Debate

Disclosure of

Negligence of

Colleague

My view on this Debate is

We should NEVER

Let me tell you one Imaginary Story

He is Dr. XSenior Ob/Gyn

Practicing since 30 years at the town RAMPURExperienced and well reputed

She is Dr.(Mrs) YDaughter of Dr. X

Practicising Ob/Gyn independently at same town few km away from his dad’s Nursing Home.

Sincere and Hard working Doctor

One night at 1 AM An unregistered Primi patient

admitted to her hospital with prolong second stage of labor.

Full dilatation since 2 hours. Dr. Y rushes to the Hospital in

10 minutes. Managed the case nicely by

doing Perineal forceps. Good cry of Baby.

But the Episiotomy tear was extended deeply.

Some traumatic PPH. She sutured very well .

Since there was some ozzing from streched wall of vagina – she inserted

TWO PACKS in Vagina. All well and Dr. went home at 4 AM in morning . She was tired and stressed.

Next Day Dr Y was busy in her routine practice.

Forgot to inform the staff sister about TWO packs kept in Vagina.

Patient was fine in the evening and was discharged by the staff as a routine procedure and ask to come after one week for follow up.

After 5 days Patiend had fever Pain and dischage

She went to Dr. Y and Dressing was done from outside.

But she had continous fever-Pain-Foul smell discharge..

So relatives thought to take second opinion of Senior Dr.X.

Dr.X show the file of her daughter innocent smile on his face.

Took the patient in to examination room.

Did P/S examination. Saw the infected packs. Removed it silently. Did dressing. Gave higher antibiotics and

Vitamins.

Informed the relatives that its all FINE.

Its just due to prolong labor-low resistance of patients and lack of proper care by her at home.

He called the patient daily for five days –Did dressing – Counsell her well everytime.

and All well after a week.Patient

and relatives were happy.

Now she is Dr.(Mrs ) Z Sincere and experience Ob/Gyn

Practicing in same area of Dr..Y. She had good name in town and so

naturally a competitor of Dr. Y.

A After one month of the above story she got the ditto patient as Dr Y had. Same treatment.Same forgotten packs

and patient was discharged. Develop fever –and ultimately goes to

Dr.X for expert opinion and managment

Dr.X saw TWO forgotten packs in vagina.

Smiled sarcastically. Called the husband and the

Mother of patient inside the room-showed them the foul smelling packs and asked them –

This is the reason of fever. She has done mistake-forgotten the packs and that has caused severe infection. She needs admission and expert management as indoor patient.

Patient was admitted Pints and Blood transfusion

given Heavy injectable antibiotics and all sorts of show. Patients was fine after 5 days

and was discharged.

The Bill of Doctor was Rs.25000 which was happily paid by Husband and thanked Dr.X for saving the life of his wife.

After one month Dr.Z gets the notice from

lawyer about her negligent management of patient and was sued for Rs.5 Lakhs.

Dr.Z was depressed and frustrated. Next few months She remained busy with Patients-Police-Public-Press-Pleaders and had to go to Psychologist for her treatment of depression.

Now look at Both Same type of patients –same

management- same mistake but

One was HAPPY and other one was depressed.

Who and What is responsible for this?? is a real answer of this debate.

One was relative – so Dr.X Closed the matter

Other was Colleague – so Disclose the matter.

Will WE do this – NO- NEVER

• Ob/Gyn is an unpredictable, risky and stressful branch. • In our branch 1+1 is not equal to two always .It can be 0 to

11 . • If some mistake done innocently by our professional

colleague today, it can happen to anyone of us tomorrow. We all are sailing in the same boat.

• When we accept the patient at our hospital it is always with full positive mind with an aim to manage them in best possible way without thinking of the returns.

• But as we all know accident occurs with all professionals.

Disclosing Negligence of our colleague to the patients and relatives invites troubles to our colleague in the form of litigation-Mob violence , adverse press publicity and so on n on….

It affects our colleagues in many ways. Practice loss – Prestige loss – even frustration and depression.

It invites problems from Press-Public-Prosecutor and Police.

How to deal with negligence of colleague ?• As such any complication to the patients are being taken as

Negligence by the relatives which is not true. • Lack of communication with colleague and professional

rivalry leads to disclosure of negligence.

Best thing is to inform our colleague about the case very respectfully - and make a plan how to deal with the case. Our priority should be that NO harm should occur to the patient as well as our own colleagues.

• I represent here all my clinician colleagues who do not know

• M of Medicolegal and N of Negligence• But they know D of Duty - H for Humanity and • U for Unity.

So in nutshell No Double standards in our Practice .Consider our colleagues like our own family Members.

Good communications with colleagues and no rivalry.

No harm to the patients as

well as our colleagues .

To manage the patient jointly. Never to criticize our colleagues instead HELP them.