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MEDICOLEGAL CASE Table of Contents   
Year : 2009  |  Volume : 12  |  Issue : 1  |  Page : 92-93
Sedated, unconscious patients - Hot water bags



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How to cite this article:
. Sedated, unconscious patients - Hot water bags. Ann Card Anaesth 2009;12:92-3

How to cite this URL:
. Sedated, unconscious patients - Hot water bags. Ann Card Anaesth [serial online] 2009 [cited 2019 Nov 19];12:92-3. Available from: http://www.annals.in/text.asp?2009/12/1/92/45026

Reproduced with permission from Medical Law Cases from Doctors, Dec-2008


Karnataka state consumer disputes redressal commission, Bangalore


   Facts of the Case Top


The patient delivered a baby and underwent tubectomy operation. Soon after the operation she developed chill. The staff nurse attending her placed hot water bags on both the lower limbs at the directions of the doctors (OP). The patient suffered burns on both the lower limbs.


   Patient's Allegation /s of Medical Negligence Top


It was alleged that since the lower limbs of the patient were under anesthesia, she was unable to realize the temperature of water in the bags and so she sustained severe burn injuries on account of the continuous placing of the hot water bags on her legs. The patient produced documents and medical bills to show that she has taken treatment in another hospital for burn injuries. She also produced audio and video cassettes and photographs to prove that she had burn injuries.


   Doctor's Defense Top


  • In defense it was admitted that the patient suffered chill after the operation and was treated by administering drugs and by hot water therapy. But it was denied that hot water bags were placed on the patient's legs or that she suffered any burn injuries when she was under treatment. Police report negating the allegations of negligence was cited in support.
  • It was further stated that if hot water bags were placed on the legs for real, the patient would have complained of burning sensation when the temperature in hot water bags started burning the tissues of her legs.
  • It was stated that the patient had not stated the name of the staff nurse who kept the hot water bags on her lower limbs.



   Findings of the Court Top


  • The court found that it was not disputed that delivery and tubectomy were conducted, patient had complained of chill, and the chill was treated by administering drugs and by hot water therapy. The court observed that the doctors (OP) did not explain as to what was the hot water therapy given to the patient if it was something other than placing of hot water bags on her legs. The court held that tubectomy operation is conducted under the influence of anesthesia and hence accepted the patient's contention that she was unable to gauge the temperature of the hot water bags so as to enable her to complain of burning sensation.
  • The court refused to draw adverse inference against the patient on the ground that the name of the nurse was not known to the patient as every nurse dose not wear a name plate; every patient cannot read names; and there was an assured method of informing the name of the staff nurse on duty to every patient who came for treatment.
  • The court, in fact, drew adverse inference against the doctors (OP) for not bringing the nurse as their witness before the court to deny the patient's evidence.
  • The court observed that it was highly improbable that a long-standing patient of a doctor complains of negligence on the part of the doctor unless there is strong reason for the patient to make complaint against the doctor, as in the instant case.
  • Hence the doctors (OPs) were held negligent.



   Suggested Precautions Top


  1. Old patients, as well as unconscious and anesthetized patients must be handled with utmost care, especially in procedures like giving hot water bags that may cause burn injuries.
  2. Police investigation and report is of little consequence in consumer courts. Consumer courts may hold an opinion contrary to the police investigation and report. In a given case, if the police have held the doctor not negligent, consumer court may still hold the doctor negligent and vice-versa.
  3. Name, permanent address, contact number, etc. of all the members of medical, paramedical, and nursing staff must be preserved. In case of litigation, all efforts must be made to produce them before the court as their absence is not taken kindly by the court.


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