on Venu on time and that the medical college authorities had not bothered to explain the treatment to the family. They stood by their argument that the patient was not given due care, even though he had been admitted to the hospital from Saturday night. “We reached the hospital on Saturday night and as the next day was a Sunday, there was no duty doctor. I was told to take an out-patient ticket on Monday to show him to the cardiologist. The cardiologist said that an angiogram can be conducted on Wednesday or Friday. Then, when his condition worsened and I told the nurses that several times, the doctor came and prescribed some medicines. But he died in the end,” Venu’s wife told reporters. The family has sent formal complaints on the alleged medical negligence to Health Minister Veena George and the Chief Minister and threatened legal measures against the authorities. Meanwhile, the Health Minister has sought a detailed report from the Director of Medical Education on the incident. The incident led to loud protests by Youth Congress activists who tried to force their way into the office of the Superintendent, following which two persons were arrested and removed by the police. Even as the medical college authorities affirm that the patient was given due care, the family’s contention that he was not given angiogram test even after he was at the hospital for five days raises the question whether the treatment details of the patient - the fact that doctors had considered angiography too risky a procedure for the patient -was conveyed properly to the patient and his family. Proper communication Senior doctors at the hospital said that the latest incident is yet another example of how more diligence was required in handling various aspects of patient care, including proper communication and briefing of the patient’s condition and the treatment being given to him/her to families and how this was becoming increasingly impossible in a hospital which was being bogged down by overcrowding and an acute shortage of staff. “The doctors are managing so many cases at a time that they just may not have time to spend counselling the patients’ families. We have an acute shortage of nursing staff in wards and we do not have any care coordinators or patient counsellors or medical social workers as one might find in private sector hospitals to exclusively deal with patients’ families,” a senior doctor said “It is also true that many of the young doctors on duty or residents taking rounds have no idea how to talk and explain medicine in layman’s terms to patients or their families,” he added.
