UTI patient in Chennai suffers brain damage after Ceftriaxone infection; hospital ordered to pay over ₹50 lakhs to her son

Tagore Medical College and Hospital has been directed to pay a total of ₹51,14,431 as compensation to the woman's family.

BySumit Jha

Published Jul 11, 2024 | 7:00 AM Updated Jul 11, 2024 | 8:43 AM

UTI patient in Chennai suffers brain damage after Ceftriaxone infection

A patient from Chennai who suffers from a Urinary Tract Infection (UTI), visited a private hospital where a doctor administered an antibiotic injection that left her in a vegetative state.

Three years after the incident, the hospital has been ordered to pay ₹50 lakh as compensation and ₹75,000 per month for the patient’s daily care.

The District Consumer Disputes Redressal Commission in Kancheepuram directed Tagore Medical College and Hospital to pay a total of ₹51,14,431 as compensation to a man, whose mother entered a vegetative state after suffering anaphylactic shock due to the administration of Injection Ceftriaxone.

Also Read: Can men shave their beard daily? Does that cause rough skin?

Hospital visit for UTI infection

A Ramkumar, a resident of Melakottaiyur near Chennai, took his mother, M Sivagami, to Tagore Medical College and Hospital on 25 June 2021, to get her UTI treated. After registering at the hospital, they informed the doctors of her medical history and allergies, which were noted in her Patient OP Card.

The hospital took blood and urine samples for testing on the next day and advised Sivagami to return on 30 June to collect the reports. When the complainant and his mother went to collect the reports, the hospital advised her to get admitted due to high sugar levels. She was admitted.

Ramkumar stated that until 6 pm on 30 June, his mother was in good condition. However, while he was out for tea, the hospital administered Ceftriaxone, an antibiotic, without a test dose first and it resulted in his mother losing consciousness and being shifted to the ICU.

Ramkumar and his family were shocked by this sudden change in her condition. Despite efforts, there was no improvement in his mother’s condition. The complainant was then tasked with procuring 25 vials of Vecuronium Bromide, of which 15 were later returned. There were no doctor’s order, nurses’ records, or drug charts documenting the administration of this medication to his mother.

According to Ramkumar, the hospital refused to provide any medical records initially, and after much struggle, he was able to obtain a single-sheet discharge summary and a single-sheet bill without any breakup on 3 July. The complete medical records were furnished only after the direction of the Tamil Nadu Medical Council on 8 December 2021.

Also Read: Rise of dengue cases in Karnataka: Amidst 7,362 cases in 2024, it’s time for action

Medical records rewritten?

Ramkumar believes that these records were rewritten to suit the hospital’s case and were not the actual medical records.

Ramkumar’s counsel further contended to the Commission that he had noticed an ink impression on his mother’s thumb in the ICU, which the doctors could not explain. Despite several inquiries, there were no updates regarding this. He also stated that no senior consultant or chief doctor visited his mother, and even after three days and knowing that her brain was affected, the hospital failed to perform EEG and MRI tests.

On 3 July, the complainant’s mother was transferred to SRM SIMS hospital, where she was diagnosed with Ischemic Hypoxia Encephalopathy, a brain dysfunction that occurs when the brain doesn’t receive enough oxygen, resulting in irreversible brain damage requiring long-term medical care.

The complainant blamed the staff and doctors of Tagore hospital for this condition, citing medical negligence. The treatment expenses at SRM SIMS amounted to ₹13,12,676, with additional costs for 24/7 bedside nursing care, daily physiotherapy, one-time medical equipment, and ongoing monthly fees totaling ₹24,25,820.

The complainant’s counsel argued that E.coli is the most common cause of urinary tract infections (UTIs), and the accepted antibiotics for treatment include Co-trimoxazole, Nitrofurantoin, Ciprofloxacin, and Ampicillin.

However, Tagore Hospital administered Ceftriaxone without a test dose. The counsel emphasised that oral options for treating E.coli UTIs include nitrofurantoin, fosfomycin, pivmecillinam, amoxicillin-clavulanate, finafloxacin, and sitafloxacin.

The hospital claimed in their response that the E.coli was sensitive and drug-resistant without providing any medical or clinical reports to support this. They instead prescribed Ceftriaxone, a steroidal antibiotic, without ensuring other antibiotics were ineffective.

Also Read: Concerns over fairness as Health Ministry decides to conduct NEET-PG in two shifts

Hospital’s version

In response, the counsel for the hospital contended that on 30 June at 5.20 pm, a test dose of Ceftriaxone was administered to ascertain any allergic reactions. The patient was observed for more than 15 minutes, and since no allergic symptoms appeared, her vitals were checked and found stable. Subsequently, she was administered the remaining quantity of Ceftriaxone, after which she became semi-conscious and disoriented.

The hospital’s counsel further contended that when the complainant’s mother was referred to a higher care facility, the referral formalities were completed efficiently.

The counse  also contended that as long as a doctor acts in a manner that is acceptable to the medical profession and the court finds that the doctor has attended to the patient with reasonable skills and care, it would be difficult to hold the doctor guilty of negligence.

The Commission’s response

The Commission noted from the complaint that the hospital allegedly administered Ceftriaxone, an antibiotic, without a test dose. Except for a single sheet discharge summary provided at the time of discharge, the hospital did not furnish further medical records regarding the complainant’s mother. The A2 summary was given to the complainant on 30 July, while A29 including the discharge summary and other medical details were provided only in December under TNMC’s direction.

“The counsel for the opposite party admitted that the discharge summary (Ex-A29) furnished to the complainant in response to the direction of the Medical Council was rewritten for the said purpose. The opposite party’s counsel, however, submitted that the contents of both discharge summaries are the same. But a bare reading of Ex-A2 and Ex-A29 would prove the contrary. Hence, it is proved that the medical records were made/rewritten for the purpose of the case,” said the Commission.

Additionally, the opposite party failed to submit initial nursing assessments for the current case, nor did they provide evidence that clinical records were given to the complainant upon discharge or upon request for a second opinion.

Further discrepancies emerged when one document indicated that a sample was taken on 27 June, while another stated it was collected on 30 June, suggesting fabrication of records for this complaint.

The commission found that Ceftriaxone was administered without a necessary test dose, leading to severe consequences for the patient, including an anaphylactic shock.

“It is proved that Xone was administered without a test dose. By such an act, an antibiotic which should have been administered as a final choice to treat UTI caused by E. coli, especially when the patient has comorbidities, it is proved that the conduct of the doctor and the hospital staff of the opposite party fell below the standards of a reasonably competent practitioner in their field. As a result, the patient had an anaphylactic shock. Such an act of the hospital constitutes medical negligence and deficiency in service. To date, the patient has not recovered from her unconsciousness. It is also proved that the hospital has indulged in manipulating medical records to cover up the negligent acts of the doctor employed by it.”

The complainant’s family has since borne significant financial burden, including ongoing medical and caregiving expenses amounting to at least ₹75,000 to one lakh per month. Additionally, they have incurred expenses for doctor visits since 03.07.2021. This situation has caused considerable hardship to the complainant’s family, including the loss of companionship for the senior citizen father.

In this case, because of the negligence of the opposite party, the complainant’s mother is now in a vegetative state. The complainant’s family is constrained to manage their mother with a 24×7 nuring assistant with requisite equipment. The complainant has filed purchase bills for the goods purchased to manage the disability caused by the negligence of the opposite party. The complainant has to engage at least two trained nurses, one nursing assistant, and one maid to manage his mother, in addition to a doctor and physiotherapist. The minimum remuneration for nures, nursing assistants, maids, and consultant doctor would definitely cost a sum of ₹75,000 to one lakh per month.

“In addition, the patient has to put forth fees for visiting doctors. The complainant have been incurring these expenses. Such recurring expenses may continue up to the patient’s lifetime or until she recovers from her present unconsciousness. Further, the complainant’s father, a senior citizen, has also lost the care and affection of his companion. Therefore, the complainant is entitled to a refund of medical expenses incurred by the complainant’s family to date and also the recurring expenses,” said the Commission.

The hospital was asked to pay ₹89,431, which was paid by the complainant to the hospital as a medical bill, a sum of ₹50 Lakh as damages towards monetary loss and mental agony suffered and to pay a sum of ₹75,000 per month from 1 May 2024 for the lifetime of the said patient. Further the Commission also directed the hospital to pay a sum of ₹25,000 towards the cost of proceedings to the complainant within two months.

(Edited by Neena)

(South First is now on WhatsApp and Telegram)