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Morning Health Talk :
New Delhi, July 17, 2018 :
Baby dies in mother’s womb
The family members of a pregnant woman staged a protest demonstration at Murshidabad Medical College and Hospital on Saturday night alleging that their baby died in her womb due to medical negligence of the doctors.
The family members of the woman alleged that during the examination, the nursing staff members told the patient that the baby was moving inside the womb. But later, the family members of the patient were told that the baby had died inside the mother’s womb.
MEDtalks: Foetal death
The stillbirth rate is approximately 6.2/1000 live births and fetal deaths. Stillbirth is the end result of many maternal, fetal, and placental disorders. However, many remain unexplained. Risk factors for stillbirth include black race, older maternal age, obesity, multiple gestation, concurrent medical disorders, smoking, and pregnancy complications.
Twenty-five to 60 percent of stillbirth is unexplained, especially late in gestation. No intervention has been proven to significantly reduce the rate of stillbirth in the general obstetrical population. Interventions such as achieving good glycemic control, induction of labor, Doppler velocimetry, and early induction of labor are useful in selected high-risk populations.
A full autopsy without restrictions and including placental pathologic examination is optimal for determining the cause of death
The diagnosis of fetal death is based on an ultrasound examination that documents absence of fetal cardiac activity. Once fetal demise has been confirmed by ultrasound, the mother/couple should be informed in person, expeditiously, in an empathetic and straightforward manner, in surroundings where she/they can react privately.
Beginning at the time of diagnosis, women/couples who lose a baby may experience the five stages of grief experienced by individuals when told that they have a terminal illness (denial, anger, bargaining, depression, acceptance).
One can follow six-step protocol (SPIKES) for delivering bad news. setting up the interview with the patient and others she chooses to include, assessing the patient’s perception of the situation, understanding the amount of information that the patient wants to receive, providing this information, addressing the patient’s emotions with empathetic responses, and lastly summarizing and developing a plan.
Woman dies during surgery, family alleges negligence
A 50-year-old woman died during a kidney operation at a private hospital in Patiala here on Sunday morning. Members of the deceased’s family have alleged negligence. However, doctors said the patient had died due to the cardiac arrest.
The deceased, Shanti Devi, was admitted to Janak Surgicare and Ankur Advanced Urology Centre for bilateral kidney ailment on July 12. Shanti Devi, a resident of Ulaana village near Ghanaur in Patiala, was earlier operated for kidney stone on July 13 and July 14. However, she died during another operation on Sunday morning, said the police.
Doctor Ankur Bansal from the hospital said: “The patient was suffering from bilateral kidney ailment. She was operated on July 13 and July 14. However, when we were operating for the third time on Sunday morning, the patient died during operation due to a cardiac arrest after anaesthesia. ( TOI, Tribune)
Anaesthesia deaths: Overall anesthesia-related mortality rates vary from two deaths per 10,000 anesthetics to one death per 200,000 anesthetics. Standard American Society of Anesthesiologists (ASA) monitors include pulse oximetry, electrocardiography (ECG), a noninvasive blood pressure device, and temperature, as well as integrated monitors on all anesthesia machines that generate alarms for common and/or serious potential problems.
Risk of surgery
No surgery is risk free.
Low-risk patients — Patients whose estimated risk of death is less than 1 percent are labeled as being low risk and require no additional cardiovascular testing.
Higher-risk patients — Patients whose risk of death is 1 percent or higher may require additional cardiovascular evaluation.
Ants in the wound
In an alleged case of medical negligence, a middle-aged unidentified man died at a state-run hospital in Chhattisgarh’s Koriya district in lack of medical treatment, as ants fed off his wounds and bed sores for days, NDTV reported.
MEDtalks: What attracts the ants and flies in the wound
- Dirty infected wound attracts ants and maggots. They bare natural scavengers.
- Unhygienic status of the wound surroundings
- In the US maggots are available in the chemist shops for use in selective cases.
Biologic — An additional method of wound debridement uses the larvae of the Australian sheep blow fly or green bottle fly, Medical Maggots, Monarch Labs, Irvine, CA) (38,39). Maggot therapy can be used as a bridge between debridement procedures, or for debridement of chronic wounds when surgical debridement is not available or cannot be performed. Maggot therapy may also reduce the duration of antibiotic therapy in some patients.
The larvae secrete proteolytic enzymes that liquefy necrotic tissue which is subsequently ingested while leaving healthy tissue intact. Basic and clinical research suggests that maggot therapy has additional benefits, including antimicrobial action and stimulation of wound healing.
How quantum of compensation is decided by district consumer courts: Death of 15 years old son with proven medical deficiency
“36) In this case in our hand the son of the present complainant’s wife of Badri Chowdhuri,
Dinanath Chowdhuri at the age of 15 years. The death of the son causes immense sufferings of the family. That son after having maturity might have do some work and earn some money for the help of the family. But death of unfortunate boy has immerged the family in the world of uncertainty.
37) Complainant stated that her son used to earn Rs. 2500-4000 per month and used to
contribute his entire earning for day to day necessities of the complainant’s family.
In this point Ops have no saying. At present, in an unfortunate death of anyone, or by accident, the average income is Rs. 72,000/-. At present the average life expectancy is 70 years. So, the working period stands as 70 – 16 = 54 years. The boy is now dead. So, his earning stands Rs. 72,000 – 24,000 = Rs. 48,000/- as one third presumed to be used by the deceased for his own and Rs. 48,000/- would
have been used for the family. So, the total loss is Rs. 48,000 * 54 years = Rs. 25,92,000/-. But this Forum has power to award maximum award of Rs. 20,00,000/-.
38) Leaving apart the above income the mother and brother of the deceased are being deprived of loving touch of deceased. The loss of a child to a mother cannot be compensated by money. Son or daughter whatsoever may be is a very essential place of peace of a woman or a man. In no way the sufferings and vacuum created by the death of Dinanath Chowdhury can be filled up including the empty heart of the mother.
39) So, after deep contemplation over the principle of law and reason explained in different cases decided by the Hon’ble National Commission and Hon’ble Supreme Court we are of opinion that Rs. 19,20,000/- if given as compensation for the death of Dinanath Chowdhury to the family of Dinanath Chowdhury then complainant’s loss will be satiated, at least, financial side and the soul of deceased shall be in peace who died for want of proper treatment.”
District consumer disputes redressal forum, hooghly, cc of 2013, complaint case no. Cc/59/1996, ( date of filing : 09 nov 1996 )
Max Shalimar Case Judgment: DMC/DC/F.14/Comp. 2269/2018/ 2nd May, 2018
The Delhi Medical Council through its Disciplinary Committee examined a suo motu notice of media reports as per which a newborn baby was declared dead alongwith his still borne twin and handed over to his parents at Max Hospital, Shalimar Bagh, New Delhi. The Order of the Disciplinary Committee dated 19th March, 2018 is reproduced herein-below:-
The Disciplinary Committee of the Delhi Medical Council examined a suo motu notice of media reports as per which a new born baby was declared dead along with his still borne twin and handed over to his parents at Max Hospital, Shalimar Bagh, New Delhi.
It is noted that the Delhi Medical Council has also received a representation from the Office of the Commissioner of Police: Delhi, Directorate General of Health Services, Govt. of NCT of Delhi and the Medical Council of India whose subject matter is same as that of aforesaid suo motu notice of media reports, hence, the Disciplinary Committee is disposing both of these matters by this common Order…..Read more
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
